Visualizing the Way to Improve Biopsies for Detecting Lung Cancer

Juhi Kunde, MA

Lida Hariri, MD, PhDAs a pathologist specializing in lung disease at Massachusetts General Hospital, Dr. Lida Hariri’s job is to analyze lung biopsy samples and diagnose patients.  After years of doing this work, she started to notice a pattern. When lung CT scans showed lesions that were difficult to access or too small to biopsy well, many doctors tended to wait and see whether the lesion grew before doing the biopsy.  In this way, they were saving patients the expense and discomfort of repeat biopsies and unnecessary surgeries. However, if the lesion was cancerous, watching and waiting could delay treatment and, ultimately, reduce survival time.

 “My mentor and I had an ‘Aha!’ moment,” explains Dr. Hariri. “We realized that when lung cancer is caught early, patients can have nearly 90% survival rates. So we need to get better biopsy samples of small early-stage tumors. That got us thinking about what we could do to help.”   

With her medical specialty in microscopy and her doctorate in biomedical engineering, Dr. Hariri was eager to find a solution. She worked closely with her mentor, Melissa Suter, PhD, at Massachusetts General Hospital, to implement a well-known technique called optical coherence tomography (OCT) to help guide biopsies. OCT measures back-scattered light from tissues to create high-resolution images. Because the light is so gentle, OCT is routinely used for light-sensitive procedures, such as conserving valuable art pieces and visualizing patients’ retinas.  Dr. Hariri and her mentor wanted to use it to visualize biopsy sites.

In preliminary studies, Dr. Hariri and her colleagues found that they could pass a tiny OCT probe through the biopsy needle to get a quick look at the surrounding tissue and assess needle placement to ensure an optimized biopsy sample. This method could potentially allow pathologists to consistently get the tissue they need for accurate diagnoses, even if the lesions are small or difficult to access. In addition, this process could allow pathologists to be in the room during the biopsy and to study more of the patient’s tissue in real-time without having to take additional samples.

But to really see the technique in action, clinical trials were needed to demonstrate that OCT actually could improve biopsy results. So, in 2016 Dr. Hariri applied for, and was awarded, a Career Development research grant from LUNGevity Foundation to continue working to improve lung biopsy results using OCT.  

“This is a phenomenal award,” she says. “It is great that there is an opportunity for junior investigators like me to get research funding that leads to lifelong careers as independent researchers specializing in lung disease. Plus, it is amazing to have access to LUNGevity’s Scientific Advisory Board—a group of seasoned experts who are incredibly supportive and eager to see junior investigators, like myself, develop successful research careers.”

Dr. Hariri’s clinical trials are already in the works. If the studies continue to go well, Dr. Hariri hopes that OCT-assisted biopsies may eventually be used in hospitals across the country.

“It would be amazing if OCT-assisted biopsies can help patients get diagnosed earlier,” she says. “Early diagnoses would be tremendous for patients. When lung cancer is caught early, patients have a much higher chance of beating the disease and that is something worth working toward.”

Dr. Hariri’s LUNGevity Career Development Award project is being funded in part by Upstage Lung Cancer.


Juhi Kunde, MA, is a science writer for LUNGevity. Juhi Kunde

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