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

项目摘要 口腔和头颈部鳞状细胞癌（OSCC）是世界上第六大常见癌症。 口腔鳞状细胞癌的主要治疗依赖于肿瘤的完全手术切除。但 建立无边缘切除术往往是困难的，因为侵略性的副作用是毁灭性的。 手术和解剖学上接近重要结构，如颈动脉和脊髓。 切缘阳性状态与生存率显著降低相关。目前，它是外科医生的 通过触摸肿瘤的边缘来确定肿瘤切口的位置。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 受到邻近重要结构损伤风险的混淆，这限制了切除边缘。这个目标 一个建议是评估一种新的，非侵入性的，成像系统的基础上动态光学对比成像 （DOCI），其已经被开发用于在手术中使用 OSCC作为模型。该成像系统是基于一种新颖的实现时间相关的测量 组织自发荧光的特性，允许在大视场内采集特定的组织特性。这 系统被优化，使得外科医生可以在癌症切除手术时使用该系统来收集 恶性肿瘤边缘的定量信息，并已在离体OSCC中得到广泛验证 样品伴随组织学已经证实了该技术的敏感性和特异性。拟议 我们将重新配置成像系统以获得大视野（FOV），然后进行术中试验 其中肿瘤将在切除之前成像，并且伤口床将被标测以检测潜在的残留物 发育不良组织将在工作的所有阶段分析配套的可见图像和组织学， 该技术的统计诊断能力。我们假设肿瘤诊断的准确性和效率 在我们的光学辅助下，切除，边缘确定和冷冻切片将显着改善 成像技术这种术中仪器将是同类仪器中的第一个，使我们有可能 显著提高确定真实OSCC边缘的灵敏度和准确性，从而使外科医生 以挽救健康组织并改善患者治疗效果。

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.