# Fluorescence microscopy for evaluation of Mohs surgical margins

> **NIH NIH K22** · UNIVERSITY OF ROCHESTER · 2020 · $186,186

## Abstract

Abstract
Mohs surgery is a widely used technique for the treatment of nonmelanoma skin cancer that obtains extremely low
recurrence rates by imaging tissue as it is removed from the body to ensure complete resection. However, Mohs is slow and
extremely labor intensive because it depends on frozen sections processing to produce histological images. The cost and
reduced throughput associated with frozen section processing limits its availability to patients while contributing to rising
health care costs. My research has developed fluorescent imaging technologies, rapid tissue labeling, and image processing
technologies enabling real-time evaluation of pathology in skin tissue with an order of magnitude reduction in processing
time as compared to frozen sections.
 This proposal will develop advanced surgical imaging technology for Mohs surgery, an application that is too cost-
sensitive for existing technologies such as two photon fluorescence microscopy. The first aim will assess the accuracy of
fluorescent diagnosis of Mohs surgical margins by imaging discarded Mohs specimens using microscopy with ultraviolet
surface excitation (MUSE), a method demonstrated to be both inexpensive and promising for Mohs surgery. The second
aim will develop two new imaging systems based on MUSE. These techniques will enable an order of magnitude reduction
in cost and imaging time compared to state of the art two photon or frozen sections, enabling new applications in
dermatopathology. Dramatic improvements in MUSE imaging contrast and resolution will be realized using novel
illumination strategies and high speed image sensors. The final aim will perform an imaging study of the technologies
developed in the previous aims in a Mohs surgical practice, demonstrating sensitivity and specificity relative to frozen
sections while reducing the time to treat patients. These studies will demonstrate that new imaging technology can reduce
the time associated with Mohs surgery, enabling greater access to image-guided surgery and reducing healthcare costs.
 This proposal will build upon my optical and software engineering experience while providing me with important new
training in dermatopathology, digital pathology, the surgical treatment of skin cancer, and the design of clinical studies.
This unmentored proposal will be conducted under the guidance of Dr. Beverly Faulkner-Jones and Dr. James Connolly
and who are clinician-scientists and experts in the fields of pathology. In addition, I will work closely with a new clinical
collaborator, Dr. Daihung Do, a Mohs surgeon. This multi-disciplinary, collaborative environment will provide an excellent
opportunity for professional growth independent of my postdoctoral advisor at MIT and training in clinical research while
enabling me to establish an independent research program in surgical imaging and digital pathology.

## Key facts

- **NIH application ID:** 9913486
- **Project number:** 5K22CA226035-02
- **Recipient organization:** UNIVERSITY OF ROCHESTER
- **Principal Investigator:** Michael Gene Giacomelli
- **Activity code:** K22 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $186,186
- **Award type:** 5
- **Project period:** 2019-04-11 → 2022-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9913486

## Citation

> US National Institutes of Health, RePORTER application 9913486, Fluorescence microscopy for evaluation of Mohs surgical margins (5K22CA226035-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9913486. Licensed CC0.

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