Breast Conserving Surgical Guidance

NIH Grant R01CA19280 (PIs Brian Pogue & Keith Paulsen)

OPTICAL SCATTER IMAGING FOR SURGICAL SPECIMEN MARGIN ASSESSMENT DURING BREAST CONSERVING SURGERY

Breast conserving surgery is routinely offered for localized breast malignancies, but approximately one third of all patients are recalled for a second re-excision because residual cancer was found on the specimen surface. This can be directly solved through a technological solution which is optimized for wide- field and volumetric scanning, coupled with computer-aided decision making. In this academic-industry partnership, wide-field optical scatter spectroscopic imaging is coupled to volumetric CT scanning of specimens, in a package which integrates a substantial pre-clinical experience and clinical specimen imaging work of the Dartmouth team. Scatter imaging allows surface scanning through high-spatial frequency imaging of the tissue, which negates erroneous signals from blood, fluid or ink on the tissue surface, which is critically important for fast in situ imaging o large tissue fields.

NIH Grant R01CA188491 (PI Scott Davis)

MULTI-PROBE FLUORESCENCE IMAGING FOR RAPID INTRA-OPERATIVE TUMOR MARGIN ASSESSMENT

The extent to which cancer tissue is completely removed during primary surgery is a critical prognostic indicator of local recurrence and overall patient survival.  This project aims to dramatically reduce this rate by advancing a novel optical imaging strategy to rapidly identify incomplete tumor resection during surgery, using topical application of targeted probes to excised fresh tissue during surgery.  Applying a dual-probe difference specimen imaging (DDSI) strategy increased tumor-to-normal contrast by between 5 and 340-fold, depending on the normal tissue type considered, over approaches which use a single targeted probe. Specifically, we will develop and evaluate a multi-channel wide-field fluorescence imaging system dedicated to biomarker-specific DDSI in the operating room (OR).