Imaging Goggles for Fluorescence-Guided Surgery

Despite advances in pre-operative diagnostic imaging and highly skilled surgeons, the positive margin rate (PMR) for HNC remains unacceptably high at 10-30%. Fluorescence-guided surgery (FGS) using cancer- targeted imaging agents highlights potential cancerous areas for immediate removal, reducing the risk of incomplete resections and subsequent rapid cancer recurrence. Previously, we’ve evolved the Cancer Vision Goggle (CVG) FGS technology into a user-friendly, lightweight, head-mounted system that’s untethered from cumbersome computers or displays, offering real-time monitoring of tissue and tumor locations and adjusting for positional changes during surgical manipulations. This innovation affords surgeons greater mobility and the convenience of hands-free operation with instantaneous fluorescence signal visualization, though weaknesses have been identified during our preclinical and clinical testing. The current CVG system, initially designed for breast cancer (BC) and head and neck cancer (HNC) surgeries, is now in use with aspirations to broaden its application across various cancer types and even non-cancerous procedures. Despite the system’s success, our collaborative surgeons have pinpointed critical areas for improvement to further advance this technology. These enhancements are essential for transforming the CVG into a versatile tool across a range of clinical settings. To address these shortcomings in this academic-industrial partnership, we will: 1) Transition from a monocular camera setup to a stereoscopic vision system. This will significantly improve the visualization of tissue contours and align the real and virtual worlds more accurately; 2) Integrate intraoperative ultrasound to address the limitations of pre-incision, subsurface tumor detection, that will work in tandem with optical methods of the existing system; and 3) augment the CVG with external exoscope microscopic imaging capabilities, enabling surgeons to more closely examine areas of concern that are highlighted during the video stream. These targeted enhancements are expected to elevate the CVG’s functionality, making it an indispensable asset in the operating room. Project Number: 9R01CA301382-05A1 | Fiscal Year: 2026 | NIH Institute/Center: National Cancer Institute (NCI) | Principal Investigator: Samuel Achilefu (+1 co-PI) | Institution: UT SOUTHWESTERN MEDICAL CENTER, DALLAS, TX | Award Amount: $623,432 | Activity Code: R01 | Study Section: Special Emphasis Panel[ZRG1 CTH-E (57)] View on NIH RePORTER: https://reporter.nih.gov/project-details/11298069