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Map HPB: Mapping Hepato-pancreato-biliary abnormalities (Cholangiobotics Project)

Cholangiocarcinoma (CCA) affects 3000 people in the UK each year, with dismal prognosis: only 13% of patients survive 3 years. CCA arises in the bile duct, which is a narrow tube with a diameter of about 6mm. As the cancer grows inside, the bile duct is further narrowed, and routine scans cannot confirm if the narrowing is due to inflammation or the cancer. Diagnosis relies on the microscopy of samples taken from the narrowed area, but, when narrowed or blocked, it is even harder to obtain samples.

In addition, CCA tissue within a tumour varies with different areas being genetically different which accounts for resistance of CCA to drug treatment. Moreover, insertion of devices for the diagnosis and mapping of the narrowed bile duct (biliary stricture) must be combined with biliary drainage (stent insertion) to reduce the risk of complications such as infections.

What is the purpose of the study?

To address the combination of challenges in both diagnosis and treatment we bring together expertise from many different specialities.

The proposed research will be conducted in 4 interdependent work packages (WP). In WP1, a 'snake-like' robot carrying an imaging device that can navigate to the narrowed bile duct will be developed. This will have capability to be inserted into the narrowed area of the bile duct (in CCA tissue removed from patients during standard surgical cancer treatments) and take 3D pictures.

In WP2, we will create nanoparticles which will be loaded on to the stents that are usually used to open bile ducts blocked due to CCA. These nanoparticles are taken up by the cancer cells. When a wireless electrical field is generated in the vicinity, the nanoparticles stimulate the death of cancer cells.

WP3 involves the clinical characterisation of patients with CCA including assessment of their cancer using different types of imaging and tests. These images will be used by WP1 to inform the design of 3D bile duct models in which we will assess the flexible robot. In addition, samples from the cancer will be used in WP2 laboratory experiments to assess biological properties and process of cell death in CCA cells. We will create a database and tissue bioresource to characterize variability in CCA types. We will also use tissue resected during surgical treatment to evaluate devices designed and developed in WP1and WP2.

WP4 will co-ordinate and integrate activities across disciplines and WPs to maximise shared learning across the team and deliver the work proposed.