16 Feb 2022
Funding from EPSRC will support research into assessing tumor margins.National Robotarium for work on a new robot-assisted surgery technique.
Based at Edinburgh's Heriot-Watt University, the center has been created to specialize in research on robotics and artificial intelligence, supported with £21 million from the UK Government and £1.4 million from the Scottish Government. Although research programs have already started work, the National Robotarium center itself is due to open later in 2022.
The new funding is intended to support research into ways that robotic surgery platforms can accurately remove malignant tissue during cancer surgery, without unnecessarily removing healthy surrounding tissue as well.
This critical determination of where tumor margins are precisely located has been a key challenge in bioimaging for some time, with several different approaches employed, each with advantages and drawbacks.
Examples have included a 2020 project at the University of California, Davis, combining fluorescence lifetime imaging (FLIM) and machine learning to allow diagnostic data about tumor margins to be gathered from breast tumor specimens in real-time. Photoacoustic imaging is another strong candidate, thanks to its ability to precisely image oxy- and deoxyhemoglobin and reveal the locations of fine blood vessels.
Optical imaging by a suitable method is potentially better than traditional preoperative imaging using CT scans together with visual observations, or removal of tissue specimens for time-consuming pathology examination. However, the advent of robotic surgery platforms has opened the question of how such machines will determine tumor margins, and using which techniques.
"Although surgeons use detailed preoperative scans to decide on surgical margins during surgery, they also use vision and 'feel' to distinguish normal and abnormal tissue," commented Hugh Paterson of Edinburgh's Western General Hospital. "'Feel’ is much reduced in key-hole surgery, and almost completely absent in robotic-assisted surgery."
Restoring the expert 'feel' to surgeons doing robotic surgery will assist accurate assessments and allow greater precision, benefiting patients and significantly limiting repeat surgery or the need for additional treatments.
In-house laser-based manufacturing
The National Robotarium intends to bring together expertise from laser manufacturing, fiber-optic sensors, micromechanical probing and computational modelling, to create a mechanical imaging probe capable of detecting cancerous tissue that can be used with a standard minimally-invasive surgery instrument.
Coupled to this will be a data modelling framework integrated into the probe operation, for tumor identification and surgical margin assessment. The goal is to effectively eliminate the margin of error for surgeons, according to the project group, giving clinicians confidence that they have removed the correct amount of tissue during the operation itself.
"One key function of the 'probe' we are developing is the ability to make mechanical measurements, working as part of the surgical robotic system, on and around the tissue," commented project leader Yuhang Chen to Optics.org. "This would allow us to use the mechanical data for tumor identification and surgical margin assessment."
For this to happen, the probe's measurement systems will need to be miniaturized, manufactured to a high precision, and incorporate sensing technologies appropriate for the surgeries undertaken.
"Fiber-optic sensor technology will be integrated into a purpose-designed mechanical sensing compartment of the probe," said Yuhang Chen. "Component miniaturization will exploit our advanced in-house laser-based manufacturing to realize probe dimensions compatible with surgical robotic systems currently in use."
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