Handheld Fluorescence Imaging for Real-Time Tumor Margin Visualization
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Solution Overview
Problem
Current surgical margin assessment technologies struggle to accurately co-localize positive margins on excised tissue to the surgical bed, leading to increased re-excision rates and poorer patient outcomes in breast conservation surgery due to residual cancer cells, and existing techniques like margin shaving result in untargeted tissue removal.
Innovation Solution
A handheld, fluorescence-based imaging device that uses excitation light sources to induce porphyrin fluorescence in tumor cells, combined with autofluorescence imaging, allows real-time visualization of surgical margins and provides guidance for targeted resection of residual cancer cells and satellite lesions.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If standard white light imaging is used to visualize surgical margins, then the imaging process is simple and quick, but the tumor-to-normal tissue contrast is low making it difficult to accurately identify residual cancer cells
Solution Approach 1:
The patent utilizes fluorescence emission at different wavelengths (e.g., red fluorescence from ICG at ~835 nm and green fluorescence from porphyrins at ~635 nm) to create spectral contrast between tumor and normal tissues. This color/ wavelength differentiation enables clear visualization of surgical margins that is not possible with standard white light imaging, directly resolving the low contrast problem while maintaining a relatively simple handheld device architecture.
2Measurement precision
If specimen radiography or intraoperative histopathology is used to assess margins, then cancer cell detection is possible, but there is a time delay of approximately 20 minutes that prevents real-time surgical guidance
Solution Approach 1:
The fluorescence imaging system provides real-time, self-service margin assessment during surgery without requiring external laboratory processing. The handheld device enables immediate visualization of surgical margins using fluorescence emission from ICG and porphyrins, eliminating the 20-minute delay inherent in radiography and histopathology while maintaining detection accuracy.
3Reliability
If margin shaving is performed to remove residual cancer cells, then complete tumor removal is achieved, but healthy tissue is removed in an untargeted manner resulting in poorer cosmetic outcomes
Solution Approach 1:
The fluorescence imaging system enables surgeons to identify and remove only the specific areas containing residual cancer cells based on their unique fluorescence emission characteristics. This localized identification allows targeted resection rather than diffuse margin shaving, preserving healthy tissue with normal fluorescence properties while removing only the problematic fluorescent areas, thus improving both complete removal reliability and surgical precision.
4Measurement precision
If multiple optical filters are used to separate different fluorescence emissions, then accurate differentiation between tumor and normal tissue is achieved, but the device complexity increases
Solution Approach 1:
The patent segments the fluorescence detection into separate channels using optical filters - a first optical filter for red fluorescence (ICG) and a second optical filter for green fluorescence (porphyrins). This segmentation allows simultaneous detection of multiple fluorescent markers with distinct wavelength ranges, achieving accurate tissue differentiation while keeping each individual filter's design relatively simple and manageable.
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
Enhances the accuracy of surgical margin assessment by identifying residual cancer cells in real-time, reducing re-excision rates and preserving healthy tissue while ensuring complete tumor removal.
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
Implementation Method 2
a first optical filter configured to filter optical signals emitted by the surgical margin responsive to illumination with excitation light and permit passage of autofluorescence emissions of tissue cells and fluorescence emissions of the induced porphyrins
Data Source
AI summary
An imaging device includes a body having a first end portion configured to be held in a user's hand and a second end portion configured to direct light onto a surgical margin. The device includes 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. A white light source is configured to illuminate the surgical margin during white light imaging of the surgical margin. The device includes an imaging sensor, a first optical filter configured to permit passage of autofluorescence emissions of tissue cells and fluorescence emissions of the induced porphyrins in tissue cells to the imaging sensor, and a second optical filter configured to permit passage of white light emissions of tissues in the surgical margin to the imaging sensor. Systems and methods relate to imaging devices.