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 口腔和头颈鳞状细胞癌（OSCC）是世界上第六大常见癌症。 OSCC 的主要治疗依赖于肿瘤的完整手术切除。然而， 考虑到侵袭性切除术具有毁灭性的副作用，建立无切缘切除术通常很困难。 手术以及与颈动脉和脊髓等重要结构的解剖学接近度。 阳性切缘状态与生存率显着下降相关。目前，这是外科医生的 通过触诊肿瘤边缘来确定肿瘤切口的手指。准确度各不相同 广泛基于外科医生的经验以及肿瘤的位置和类型。功效更进一步 邻近重要结构受损的风险会限制切除范围。此举的目标 提案是评估一种基于动态光学对比成像的新型非侵入性成像系统 (DOCI) 已开发用于在术中区分癌组织和正常组织 OSCC作为模型。该成像系统基于时间相关测量的新颖实现 组织自发荧光，允许在大视野范围内获取特定组织特性。这 系统经过优化，外科医生可以在癌症切除手术时使用它来收集 有关恶性肿瘤边缘的定量信息，并已在离体 OSCC 中得到广泛验证 样品。伴随组织学验证了该技术的敏感性和特异性。在提议的 在工作中，我们将重新配置成像系统以实现大视场 (FOV)，然后进行术中试验 在切除之前将对肿瘤进行成像，并对伤口床进行绘图以检测潜在的残留物 发育不良的组织。将在工作的各个阶段分析伴随的可见图像和组织学，确保 该技术的统计诊断能力。我们假设肿瘤检测的准确性和效率 在我们的光学辅助下，切除、切缘确定和冷冻切片将得到显着改善 成像技术。这种术中器械将是同类中的第一个，使我们有可能 显着提高确定真实 OSCC 边缘的灵敏度和准确性，从而使外科医生能够 拯救健康组织并改善患者治疗效果。