Neurosurgery Guidance

NIH Grant R01NS052274 (PIs David Roberts, Keith Paulsen)

COREGISTERED FLUORESCENCE-ENHANCED RESECTION OF MALIGNANT GLIOMA

This work supports the development and evaluation of fluorescence imaging (FI) in guiding the resection of intracranial tumors. Utilizing quantitative FI (qFI) concepts developed during the first funding period, and realized in the form of an intraoperative probe, concentrations of d-aminolevulinic acid (ALA) induced protoporphyrin IX (PpIX)  indicate for the first time that diagnostically significant PpIX concentrations exist brain tumors which are below the threshold of human visual detection – even in low grade glioma (LGG) – tumors previously found inaccessible with visual FI (vFI), despite the significant clinical impact to be gained from improving their completeness of surgical resection through FI technique. Our overall research plan for continuation outlines clinical and technical/ preclinical studies that will be pursued in parallel

 

NIH Grant R01CA167413 (PIs Brian Pogue & Keith Paulsen)

MOLECULAR FLUORESCENCE-GUIDED SURGERY PLATFORM

This Academic-Industrial Partnership (AIP) for the development and translation of molecularly-targeted optically-fluorescent imaging agents, GMP-produced for guiding surgical resection in phase 0 clinical trials. While recent advances in the technology for guiding surgical oncology will establish an efficient pipeline have been impressive, significant limitations remain in determining, intraoperatively, the biological margins of disease. Contrast agent testing will be carried out with end-points of surgical testing in phase 0 micro dosing studies signal detection and binding specificity being the primary outcomes from the phase 0 trials. The AIP is between Dartmouth (Engineering and Medical Schools), Affibody AB, and LI-COR bringing together 3 partners to advance molecularly-targeted fluorescent tracers for surgical guidance.

 

NIH Grant K99CA190890 (PI Jonathan Elliott)

MOLECULAR GUIDED SURGERY FOR IMPROVED RESECTION OF GLIOBLASTOMA MULTIFORME

This work will improve extent of tumor resection (EOTR) in brain cancer, by advancing fluorescence-guided surgery (FGS) within the context of neurosurgical oncology. The project evaluates a novel method of FGS- molecular-guided surgery (MGS) by means of intraoperative receptor concentration imaging (iRCI). The project will extend the rapidly growing field of FGS, applying a novel kinetic imaging approach to allow intraoperative evaluation of tumor-associated receptor expression, and to use this to guide surgical resection.