An Imaging Technology for Intra-Operative Surgical margin assessment in oral and Head and Neck Cancers (OSCC)

用于口腔癌和头颈癌 (OSCC) 术中手术切缘评估的成像技术

• 批准号: 9672761
• 负责人: WARREN S GRUNDFEST
• 金额: $ 9.91万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-06-15 至 2022-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9672761
• 关键词: Adverse effects; Anatomy; Area; Award; Bayesian Modeling; Beds; Biopsy; Cancerous; Carotid Arteries; Clinical; Clinical Protocols; Clinical Research; Clinical Trials; Companions; Data; Detection; Diagnostic; Ensure; Excision; Feedback; Fingers; Frozen Sections; Generations; Goals; Head and Neck Cancer; Head and Neck Squamous Cell Carcinoma; Histologic; Histology; Image; Image Analysis; Image-Guided Surgery; Imagery; Imaging Device; Imaging technology; Lighting; Location; Malignant Neoplasms; Maps; Measurement; Modeling; Multi-Institutional Clinical Trial; Normal tissue morphology; Operative Surgical Procedures; Optics; Oral; Patient-Focused Outcomes; Patients; Preparation; Property; Research; Resected; Residual state; Risk; Sampling; Sensitivity and Specificity; Spinal Cord; Structure; Surgeon; Surgical margins; System; Techniques; Technology; Testing; Time; Tissues; Validation; Work; base; cancer surgery; contrast imaging; design; experience; imaging system; improved; in vivo; in vivo imaging system; instrument; lens; non-invasive imaging; novel; optical imaging; statistics; tool; tumor; wound

Project Abstract Oral and Head and neck squamous cell carcinoma (OSCC) is the sixth most common cancer in the world. The primary management of OSCC relies on complete surgical resection of the tumor. However, the establishment of margin-free resection is often difficult given the devastating side effects of aggressive surgery and the anatomic proximity to vital structures such as the carotid artery and the spinal cord. Positive margin status is associated with significantly decreased survival. Currently, it is the surgeon's fingers that determine where the tumor cuts are made, by palpating the edges of the tumor. Accuracy varies widely based on the experience of the surgeon and the location and type of tumor. Efficacy is further confounded by the risk of damage to adjacent vital structures, which limit resection margins. The goal of this proposal is to evaluate a novel, non-invasive, imaging system based on Dynamic Optical Contrast Imaging (DOCI) that has been developed to differentiate between cancerous and normal tissue intraoperatively using OSCC as the model. The imaging system is based on a novel realization of temporally dependent measurements of tissue autofluorescence that allow the acquisition of specific tissue properties over a large field of view. This system is optimized such that it can be used by surgeons at the time of cancer resection surgery to gather quantitative information on margins of malignancies and has been extensively validated in ex vivo OSCC samples. Companion histology has verified the sensitivity and specificity of the technique. In the proposed work we will reconfigure the imaging system for a large field of view (FOV), then pursue an intraoperative trial where tumors will be imaged prior to resection and wounds beds will be mapped to detect potential residual dysplastic tissue. Companion visible imagery and histology will be analyzed at all stages of the work ensuring statistical diagnostic power of the technique. We hypothesize that the accuracy and efficiency of tumor resection, margin determination and frozen sections will improve significantly when aided by our optical imaging technology. This intraoperative instrument would be the first of its kind, giving us the potential to significantly improve the sensitivity and accuracy of determining true OSCC margins thus enabling the surgeon to save healthy tissue and improve patient outcomes.

项目摘要 口服，头颈部鳞状细胞癌（OSCC）是世界上第六个最常见的癌症。 OSCC的主要管理依赖于肿瘤的完整手术切除。但是， 鉴于侵略性的毁灭性副作用，通常很难建立免边距切除 手术和与重要结构（如颈动脉和脊髓）的解剖结构。 正缘状态与生存率显着降低有关。目前，是外科医生的 通过触诊肿瘤的边缘，确定肿瘤切割的位置的手指。精度有所不同 广泛基于外科医生的经验以及肿瘤的位置和类型。疗效是进一步的 被损害相邻生命结构的风险而混淆，这些结构限制了切除边缘。目标的目标 建议是根据动态光学对比成像评估一种新颖的，非侵入性的成像系统 （文档）已开发用于使用术中癌和正常组织的区分 OSCC作为模型。成像系统基于对时间依赖的测量的新颖实现 允许在大型视野上获得特定组织特性的组织自荧光。这 对系统进行了优化，以便外科医生在癌症切除手术时可以使用它来收集 关于恶性肿瘤边缘的定量信息，并已在离体OSCC中得到了广泛的验证 样品。伴侣组织学验证了该技术的敏感性和特异性。在提议中 工作我们将重新配置成像系统以进行大型视野（FOV），然后进行术中试验 切除前将对肿瘤进行成像，并将伤口床映射以检测潜在的残留 发育不良组织。伴侣可见的图像和组织学将在工作的各个阶段进行分析，以确保 该技术的统计诊断能力。我们假设肿瘤的准确性和效率 当我们的光学帮助时，切除，边缘确定和冷冻部分将显着改善 成像技术。这种术中工具将是第一个此类工具，使我们有潜力 显着提高确定真正OSCC边缘的灵敏度和准确性，从而使外科医生能够 节省健康的组织并改善患者的结局。