The ERC Synergy project MULTIPROBE is set to revolutionize endoscopy by transforming it into a true theragnostic platform, where diagnosis and treatment occur simultaneously in a single procedure. By exploiting advanced multimode nonlinear optical fibers, the system enables real-time “optical biopsy,” providing high-resolution, label-free characterization of tissues without the need for conventional histopathology. At the same time, the same endoscopic probe delivers precisely controlled jets of cold atmospheric plasma, a non-thermal therapy that selectively eradicates cancer cells while preserving surrounding healthy tissue. This seamless integration eliminates delays between diagnosis and intervention, reduces invasiveness, and opens the way to immediate, personalized treatment strategies—marking a decisive shift from conventional endoscopy toward real-time, intelligent, and highly targeted cancer care.

“MULTIPROBE embodies the future of endoscopy—where light not only reveals disease at its earliest stage but also guides and delivers treatment in real time, turning diagnosis into immediate, precise action.”

The ERC Synergy project MULTIPROBE represents one of the most ambitious attempts to redefine endoscopy as a fully integrated theragnostic platform—where diagnosis and therapy are no longer sequential steps, but occur simultaneously in real time. Funded with over €6 million and involving leading institutions such as Sapienza University of Rome, Università Cattolica del Sacro Cuore, and the University of Limoges, the project brings together expertise in photonics, nonlinear optics, plasma physics, and clinical gastroenterology to address one of medicine’s key bottlenecks: delayed and invasive cancer diagnosis. 

A new paradigm: real-time optical biopsy + immediate therapy

At the heart of MULTIPROBE is the development of a miniaturized hybrid endoscope capable of performing “optical biopsy” in vivo. Instead of removing tissue and waiting days or weeks for histopathology, clinicians obtain immediate, high-resolution biochemical and structural information using advanced nonlinear optical imaging through multimode fibers. 

At the same time, the same probe delivers cold atmospheric plasma, a non-thermal treatment that selectively destroys cancer cells by inducing apoptosis while sparing healthy tissue. This dual capability effectively eliminates the gap between detection and intervention, enabling a seamless see–diagnose–treat workflow.

Concrete application scenarios

1. Early gastrointestinal cancer detection and treatment
The first clinical target is gastrointestinal (GI) oncology. For example, during a routine colonoscopy, a suspicious lesion could be:

• identified via multimodal optical imaging,
• classified in real time (benign vs dysplastic vs malignant),
• immediately treated with plasma—without removing tissue or scheduling a second procedure.

This is particularly impactful for low- and high-grade dysplasia, where early intervention dramatically improves prognosis. 

2. Optical biopsy in difficult-to-access tissues
In areas where conventional biopsy is risky or impractical (e.g., fragile mucosa or multiple diffuse lesions), optical biopsy allows clinicians to scan large tissue areas non-invasively and selectively target only clinically relevant regions. 

3. Extension beyond gastroenterology
Although initially focused on GI endoscopy, the technology is designed to expand to other domains such as pulmonary, urological, or even intraoperative imaging—where real-time tissue characterization could guide surgical decisions.

Technological innovation: why it is different

The breakthrough lies in multimode nonlinear optical fibers, which exploit complex light propagation phenomena (such as beam self-organization) to maintain high-quality imaging even under bending and motion—conditions typical in endoscopy. This enables:

• higher spatial resolution,
• deeper tissue penetration,
• improved contrast without dyes. 

Coupled with adaptive optics and multimodal imaging (e.g., nonlinear fluorescence, Raman spectroscopy), the system provides a multi-layered view of tissue—from morphology to molecular composition. 

Expert perspectives and vision

Leading researchers involved in the project emphasize its disruptive nature. According to the project coordinators, MULTIPROBE aims to “update the long-awaited concept of in vivo, real-time optical diagnosis” with unprecedented resolution and therapeutic integration. 

Clinical experts further highlight that the technology could “eliminate the need for separate procedures” and establish a new standard in oncology, where diagnosis and treatment are performed in a single session. 

More broadly, the project is seen as a model of translational and interdisciplinary research, where fundamental physics (nonlinear optics, plasma science) directly enables clinical innovation and patient benefit.

Critical analysis: impact and challenges

From an analytical perspective, MULTIPROBE could transform healthcare along three major axes:

• Clinical efficiency: reducing diagnostic delays and hospital costs
• Patient outcomes: enabling earlier, less invasive interventions
• Precision medicine: tailoring treatment in real time based on tissue-specific information

However, challenges remain, including system complexity, integration into clinical workflows, regulatory approval, and the need for physician training. Scaling the technology from prototype to routine clinical use will be a crucial step.

Final insight

MULTIPROBE is not just a technological upgrade—it represents a conceptual shift. By merging imaging, diagnosis, and therapy into a single intelligent instrument, it moves endoscopy toward a future where light becomes both the eye and the scalpel of medicine, enabling faster, safer, and more personalized cancer care.