SMART-Endomicroscopy (Sensing and Mechatronically Assisted Real-Time Endomicroscopy)

As surgical techniques become more minimally invasive, there is an inevitable increase in complexity of the operating platforms. Clinically, it is of vital importance to integrate real-time microscopic visualisation into the surgical workflow in a seamless way and in combination with the existing imaging modalities such as MRI, CT and ultrasound. The aim of this proposal is to develop a new SMART-endomicroscopic probe that integrates in situ sensing and mechatronic control to allow for flexible and consistent tissue characterisation for Minimally Invasive Surgery (MIS). It addresses specific research and engineering challenges related to biophotonics, mechanical/optical miniaturisation and integration, super-resolution image reconstruction, as well as tracking, localisation and large area coverage for in vivo, in situ tissue characterisation. Through multi-scale minimally invasive imaging integration, the proposed SMART-Endomicroscope will potentially allow cancer staging and intervention to be performed as a single procedure, permitting histological and vascular examination to be performed at all stages of the operation, such that management decisions can be altered intra-operatively to ensure best treatment for the individual patient. This will help to transform surgical treatment options and patient cancer outcomes as personalised healthcare becomes a reality. The project echoes the current paradigm shift in MIS towards miniaturised smart instruments with integrated imaging and sensing, enhanced by robotic control. It is supported by a multidisciplinary team with complementary skills in physics, engineering, medical image computing and surgery.

The proposed project is in response to the current paradigm shift and clinical demand in healthcare for bringing cellular and molecular imaging modalities to an in vivo - in situ setting to allow for real-time tissue characterisation, functional assessment, and intraoperative guidance. The types of stakeholders will benefit from this research include: Academia (both UK and international) in medical imaging, biophotonics, sensing, vision, robotics, surgical oncology and general biomedical engineering; Public and private sectors in healthcare provision; Medical devices industry; Charities championing improved healthcare provision and disease focussed organisations particularly on cancer therapy; and more importantly patients and the general public. The benefit from this research includes potentially significant technological, social, commercial and economic impact. It not only enhances research capacity but also brings tangible knowledge transfer opportunities. The project addresses important research and development challenges, and the end results are likely to transform clinical research and practices in cancer staging, minimally invasive surgery, interventional imaging, and the development of molecular imaging techniques. The proposed project will potentially allow cancer staging and intervention to be performed as a single procedure, permitting histological and vascular examination to be performed at all stages of the operation, such that management decisions can be altered intra-operatively to ensure best treatment for the individual patient. The project provides an exciting opportunity in cross-scale morphological and functional integration of surgical information, not only because of the acquisition of real-time images which can be relayed to the surgeon using the same interface as other imaging modalities, but also because of the relatively small and flexible nature of the hardware probe. As the technical innovations described are introduced we are likely to generate opportunities in clinical applications which are not imaginable with current operating platforms, aiding in the minimisation of patient trauma and personalisation of healthcare treatment.