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Report

Teaser, summary, work performed and final results

Periodic Reporting for period 1 - QuantSURG (Quantitative Surgical Guidance for Colorectal Surgery using Endogenous Molecular Contrast)

Teaser

Summary

Despite significant advances in medical imaging technologies, there currently exist no tools to effectively assist healthcare professionals during colorectal surgery. Surgeons mainly rely on their own senses, vision and touch to identify diseased tissue that should be removed or healthy tissue that should be avoided. In turn, surgery remains subjective and dependent on the experience of the surgeon, resulting in unacceptable failure, recurrence and morbidity rates, as well as in significant quality of care disparities across hospitals.
The hypothesis underlying our study is that near-infrared light travels deeply into living tissues and interacts with endogenous molecular constituents, namely oxy- and deoxy-hemoglobin, water and lipids, providing key information regarding tissue perfusion, oxygenation, hydration and metabolism. In turn, such information can be used to differentiate diseased from healthy tissue. We recently introduced a novel concept that enables the quantitative imaging of endogenous molecular information over large fields-of-view. Because this concept can be implemented in real-time, it is amenable to provide video-rate endogenous information during colorectal surgery.
In this study, we propose to push the limits of this concept by developing ground-breaking theory & technology, and creating a novel surgical guidance device capable of real-time imaging of key endogenous information for colorectal surgery. Correlation between endogenous contrast measurements and histological tissue status will be investigated onto bowel ischemia and colorectal cancer animal models. Finally, a clinically-compatible imaging device will be fabricated and translated into a first-in-human study in patients undergoing colorectal surgery. If successful, this study has the potential to solve a longstanding clinical problem by providing real-time objective feedback during colorectal surgery.

Work performed

Over the first period of the QuantSURG project, essential theory and instrumentation has been developed to address the first specific objective of the project, namely â€œTo develop novel theory and methods to perform real-time wide-field quantitative endogenous imagingâ€. Doctoral students, and engineers were recruited to help in this objective. Concretely, the proof of principle for endoscopic quantitative imaging was performed and published, the new multispectral imaging method was validated and presented at a conference (publication pending) and the real-time imaging algorithms validated and presented at a conference (publication pending). The imaging system using these developments is being built and prepared for preclinical testing. The animal experiment agreements are being prepared in parallel for testing of the imaging system and methods in Years 3&4. Documentation for human testing is pending the preclinical tests to be completed.

Final results

- Real-time quantitative imaging system deployed for preclinical validation
- Correlation study between optical signals and the occurence of hypoxia
- Correlation study between optical signals and the occurence of colorectal cancer
- Real-time quantitative imaging system deployed for clinical study