Fluorescence lifetime imaging/spectroscopy system for robotic cancer surgery guid

用于机器人癌症手术引导的荧光寿命成像/光谱系统

• 批准号: 8750780
• 负责人: DONALD GREGORY FARWELL
• 金额: $ 29.84万
• 依托单位: UNIVERSITY OF CALIFORNIA AT DAVIS
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-12 至 2019-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8750780
• 关键词: Address; Anatomy; Biochemical; Biopsy; California; Cancer Patient; Carcinoma; Clinical; Clinical Data; Clinical assessments; Colorectal Cancer; Coupled; Data; Databases; Development; Devices; Diagnosis; Diagnostic; Diagnostic Procedure; Electrocoagulation; Engineering; Excision; Feedback; Fiber Optics; Fluorescence; Fluorescence Spectroscopy; Future; Generations; Goals; Head and Neck Cancer; Head and Neck Surgery; Histocompatibility Testing; Histopathology; Image; Knowledge; Label; Location; Malignant Female Reproductive System Neoplasm; Malignant Neoplasms; Malignant neoplasm of thorax; Maps; Measurement; Measures; Mechanics; Methods; Normal tissue morphology; Operative Surgical Procedures; Optics; Oral cavity; Palpable; Pathology; Patients; Play; Procedures; Protocols documentation; Quality of life; Recurrence; Research; Research Infrastructure; Robot; Robotics; Role; Scanning; Spectrum Analysis; Surgeon; Surgical Instruments; Survival Rate; System; Tactile; Techniques; Technology; Time; Tissues; Tumor Tissue; Universities; Urologic Cancer; Validation; Work; base; cancer surgery; commercialization; data acquisition; design and construction; experience; experimental analysis; fluorescence imaging; improved; industry partner; instrument; minimally invasive; public health relevance; rapid technique; research and development; robot assistance; tool; tumor

DESCRIPTION (provided by applicant): We propose to advance and clinically evaluate a multispectral Time-Resolved Fluorescence Spectroscopy (ms-TRFS) diagnostic technique as a tool for enhancing the functionality of the widely-used commercial da Vinci Surgical platform. This is a partnership between the University of California, Davis, which has pioneered intra-operative use of ms-TRFS and Intuitive Surgical, the global technology leader in minimally invasive robotic-assisted surgery. The ms-TRFS technique will provide label-free real-time (~secs) measures of biochemical and functional tissue features during robotic surgical procedures. We will integrate an optical port within the da Vinci instruments that when coupled to the ms-TRFS apparatus allows for both point- and imaging spectroscopy of tissue. The ms-TRFS parameters will provide surgeons with rapid clinical assessment of local pathologies, identification of tumor margins and other relevant tissues, and guidance of biopsy during robotic-assisted surgery. The initial clinical target of this proposal is intra-operative assessmen of head & neck cancer in patients undergoing TransOral Robotic Surgery (TORS). Incomplete surgical resection is strongly associated with tumor recurrence and the visible and palpable interface between normal and abnormal tissue is frequently subtle. As such it is particularly difficult and critical to accurately determine the boundary between tumor and normal tissue. We have extensive experience with both the fluorescence lifetime signatures of this cancer and clinically-compatible TRFS technology. The proposed work builds on our preliminary clinical data showing that TRFS can distinguish different types of tissues in the oral cavity including carcinoma. The proposed research strategy involves two steps: The first is to accelerate the clinical validation of a platform which will integrate the ms-TRFS device with the da Vinci Surgical Robot via a clinically available instrument, i.e. the Intuitive Surgical 5 French Introducer. This instrument includes a fiber optic port and will be initially used to provide direc measurements from various tissue types including cancer of the head & neck. This step will allow rapid generation of a database of optical features from different tissues types that can be used to determine the ms-TRFS diagnostic potential and represents a "derisking" step for the industry partner. The second is to develop a more specialized instrument including a port that can accommodate specific diagnostic needs during robot-assist surgical procedures. This will address our industrial partner's longer-term R&D programmatic goals and commercialization strategy. In summary, the proposed study addresses two critical challenges in robot-assisted head & neck surgery, i.e. the lack of tactile feedback and the inability to perform tissue diagnosis in real time during surgery; and has the potential to improve the surgeon's ability to perform complete surgical resection with low recurrence rates while preserving normal tissue and function. While the focus of this application is on TORS, we note the proposed technique can be broadly applied as the da Vinci Robot is used in a range of tumor surgeries including urologic, colorectal, gynecologic, and thoracic cancers.

描述(由申请人提供)：我们建议发展和临床评估多光谱时间分辨荧光光谱(MS-TRFs)诊断技术，作为增强广泛使用的商业达芬奇手术平台功能的工具。这是加州大学戴维斯分校(University of California，Davis)和直觉外科(Intuitive Surgical)之间的合作伙伴关系，前者率先在手术中使用ms-TRFs，后者是全球微创机器人辅助手术的技术领先者。MS-TRFS技术将在机器人手术过程中提供生化和功能组织特征的无标记实时(~SECS)测量。我们将在达芬奇仪器中集成一个光学端口，当连接到MS-TRFS设备时，它允许对组织进行点光谱和成像光谱。Ms-TRFs参数将为外科医生提供快速的局部病理临床评估，识别肿瘤边缘和其他相关组织，并在机器人辅助手术期间指导活检。这项建议的最初临床目标是在接受经口腔机器人手术(TORS)的患者中术中评估头颈部癌。手术切除不彻底与肿瘤复发密切相关，正常组织和异常组织之间的可见和可触摸的界面往往是微妙的。因此，准确地确定肿瘤和正常组织之间的边界是特别困难和关键的。我们在这种癌症的荧光寿命信号和临床兼容的TRFs技术方面都有丰富的经验。这项拟议的工作建立在我们的初步临床数据的基础上，该数据表明，TRFs可以区分口腔中不同类型的组织，包括癌症。拟议的研究战略包括两个步骤：第一步是加快平台的临床验证，该平台将通过临床可用的仪器，即直觉的Surgical 5 France Introducer，将ms-TRFS设备与达芬奇外科机器人集成在一起。该仪器包括一个光纤端口，最初将用于提供包括头颈部癌症在内的各种组织类型的DREC测量。这一步骤将允许快速生成来自不同组织类型的光学特征数据库，该数据库可用于确定ms-TRFs的诊断潜力，并代表了行业合作伙伴的一个“去风险”步骤。第二是开发一种更专业的仪器，包括一个端口，可以在机器人辅助手术过程中满足特定的诊断需求。这将解决我们工业合作伙伴的长期研发计划目标和商业化战略。总之，这项拟议的研究解决了机器人辅助头颈手术中的两个关键挑战，即缺乏触觉反馈和无法在手术中实时进行组织诊断；并有可能提高外科医生在保留正常组织和功能的同时执行低复发率的完全手术切除的能力。虽然这项应用的重点是Tors，但我们注意到，建议的技术可以广泛应用，因为达芬奇机器人用于一系列肿瘤手术，包括泌尿外科、结直肠癌、妇科和胸癌。