# Fluorescence Lifetime Imaging/Spectroscopy System For Robotic Cancer Surgery Guidance

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA AT DAVIS · 2023 · $636,867

## Abstract

PROJECT SUMMARY
In this competitive renewal for R01 CA187427, we will continue to advance label-free Fluorescence Lifetime
Imaging (FLIm) to enhance the functionality of the widely-used da Vinci Surgical platform with an emphasis on
Trans-Oral-Robotic-Surgery (TORS). UC Davis has pioneered the intra-operative use of FLIm and our partner,
Intuitive Surgical, is the global leader in robotic-assisted surgery. To date, we have demonstrated a) the
synergetic integration of a point-scanning FLIm device with the da Vinci Surgical System (first-of-its-kind); b) the
potential of this approach to improve surgical decision-making during TORS without modifying conventional
clinical protocols; and c) the utility of FLIM-derived parameters detecting biochemical and metabolic
characteristics to distinguish oral and oropharyngeal cancer in real-time from surrounding normal tissue in
patients in-situ.. We also developed innovative methods for real-time dynamic augmentation of imaging
parameters on the surgical field of view. Capitalizing on the major accomplishments and knowledge gained under
the current R01, the overarching objective of this renewal application is to 1) demonstrate FLIm’s diagnostic
value in prospective studies by accounting for biological/experimental variables identified as critical under the
current R01 and leveraging pre-operative imaging and clinical information and 2) enhance the visualization of
FLIm-based classifiers on the surgeon console for real-time intraoperative feedback. To accomplish our overall
objective, we propose three specific aims: Aim 1. Expand the FLIm database and develop tissue-type classifiers
(retrospective analysis) accounting for biological variables (e.g., patient age/sex, tumor origin/location) and
experimental situations (e.g., epithelial surface vs deep margins, tumors of an unknown primary) and the pre-
operative imaging (CT, PET) features used in surgical planning. Aim 2. Develop, validate and perform regulatory
activities for enhanced FLIm data visualization in support of prospective clinical studies. Aim 3. Validate FLIm as
a means of real-time intraoperative TORS guidance in a prospective study analysis.
In summary, this study will demonstrate the clinical feasibility and utility of FLIm for intraoperative real-time
assessment of oral and oropharyngeal cancer surgical margins. The acquired FLIm parameter database will
enable subsequent large clinical trials for automated tissue classification and diagnostic prediction. While the
focus of this application is on TORS surgeries, the label-free FLIm-based tissue assessment, characterized by
simple, fast and flexible data acquisition and display, can be broadly applied to other procedures as the da Vinci
Surgical System is used in a wide range of tumor surgeries including urologic, colorectal, gynecologic, and
thoracic cancers.

## Key facts

- **NIH application ID:** 10625282
- **Project number:** 5R01CA187427-09
- **Recipient organization:** UNIVERSITY OF CALIFORNIA AT DAVIS
- **Principal Investigator:** Andrew Charles Birkeland
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $636,867
- **Award type:** 5
- **Project period:** 2014-09-12 → 2026-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10625282

## Citation

> US National Institutes of Health, RePORTER application 10625282, Fluorescence Lifetime Imaging/Spectroscopy System For Robotic Cancer Surgery Guidance (5R01CA187427-09). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10625282. Licensed CC0.

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