A renowned surgical oncologist at Carle Health is leading the clinical translation of a novel intraoperative camera system developed in partnership with researchers at the University of Illinois Urbana-Champaign and Carle Illinois College of Medicine (CI MED).
Using ultraviolet and near-infrared light, the camera could help surgeons instantly determine whether to remove a patient’s lymph nodes during cancer surgery. From the clinical perspective, the system delivers a ‘smart vision’ view to inform real-time decisions, streamline surgical workflows and improve patient outcomes.
“The work exemplifies how Carle Health and CI MED translate Illinois engineering into bedside
impact,” Claudius Conrad, MD, PhD, surgical oncologist at Carle Health and associate dean for research and innovation at CI MED, said. “Engineering breakthroughs reach patients only when clinicians are embedded in the development process from the start. My role is to ensure the sensor innovation is shaped into a tool surgeons can use in the operating room and truly help patients in real time,” he said.
CI MED Professor and Principal Investigator Viktor Gruev said, “This technology addresses an important unsolved problem in surgery: determining during the operation whether a lymph node is metastatic (the site of cancerous spread).”
With breast, lung and bile duct cancers, surgeons face difficult decisions about how many lymph nodes to remove since these cancers frequently spread through the lymphatic system. The current standard requires removing lymph nodes for microscopic analysis but if the cancer has not spread, the patient is exposed unnecessarily to surgical risk and to post operative complications such as lymphatic edema.
“Our system combines ultraviolet, visible and near-infrared imaging on a single chip, allowing surgeons to localize lymph nodes and assess whether they are likely metastatic,” said Zhongmin Zhu, a doctoral student in electrical and computer engineering at Illinois who served as lead author on the project.
The team’s triple-signal approach is inspired by the remarkably wide-spectrum vision of the mantis shrimp, which can detect light invisible to the human eye. Near-infrared (NIR) light illuminates even hard-to-find lymph nodes using a medical dye called indocyanine green (ICG). Imaging with deep ultraviolet (UV) light reveals the presence (or absence) of high levels of tryptophan, a naturally occurring chemical marker associated with malignancy. The camera captures standard color images, UV and NIR signals in a single view.
When fully developed for surgical use, Gruev says the images could inform clinical decisions in real time. “If a lymph node is healthy, future versions of this approach could help surgeons leave it in place, which may reduce unnecessary node removal and lower the risk of complications such as lymphedema (tissue swelling) and reduced mobility. If a lymph node is positive (for cancer), the surgeon could potentially adjust the operation immediately, which may help avoid secondary surgeries,” he said.
The imaging system was developed through a multi-disciplinary partnership involving three universities, led by engineering experts at Carle Illinois College of Medicine. It was tested in lab experiments and with surgical specimens from breast cancer patients in a hospital in North Macedonia in Europe immediately following mastectomy surgery. Results showed that the camera efficiently identified cancerous lymph nodes (97% sensitivity) and avoided false alarms most of the time (89% specificity). The system hasn’t been tested in a living organism (in vivo testing).
From the clinical setting perspective, Dr. Conrad advised on benefits of real-time lymph node assessment, how the camera’s interpretation is useful to a surgeon in the operating room, how to adapt the camera’s use for a live patient, and translating the alignment of photonics with the language of oncologic surgery so use stays grounded in the needs of a live patient.
The team’s work, Bioinspired Ultraviolet-to-Near-Infrared Imager for Label-Free Intraoperative Assessment of Lymph Node Metastasis, recently published in the journal Optica, a leading journal in the field of optics and photonics. In addition to Zhu, PhD candidate Yifei Jin was a lead author on the project.
The team’s research was supported by the U.S. Air Force Office of Scientific Research, the Office of Naval Research, the National Science Foundation, and the National Institutes of Health, including an NIH program that supports Gruev’s broader collaboration with the University of Pennsylvania.
Adapted from article by Carle Illinois College of Medicine
Large image provided by Carle Illinois College of Medicine
Categories: Redefining Healthcare, Community
Tags: Carle Cancer Institute, Carle Illinois College of Medicine, oncology, research