PROJECT SUMMARY Lung cancer is the leading cause of death from cancer worldwide with an estimated 1.8 million deaths a year, killing more patients than breast, prostate, and colon cancer combined. Current manual and robotic bronchoscopes only provide visual feedback to the clinician, and in some cases, the camera needs to be removed to insert surgical tools (i.e., needles, forceps, or brushes), leaving no direct sensor feedback. Hence, there is a need for safe, advanced sensing methods to monitor tissue-tool contact as well as tool position and shape during navigation, diagnosis, and therapy tasks. This supplement research will fulfill these clinical and technological needs and will ultimately improve procedural safety, biopsy accuracy, and diagnostic yield of bronchoscopy. This proposal aims at developing and validating miniaturized soft optical sensors for position and shape monitoring of the soft robotic bronchoscope (developed in the parent grant) as well as tissue-tool contact monitoring. Soft optical sensors are a promising emerging approach since they are low cost, immune to electromagnetic interferences, easy to fabricate, and versatile in their design. The sensory information these sensors provide will act in concert with the onboard microcamera information and can act as a standalone sensory feedback mechanism in case vision feedback is hampered (e.g., due to bleeding occurring during biopsy or by inflamed tissue). Our goal is to improve procedural safety as well as robot localization and tracking during all stages of bronchoscopy (i.e., navigation, diagnosis, and therapy tasks). The proposed work is structured in two specific aims. Aim 4 focuses on design and manufacturing of miniaturized, multi-modal soft optical sensors for contact and shape monitoring. The multi-modal soft optical sensors will be created through a laser precision machining surface functionalization technique of medical soft optical tubing, resulting in a simple, low-cost, and versatile solution. The capability of the sensors to monitor contact forces and shape will be validated with dedicated testing setups to measure sensing range and resolution. Aim 5 focuses on sensor integration within the soft robotic bronchoscope and validation through in-vitro and ex-vivo testing with our clinical collaborator. We will assess robotic-assisted navigation in-vitro (informed by onboard sensor feedback – contact and shape sensing) through a desired path, until a specific or desired location is reached in the lung simulator. For ex-vivo tests, we will use explanted porcine lungs that represent a good analog of human lungs. This will provide insights into robot operation with actual biological tissue. We will assess robot-tissue contact forces and evaluate potential tissue trauma by analyzing potential perforations, tears, and bruising locations count by visual inspection post-procedure. Providing tissue-tool contact monitoring and feedback to the clinician will minimize risks of a...