# Ergonomic fluorescence-guided surgery imaging platform for intraoperative assessment of blood and lymphatic vasculature

> **NIH NIH R44** · ONLUME, LLC · 2021 · $822,516

## Abstract

Project Summary/Abstract
This proposal aims to address the unmet clinical need for intraoperative assessment of blood and lymphatic
vasculature to reduce the prevalence of two breast cancer-related morbidities: lymphedema and tissue
necrosis. Current imaging systems are cumbersome, requiring ambient room lights to be turned off, have poor
fluorescence sensitivity, or provide images that are difficult to interpret. OnLume will develop the clinical cart-
based Asimov Imaging Platform to work in combination with the FDA-approved fluorescent dye, indocyanine
green, that not only enables real-time image capture of small vessels with ambient lights on without
degradation to image contrast, but also is easy for surgeons to use and interpret resulting in a platform that will
be optimized to provide clinical value across multiple procedures in the breast cancer surgery workflow.
More than 250,000 women a year undergo surgery for breast cancer in the United States. Conventionally,
surgeons rely on white light reflectance as a guide to assessing vessel patency, which is extremely difficult to
visualize. Lymphedema, an incurable disease associated with damage to lymphatic vessels, may occur in up
to 40% of breast cancer survivors; associated symptoms include pain, heaviness and limitations in motility and
associated costs range from $3000 to $16,000 per annum. Resection of lymph nodes that drain from the
breast while sparing the lymphatic channels may decrease the risk of lymphedema.
Some women who undergo mastectomy may choose breast reconstruction with a free flap surgery, where
plastic surgeons reattach blood vessels between donor and recipient tissue sites to reconstruct a breast
mound. Surgeons must assess vessel patency to decrease the risk of tissue necrosis and secondary
operations. In 15-25% of cases, patients undergo secondary surgery to correct tissue necrosis, incurring costs
that can exceed $14,000 per procedure.
Our novel imaging system will be evaluated in a pilot study to measure the efficacy of the visualization of the
blood and lymphatic architecture. This Phase II proposal has three specific aims: (1) complete development
and integration of novel technology into a clinical transient lighting-enabled, wide-field fluorescence-guided
surgery cart-based imaging platform, (2) demonstrate enhanced contrast of lymphatics for axillary reverse
mapping (ARM), and (3) evaluate blood vessel patency in free flap breast reconstruction. Successful
completion will result in a commercially available clinical wide-field FGS imaging system, providing critical
intraoperative imaging that could enable breast surgeons and plastic surgeons to improve the health and
quality of life for breast cancer survivors.

## Key facts

- **NIH application ID:** 10249334
- **Project number:** 5R44CA206754-03
- **Recipient organization:** ONLUME, LLC
- **Principal Investigator:** Adam John Uselmann
- **Activity code:** R44 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $822,516
- **Award type:** 5
- **Project period:** 2016-07-21 → 2023-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10249334

## Citation

> US National Institutes of Health, RePORTER application 10249334, Ergonomic fluorescence-guided surgery imaging platform for intraoperative assessment of blood and lymphatic vasculature (5R44CA206754-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10249334. Licensed CC0.

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