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Residual cancer cells left behind following surgery increase the chance of cancer returning in almost every cancer subtype and is particularly challenging in prostate and breast cancer where tumor cells may surround the main tumor and invade regional lymph nodes.

These cells cannot be detected with current approaches and are often 20 to 40% of the time left behind driving an increased risk of recurrence and significant additional treatment.

This proposal develops a new imaging technology that allows surgeons to identify and remove all cancerous tissue down to the single cell level at the time of initial surgery without removing healthy tissue.

Here we introduce VISION, a versatile chip scale NIR II imager for single cell intraoperative optical navigation, a thin planar fluorescent imaging platform manipulable by a robotic or laparoscopic arm capable of ultra-fast imaging during surgery.

VISION breaks free from conventional optics and enables an extraordinarily leap in sensitivity allowing identification of microscopic residual disease (MRD) during laparoscopic surgery of single cells.

We accomplish this by developing a drop-in probe with a highly sensitive multicolor chip scale fluorescence imager and validating performance in multiple models of prostate and breast cancer patient tissues and large animal models.

We improve resolution to the subcellular scale without lenses via new methods in optics.

To aid in imaging across cancers, we develop self-amplifying modular peptide-based imaging probes targeting tumor-associated proteases across breast, prostate, and a host of other cancers.

Finally, we push intraoperative imaging into the NIR II range where scatter and autofluorescence are significantly reduced, visualizing deep into tissue with high sensitivity and resolution via novel NIR II fluorophores.

We introduce automated image recognition and integrate all 3 innovations into the VISION platform to obtain single cell sensitivity with sub-micron resolution imaging in less than 1 second.

This platform will have a wide and immediate impact on patients as surgery is an essential component of treatment in nearly all non-metastatic breast cancer patients and a significantly number of prostate cancer patients.

In addition to significantly lowering cancer recurrence, this will have a major impact on patients by reducing the need for additional radiation and hormone therapy required for positive margins found postoperatively in prostate cancer and re-excision in breast cancer.

The versatile form factor along with the pancancer fluorescent probe and low cost of the platform will make VISION widely accessible.

San Francisco Regents Of The University Of California

THE FOUR INITIAL FOCUS AREAS ARE1 HEALTH SCIENCE FUTURES2 SCALABLE SOLUTIONS3 PROACTIVE HEALTH4 RESILIENT SYSTEMS

93.384 - ADVANCED RESEARCH PROJECTS AGENCY for HEALTH (ARPA-H)

Interior Business Center (IBC) [DOI]

California United States

State-Wide

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