Article Topic: Endometrial Cancer

Quick Optical Biopsy Could Be Early Detection Method for Endometrial Cancer

WashU researchers at Siteman Cancer Center combine optical coherence tomography and machine learning for rapid, accurate test

Endometrial cancer is the most common gynecologic cancer, with more than 69,000 cases diagnosed in the U.S. in 2025 and increasing up to 3% annually. Diagnosis requires an often painful and invasive biopsy that carries a risk of false negatives. A multidisciplinary research team at Washington University in St. Louis and Siteman Cancer Center, based at Barnes-Jewish Hospital and WashU Medicine, is looking to a fast, safe and noninvasive imaging method combined with machine learning for an accurate detection and diagnosis of precancerous lesions and early cancers.

The team, led by Quing Zhu, PhD, the Edwin H. Murty Professor of Engineering in the McKelvey School of Engineering at Washington University in St. Louis, conducted an initial investigation using optical coherence tomography (OCT), which detects differences in how tissue reflects light and acquires high-resolution 3D images with a depth of up to 1 to 2 millimeters. With a custom catheter probe developed in Zhu’s lab, the team took images of the entire endometrial cavity in less than three minutes, creating an optical biopsy. It is the first catheter-based, 3D OCT imaging study that integrated optical functional, structural and radiomic features for endometrial assessment. Results of the research were published in npj Imaging June 3, 2026.

To obtain images from patient tissues, the team collaborated with WashU Medicine physicians led by Lindsay Kuroki, MD, MSCI, associate professor of obstetrics & gynecology, and Ian Hagemann, MD, PhD, professor of pathology & immunology and of obstetrics & gynecology. They, along with Zhu, are research members at Siteman Cancer Center, where Kuroki also treats patients. The team acquired OCT images from 57 post-hysterectomy uteri in 2025. Of these, 34 contained high-risk precancerous lesions or early-stage cancers.

The 3D OCT images provided a close view of tissue microstructure and optical properties, revealing clear differences among normal endometrium, benign endometrium, high-risk precancerous lesions, and endometrial cancer at different stages.

First authors Sanskar Thakur, a doctoral student in Zhu’s lab, and Yixiao Lin, who earned a doctorate in biomedical engineering from WashU in 2025, developed an imaging feature extraction pipeline and a machine learning model to categorize the results into two groups of normal and benign, and pre-cancer and cancer using 26 extracted imaging features. Their model achieved an exploratory sensitivity of 94% and specificity of 87%.

“Current endometrial biopsy practice has an estimated false-negative rate of about 10% (approximately 90% sensitivity), largely due to sampling limitations and interpretive variability,” Zhu said. “With our three-dimensional OCT imaging system combined with machine learning, we can image the entire endometrial cavity in 2 to 3 seconds and may have a potential to achieve higher sensitivity than random biopsy sampling.”

“There is currently no reliable screening for endometrial cancer,” said coauthor David Mutch, the Ira C. and Judith Gall Professor and vice chair of obstetrics & gynecology at WashU Medicine, a Siteman research member and principal investigator of the National Cancer Institute-funded Route 66 Endometrial Cancer Specialized Program of Research Excellence (SPORE) grant. “This technology, developed by Dr. Zhu and her colleagues, should allow us to better screen for this cancer and at a minimum catch it much earlier in its development,” Mutch added. “This is really novel, cutting-edge technology.”

Going forward, Zhu said the team plans to evaluate the catheter in live patients to demonstrate the translational potential of the AI-assisted OCT technology.

Thakur S, Lin Y, Xu J, Nie H, Badwan S, Wang L, Sanders BE, Thaker PH, Hagemann AR, McCourt CK, Khabele DM, Powell MA, Mutch DG, Kuroki LM, Hagemann IS, Zhu Q. Optical coherence tomography enables optical biopsy of endometrial tissue for early cancer detection. npj Imaging, June 3, 2026, https://doi.org/10.1038/s44303-026-00160-z.

This work was funded by the Developmental Research Program (DRP) of the NCI Route 66 Endometrial Cancer SPORE (5P50CA265793-03). Partial support for this work was provided by the NCI (R01CA237664) and the NIBIB (R01EB034398).

Siteman Cancer Center Shares the Latest in Medical Oncology, Screening Innovation and Translational Science at ASCO

WashU Medicine physician-scientists and others affiliated with Siteman will share findings from multi-institutional studies they lead and will present on health equity, mentorship and more at the 2026 American Society of Clinical Oncology (ASCO) Annual Meeting.

At the 2026 annual meeting of the American Society of Clinical Oncology (ASCO), WashU Medicine scientists and physician-researchers at Siteman Cancer Center will present on the scale, depth and translational impact of their most recent research in advancing cancer outcomes worldwide.

With presentations representing the continuum of scientific and medical discovery, health equity, mentorship and more, Siteman will share its newest advances that reflect where oncology is headed –— more personalized therapies, smarter screening strategies, multidisciplinary treatment models and deeper understanding of how biology and lived experience intersect in cancer outcomes.

Nearly 45,000 scientists, clinicians and other healthcare professionals, survivors, patients and advocates gather at the conference in Chicago each year to share and discuss the latest breakthroughs. This year’s meeting takes place from May 29-June 2 and will feature key findings from WashU Medicine faculty members, fellows and others associated with Siteman Cancer Center, based at Barnes-Jewish Hospital and WashU Medicine.

“Siteman Cancer Center is proud to once again take the stage at ASCO, where the brightest minds in oncology gather to push the boundaries of what’s possible,” said Timothy J. Eberlein, MD, director of Siteman, based at Barnes-Jewish Hospital and WashU Medicine in St. Louis. “The research our team brings to this meeting reflects both scientific rigor and an unwavering dedication to patients. This is where ideas become breakthroughs — and breakthroughs become better lives.”

In one of the most anticipated oral abstract sessions at ASCO, Matthew A. Powell, MD, the Ira C. and Judith Gall Professor of Obstetrics and Gynecology at WashU Medicine, will present data from the landmark RUBY trial, which evaluated the addition of dostarlimab to standard chemotherapy with carboplatin and paclitaxel for patients with advanced endometrial cancer. 

Powell, a nationally recognized physician-scientist who treats patients at Siteman Cancer Center, was recently installed as president of the Society of Gynecologic Oncology (SGO). 

WashU Medicine physician-scientists at Siteman also will present key findings in lung cancer: 

  • Ramaswamy Govindan, MD, FASCO, the Anheuser Busch Endowed Chair in Medical Oncology and Associate Chief of Oncology and principal investigator of a Phase III study under the National Cancer Institute’s ALCHEMIST platform, will discuss findings from the trial, which found that erlotinib did not improve overall survival but did improve disease-free survival in resected EGFR-mutant non-small cell lung cancer. 
  • Brendan Heiden, MD, MS, MBA, Assistant Professor of Surgery, will present an analysis of the data of nearly 1 million U.S. veterans that may support a shift in national screening guidelines. 

Additional details of these and other Siteman and WashU-led advances and presentations are below. For a full schedule, click here.

Below are highlighted presentations by WashU Medicine researchers and physician-scientists at Siteman. And be sure to follow us at #ASCO26 on X @SitemanCenter and Bluesky @sitemancenter.bsky.social.

All presentations will be at Chicago’s McCormick Place and available via live stream, if noted, for virtual registrants. All times are CDT.

Friday, May 29

Matthew A. Powell, MD, Ira C. and Judith Gall Professor of Obstetrics and Gynecology, WashU Medicine



Powell will present full data on model-based predictions from the pivotal phase 3 ENGOT-ENG-NSGO/GOG-3031/RUBY trial (NCT03981796) that suggest the potential for cure with dostarlimab-gxly (Jemperli) plus carboplatin and paclitaxel in patients with mismatch repair–deficient (dMMR)/microsatellite instability–high (MSI-H) primary advanced or recurrent endometrial cancer.

Presentation: Long-term survival rates and cure modeling with dostarlimab plus chemotherapy in mismatch repair deficient/microsatellite instability-high (dMMR/MSI-H) primary advanced or recurrent endometrial cancer in the ENGOT-EN6-NSGO/GOG-3031/ RUBY trial.  


When: 2:45-2:57 p.m.
Where: Room S100bc + Live Stream



Saturday, May 30

Douglas R. Adkins, MD, Professor of Medicine, WashU Medicine



Adkins will discuss an exploratory analysis of the international KEYNOTE-689 trial (NCT03765918) that found neoadjuvant and adjuvant pembro plus surgery and postoperative [chemo]radiotherapy (SOC) significantly improved event-free survival versus SOC in patients with resectable locally advanced head and neck squamous cell carcinoma.



Poster Presentation: Neoadjuvant and adjuvant pembrolizumab (pembro) plus standard of care (SOC) for resectable locally advanced head and neck squamous cell carcinoma (LA HNSCC): Efficacy by surgical outcomes in the phase 3 KEYNOTE-689 trial.


When: 1:30-4:30 p.m.
Where: Hall A



Sunday, May 31

Emily L. Podany, MD, Assistant Professor of Medicine, WashU Medicine



Podany will discuss findings of a multi-institutional study of 851 metastatic breast cancer patients that found that those living in food deserts had distinct tumor DNA profiles — including more RTK/RAS mutations and CCNE1 variants — and significantly shorter survival, particularly among Black patients, highlighting the critical intersection of tumor biology and social determinants of health.



Presentation: Impact of food access and poverty on somatic genomic profiles and clinical outcomes in metastatic breast cancer.


When: 11:42-11:48 a.m.
Where: Hall D1 + Live Stream



Monday, June 1

Ramaswamy Govindan, MD, FASCO, Anheuser Busch Endowed Chair in Medical Oncology and Associate Chief of Oncology, WashU Medicine

Govindan, principal investigator of the Phase III A081105 trial (NCT02193282), will discuss findings from the evaluation of adjuvant erlotinib versus placebo in resected EGFR-mutant non-small cell lung cancer. Among 390 patients, erlotinib did not significantly improve overall survival but did improve disease-free survival. Erlotinib did not significantly improve overall survival but did improve disease-free survival in 390 of 450 patients.

Presentation: Adjuvant erlotinib versus observation after complete resection of EGFRmutant NSCLC: Final overall survival results of Alliance A081105.


When: 1:27-1:39 p.m.
Where: Hall D1 + Live Stream



Brendan Heiden, MD, MS, MBA, Assistant Professor of Surgery, WashU Medicine



Heiden and his fellow researchers analyzed the data of nearly 1 million U.S. veterans to compare tobacco smoking duration (TSD) versus pack-years (TPY) for lung cancer screening eligibility. TSD identified more at-risk individuals, reduced missed diagnoses from 30% to 7.5% and improved equity across racial and sex subgroups — supporting a shift in national screening guidelines toward smoking duration.

Presentation: Redefining lung cancer screening eligibility: Smoking duration vs. pack-years in a national VA cohort of nearly 1 million patients.


When: 2:27-2:39 p.m.
Where: Hall D1 + Live Stream

Dineo Khabele, MD, Mitchell & Elaine Yanow Professor and Chair of OB/GYN, WashU Medicine



Khabele joins other senior leaders in academic oncology to discuss her perspective on career development, including strategic planning and actionable steps for each level.



Presentation: Senior Career Perspective: Gynecologic Oncologist


When: 3:36-3:48 p.m.
Where: Room E350



Tuesday, June 2

Cynthia X. Ma,  MD,  PhD, Professor of Medicine, WashU Medicine



Ma is chair and moderator of this session featuring 11 presenters who will give an overview of their novel research and answer questions during a panel discussion.

Rapid Oral Abstract Session: Developmental Therapeutics—Molecularly Targeted Agents and Tumor Biology


When: 9:45-11:15 a.m.
Where: Room E451



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About Siteman Cancer Center

Siteman Cancer Center is one of only a few cancer centers to receive the highest rating of the National Cancer Institute (NCI) — “exceptional.” Comprising the cancer research, prevention and treatment programs of Barnes-Jewish Hospital and WashU Medicine in St. Louis, Siteman treats adults at six locations, including the new Gary C. Werths Building for outpatient care and an inpatient hospital on the Washington University Medical Campus, and partners with St. Louis Children’s Hospital in the treatment of pediatric patients at Siteman Kids. All locations offer patient-focused, multidisciplinary care driven by scientific breakthroughs and powered by WashU Medicine physicians.

Quick Facts

  • Established in 1999, Siteman is recognized as a leading cancer center by its peers and the NCI.
  • Every year, 75,000+ people are treated at Siteman, including 12,000+ who are newly diagnosed.
  • Siteman is powered by 600+ WashU Medicine physicians and scientists focused on the latest in cancer treatment and research.
  • With 9,000+ patients enrolled every year in 1,600+ clinical research studies, including 600+ therapeutic clinical trials, Siteman offers access to investigational therapies not generally available to the public.
  • Siteman has held NCI’s highest rating — “exceptional” — since 2015, based on a rigorous review of its research programs.
  • Siteman is also proud to receive more than $185 million annually for basic and clinical oncology research grants, including $66 million from the NCI, funding 1,400+ research projects. This includes three Specialized Programs of Research Excellence (SPORE) grants, for endometrial, leukemia and pancreatic research.
  • In 2024, WashU faculty at Siteman filed for 198 patents.
  • WashU Medicine has the second-largest research funding portfolio from the National Institutes of Health (NIH) among U.S. medical schools.