Creation of an Automated Fluorescence Guided Tumor Ablation System.

Objective: Create a device that improves the identification and extent of resection at the interface between healthy and tumor tissue; ultimately, using this device would improve surgical outcomes for patients and increase survival.

Methods: We have created a contactless tumor removal system that utilizes endogenous fluorescence feedback to inform a laser ablation system to execute autonomous removal of phantom tumor tissue.

Results: This completely non-contact surgical system is capable of resecting the tumor boundary of a tissue phantom with an average root mean square error (RMSE) of approximately 1.55 mm and an average max error of approximately 2.15 mm. There is no difference in the performance of the system when changing the size of the internal tumor from 7.5-12.5 mm in diameter.

Discussion: Future research steps include creating a more intelligent spectral search strategy to increase the density of points around the resection boundary, and to develop a more sophisticated classifier to predict pathologic diagnosis and tissue subtypes located regionally around the tumor boundaries. We envision this device being used to resect the boundaries of tumors identified by exogenously delivered tumor-labeling fluorophores, such as fluorescein or 5-ALA, in addition to approaches relying on autofluorescence of endogenous fluorophores.