Use of Dynamic Optical Contrast Imaging (DOCI) for Head & Neck Surgical Applications

In surgical oncology, intraoperative tissue identification is vital for the ideal surgical outcome: resection of the entire tumor tissue and maximum preservation of the adjacent normal tissue. Meanwhile, the need for negative margins should be carefully balanced against excessive resection of healthy tissue which can result in significant patient morbidity. Currently, intraoperative tissue identification relies on a combination of visual cues, palpation, and surgeon experience as well as frozen section. In this dissertation, we demonstrate that Dynamic Optical Contrast Imaging (DOCI) can help surgeons accurately identify tissue intraoperatively. DOCI is a label-free and non-invasive optical modality that provides relative fluorescence lifetime images with extremely short acquisition and computational times. We report recent progress on system implementation towards intraoperative use, as well as systematically characterized performance of the system. We report the use of DOCI system in several head and neck surgical applications. Data from animal tissue shows that DOCI accurately differentiates tissue type and clearly delineate margins from mouse cancer models. Results from ex vivo experiments demonstrate that DOCI enables sensitive and specific mapping of hypercellular parathyroid gland. It is demonstrated that DOCI allows for real-time visualization and accurate delineation of OCSCC and adjacent healthy tissue, and that DOCI can be used in to clearly delineate margins between oropharyngeal cancer and surrounding healthy tissue