A roadmap for the clinical implementation of optical-imaging biomarkers


Clinical workflows for the non-invasive detection and characterization of disease states could benefit from optical-imaging biomarkers. In this Perspective, we discuss opportunities and challenges towards the clinical implementation of optical-imaging biomarkers for the early detection of cancer by analysing two case studies: the assessment of skin lesions in primary care, and the surveillance of patients with Barrett’s oesophagus in specialist care. We stress the importance of technical and biological validations and clinical-utility assessments, and the need to address implementation bottlenecks. In addition, we define a translational roadmap for the widespread clinical implementation of optical-imaging technologies.

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Fig. 1: Visible and near-infrared light–tissue interactions.
Fig. 2: Roadmap for OIBs.
Fig. 3: Current and potential future clinical implementations of optical imaging in two case studies.


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We would like to thank F. Walter of the University of Cambridge for helpful comments on our manuscript. D.J.W., C.R.M.F. and S.E.B. are financially supported by CRUK (C14303/A17197, C47594/A16267, C47594/A21102, C55962/A24669) and EPSRC (C197/A16465, EP/N014588/1).

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D.J.W., J.P.B.O. and S.E.B. conceived the manuscript. D.J.W. researched and wrote the manuscript together with C.R.M.F. B.W.P. reviewed and edited the manuscript. All authors discussed and agreed with the final version of the manuscript.

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Correspondence to Sarah E. Bohndiek.

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S.E.B. receives research support from iThera Medical GmbH and PreXion Inc., and chairs the International Photoacoustic Standardisation Consortium (IPASC).

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Waterhouse, D.J., Fitzpatrick, C.R.M., Pogue, B.W. et al. A roadmap for the clinical implementation of optical-imaging biomarkers. Nat Biomed Eng 3, 339–353 (2019). https://doi.org/10.1038/s41551-019-0392-5

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