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Principal Investigator: Orin Bloch
Organization: UNIVERSITY OF CALIFORNIA AT DAVIS
Fiscal Year: 2024
Award: $105,412
Funding agency: National Cancer Institute
PROJECT SUMMARY/ABSTRACT
The outcome of brain tumor surgery is critically dependent on the neurosurgeon's ability to distinguish between
abnormal and normal tissue in real-time. Our goal is to enhance this discrimination by using label-free
Fluorescence Lifetime Imaging (FLIm) to detect tissue biochemical and metabolic characteristics that distinguish
among different tissue types and, by integrating FLIm into the neurosurgical workflow, to provide this information
in a real-time, visual format useful for guiding tumor biopsy and resection. FLIm-derived tissue fluorescence
feature information will be co-registered with the preoperative-MRI (pMRI) and projected onto the conventional
surgical microscope field-of-view (FOV). This should improve delineation of tumor margins and thus increase
both the diagnostic yield of brain biopsy and the extent of tumor resection.
The proposed FLIm technique will incorporate the following features: (1) Safe, rapid, and simultaneous
measurement of time-resolved fluorescence decays in multiple spectral emission bands that will acquire
extensive information in one scanning measurement of a large area of tissue selected by the surgeon; and (2)
Fast analysis, display, and augmentation of fluorescence parameters that enable real-time visualization of optical
data encoding diagnostic information onto the surgical FOV. The proposed clinical studies using FLIm as a stand-
alone tool will establish classifiers to correlate FLIm parameters with specific tissue pathologies, an important
step in demonstrating FLIm's diagnostic value. The proposed integration of FLIm as an adjunct to the
neuronavigation system and surgical microscope will provide data for combined analysis to validate the benefit
of FLIm diagnostics in neurosurgical procedures. Three aims are proposed: Aim 1) Construct and integrate a
FLIm device as a diagnostic adjunct with conventional neurosurgical tools. Aim 2) Clinically evaluate the
relationship between FLIm parameters and distinct tissue pathologies and develop classifiers for different tissue
types. Aim 3) Validate FLIm for real-time intraoperative guidance through a prospective analysis.
In summary, this study will demonstrate the clinical feasibility and utility of FLIm for intraoperative real-time
assessment of neurosurgical margins and the resulting improvement in neuropathologic diagnostic yield. The
acquired FLIm parameter database will enable subsequent clinical trials for automated tissue classification and
diagnostic prediction. The new FLIm instrumentation, characterized by simple, fast and flexible data acquisition
and display, and its seamless integration with existing neurosurgical imaging, will provide a less expensive
alternative to intraoperative MRI and a valuable complement to current standard-of-care diagnostic procedures.
Success in this area will warrant a more generalized use of FLIm in surgical oncology (other cancers) as well as
guided interventions for treatment of functional neurologic diseases (e.g. epilepsy, neurodegenerative diseases).
Terms: <Abscission><Affect><Area><Biochemical><Biometrics><Biometry><Biopsy><Biostatistics><Body Tissues><Brain><Brain Cancer><Brain Neoplasia><Brain Neoplasms><Brain Nervous System><Brain Tumors><Cancers><Cauterization><Cauterize><Cautery><Cell Communication and Signaling><Cell Signaling><Ch'i><Characteristics><Classification><Clinical><Clinical Research><Clinical Study><Clinical Trials><Cognitive Discrimination><Complement><Complement Proteins><Complex><Comprehensive Cancer Center><Conventional Surgery><Craniotomy><Data><Data Bases><Data Display><Databases><Degenerative Neurologic Disorders><Diagnostic><Diagnostic Imaging><Diagnostic Method><Diagnostic Procedure><Diagnostic Technique><Discrimination><Encephalon><Engineering><Environment><Epilepsy><Epileptic Seizures><Epileptics><Equipment><Excision><Extirpation><FLIM imaging><Fluorescence><Frameless Stereotaxy><Glial Cell Tumors><Glial Neoplasm><Glial Tumor><Glioma><Goals><Harvest><Hemostasis><Hemostatic function><Histopathology><Human><Image><Image-Guided Surgery><Imaging Device><Imaging Instrument><Imaging Procedures><Imaging Technics><Imaging Techniques><Imaging Tool><Imaging technology><Intervention><Intervention Strategies><Intracellular Communication and Signaling><Intrasurgical Resection Cavity><Label><Letters><MR Imaging><MR Tomography><MRI><MRIs><Magnetic Resonance Imaging><Malignant Neoplasms><Malignant Tumor><Malignant Tumor of the Brain><Malignant neoplasm of brain><Manufacturer><Measurement><Medical Imaging, Magnetic Resonance / Nuclear Magnetic Resonance><Metabolic><Metastasis><Metastasize><Metastatic Lesion><Metastatic Mass><Metastatic Neoplasm><Metastatic Tumor><Microscope><Modern Man><NMR Imaging><NMR Tomography><Necrosis><Necrotic><Neoplasm Metastasis><Nervous System Degenerative Diseases><Nervous System Diseases><Nervous System Disorder><Neural Degenerative Diseases><Neural degenerative Disorders><Neurodegenerative Diseases><Neurodegenerative Disorders><Neuroglial Neoplasm><Neuroglial Tumor><Neurologic><Neurologic Degenerative Conditions><Neurologic Disorders><Neurological><Neurological Disorders><Neurological Surgery><Neuronavigation><Neurosurgeon><Neurosurgical Procedures><Normal Tissue><Normal tissue morphology><Nuclear Magnetic Resonance Imaging><Operative Procedures><Operative Surgical Procedures><Optics><Outcome><Pathologic><Pathology><Patient outcome><Patient-Centered Outcomes><Patient-Focused Outcomes><Patients><Predictive Value><Procedures><Property><Protocol><Protocols documentation><Qi><Radiation necrosis><Removal><Research Resources><Research Specimen><Resection Cavity><Resources><Scanning><Secondary Neoplasm><Secondary Tumor><Seizure Disorder><Signal Transduction><Signal Transduction Systems><Signaling><Specimen><Surgeon><Surgical><Surgical Interventions><Surgical Oncology><Surgical Procedure><Surgical Removal><Surgically-Created Cystic Resection Cavity><Surgically-Created Resection Cavity><System><Systematics><Techniques><Technology><Testing><Time><Tissue Sample><Tissues><Tumor Tissue><Validation><Visual><Visualization><Zeugmatography><biological signal transduction><brain abnormalities><brain tissue><brain tumor resection><cancer metastasis><cohort><complementation><continuous learning><data acquisition><data acquisitions><data base><degenerative diseases of motor and sensory neurons><degenerative neurological diseases><diagnostic ability><diagnostic capability><diagnostic power><diagnostic utility><diagnostic value><epilepsia><epileptogenic><feature detection><feature recognition><flexibility><flexible><fluorescence life-time imaging><fluorescence life-time imaging microscopy><fluorescence lifetime imaging><fluorescence lifetime imaging microscopy><glial-derived tumor><image processing><imaging><imaging system><improved><instrumentation><interventional strategy><intra-operative imaging><intraoperative imaging><learning progression><malignancy><multidisciplinary><neoplasm/cancer><neuro-oncology><neuro-surgeon><neurodegenerative illness><neuroglia neoplasm><neuroglia tumor><neurological disease><neurooncology><neuropathologic><neuropathological><neuropathology><neurosurgery><novel><oncologic surgery><optic imaging><optical><optical imaging><patient oriented outcomes><practical implementation><pragmatic implementation><prospective><real-time images><realtime image><resection><skull incision><standard of care><success><surgery><surgical imaging><temporal measurement><temporal resolution><time measurement><tool><tumor><tumor cell metastasis><tumors in the brain><validations>