A hallmark of a successful curative-intent cancer surgery is the complete removal of all diseases, both gross and microscopic, with minimal damage to neighboring healthy tissue. Surgical guidance, however, is largely accomplished through visual and tactile feedback, which lacks adequate contrast and sensitivity, often leading to residual disease in the patient. Residual disease (or positive surgical margins) is highly correlated with recurrence and mortality and requires adjuvant treatment, incurring added costs, toxicity, and burden to the patient. 

Recently, fluorescence-guided surgery (FGS)–utilizing molecular-targeted fluorescence contrast agents to label both diseased and healthy cells in vivo–has emerged as a promising solution for enhancing surgical visualization in the operating room. However, conventional optical imaging systems suffer from performance-limiting trade-offs between sensitivity and physical maneuverability, as they rely on bulky and rigid optical components. As a result, practical intraoperative fluorescence imaging with camera systems or laparoscopes is limited to macroscopic (mm-scale) detection of disease. 

Our Solution:

To address these needs in next-generation FGS, we introduce a lens-less and chip-based fluorescence imaging platform, VISION (Versatile Imaging Sensor for Intra-Operative Navigation), capable of highly sensitive intraoperative imaging within a compact form factor for maximal maneuverability in the resection cavity. Our custom-designed image sensor is placed in direct contact with the tissue to capture fluorescence emissions before they diverge, enabling microscopic detection without bulky lenses. Through this approach, the entire imaging system is reduced to a thin planar sensor with integrated optics. Our research has taken a number of directions to enable this technology: