Advanced Intraoperative Fluorescence Imager for Nerve Identification

Project Summary Abstract Unintended nerve injury is the major cause of morbidity for many surgeriesespecially in soft tissue orthopaedic operationsDistinctive visualization of nerves from adjacent connective and fat tissues remains challengingand therefore is the major reason for the possible incidence of surgical nerve damageFluorescence guided surgeryFGSwith nerve highlighting agents has the potential to improve nerve identificationExisting FGS devices are designed for fluorescent agents in the near infrared or NIRnm tonmsuch as ICG and Methylene blueHowevermost of the demonstrated nerve labeling agents are in the visible rangeAdapting NIR systems to visible wavelengths is not trivialmainly because of the presence of the strong white light background in the operation roomORthat overwhelms the weak fluorescence signalIn this Randamp D program Physical Sciences IncPSIin collaboration with Dartmouth CollegeDartmouthproposes to develop a versatile intraoperative fluorescence imager that can capture highly specific fluorescence images at any wavelength in the visible to NIR rangeThe key innovation of this technology is the use of spatially modulated illumination to eliminate the negative impact of the ambient light background which is essentially a uniformin spacecontinuous waveA timegated detection scheme based on a high speed camera and a low duty cyclepulsed light source will be used to enable efficient rejectionof the ambient light backgroundIn Phase Iwe will develop and optimize fiber connected pulsed laser source and a spatially modulated illumination unit at PSIand then incorporate them into an existing fluorescence imaging system at DartmouthThe completed imaging system will be tested on tissue phantomsex vivo tissue specimensand finally in in vivo miceA large scale in vivo study will be performed during a subsequent Phase II programThis Randamp D project will lead to a reliable solution enabling intraoperative fluorescence imaging in both NIR and visible rangewhile with little no susceptibility to ambient light interferenceThis will promote intraoperative fluorescence imaging procedures to be seamlessly integrated into current clinical workflows for optimal patient outcome Project Narrative Physical Sciences IncPSIand Dartmouth propose to develop and demonstrate an advanced imaging system that will be able to capture high sensitivity fluorescence images of nerve tissue within the presence of a range of strong room lighting conditionsThis Randamp D project will lead to a reliable solution enabling intraoperative fluorescence imaging with little no susceptibility to ambient light interferencepromoting intraoperative fluorescence imaging procedures to be seamlessly integrated into current clinical workflows for optimal patient outcome