Handheld Fluorescence Imaging for Surgical Margin Assessment
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Solution Overview
Problem
Current surgical methods for tumor removal, particularly breast conservation surgery, face challenges in accurately visualizing tumor margins due to low tumor-to-normal tissue contrast under white light, leading to high rates of reoperation and increased healthcare costs, as existing technologies struggle to spatially co-localize positive margins on excised tissue to the surgical bed.
Innovation Solution
A handheld, white light and fluorescence-based imaging device that uses excitation light to induce porphyrin fluorescence in cancerous tissue, allowing real-time visualization of surgical margins and guiding the removal of residual cancer cells, precancerous cells, and satellite lesions, combined with a multispectral system for enhanced imaging capabilities.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Illumination intensity
If standard white light imaging is used during surgery, then the surgical procedure is simple and quick, but the tumor-to-normal tissue contrast is low making margin visualization challenging
Solution Approach 1:
The patent applies fluorescence imaging that causes cancerous tissue to emit light at different wavelengths than normal tissue. The excitation light source illuminates the surgical site, and cancerous tissue fluoresces with a distinct color signature, enabling real-time visualization of tumor margins with high contrast against normal tissue during the surgical procedure.
Solution Approach 2:
The patent uses fluorescence imaging as an intermediary technique between standard white light imaging and pathological analysis. The fluorescence modality acts as a mediator that provides real-time margin assessment during surgery, bridging the gap between intraoperative visualization needs and accurate tumor identification without requiring complex additional equipment.
2Measurement precision
If visual inspection under white light is used to assess surgical margins, then the process is fast, but the accuracy of detecting residual cancer cells is low leading to high reoperation rates
Solution Approach 1:
The fluorescence imaging system enables continuous real-time assessment of surgical margins during the entire resection process. The excitation light source continuously illuminates the tissue, and the imaging device continuously captures fluorescence signals, allowing the surgeon to assess margins continuously rather than relying on intermittent white light inspection, thereby improving detection accuracy without significant time loss.
Solution Approach 2:
The system provides immediate visual feedback to the surgeon about the presence of residual cancer cells at the surgical margins. The fluorescence signal gives real-time information about tumor boundaries, allowing the surgeon to adjust the resection in real-time to achieve complete margin clearance, thereby improving measurement precision while maintaining surgical efficiency.
3Reliability
If conservative resection is performed to preserve healthy tissue, then cosmetic outcomes are improved, but the risk of leaving residual cancer cells increases
Solution Approach 1:
The fluorescence imaging system enables local differentiation between cancerous and normal tissue at the surgical margins. By visualizing the precise location and extent of residual cancer cells through their unique fluorescence signature, the surgeon can selectively remove only the affected areas while preserving adjacent healthy tissue, thereby improving complete tumor removal reliability without excessive loss of healthy substance.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
Enables real-time, accurate visualization and targeted removal of residual cancer cells, reducing reoperation rates and improving surgical outcomes by providing precise guidance for tumor margin assessment and treatment.
Implementation Method 1
at least one excitation light source configured to excite autofluorescence emissions of tissue cells and fluorescence emissions of induced porphyrins in tissue cells of the surgical margin
Data Source
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AI summary
A method of assessing surgical margins is disclosed. The method includes, subsequent to administration of a compound configured to induce emissions of between about 600 nm and about 660 nm in cancerous tissue cells, positioning a distal end of a handheld, white light and fluorescence-based imaging device adjacent to a surgical margin. The method also includes, with the handheld device, substantially simultaneously exciting and detecting autofluorescence emissions of tissue cells and fluorescence emissions of the induced wavelength in tissue cells of the surgical margin. And, based on a presence or an amount of fluorescence emissions of the induced wavelength detected in the tissue cells of the surgical margin, determining whether the surgical margin is substantially free of at least one of precancerous cells, cancerous cells, and satellite lesions. The compound may be a non-activated, non-targeted compound such as ALA.