Next Generation Fluorescence Guided Surgery with the C-MOLECULES System - ABSTRACT
Fluorescence guided surgery (FGS) is a growing field with increasing adoption, having about a dozen companies
with FDA cleared systems for perfusion imaging with indocyanine green, and leading surgical device companies
now acquiring such systems for marketing. Advanced molecular probes are being tested in hundreds of ongoing
clinical trials in FGS, with a combination of research grade and modified commercial systems. However, each
FGS system suffers from low dynamic range and high background signals from a range of sources. The C-
MOLECULES camera has been systematically designed to solve these two key problems, by having high
adaptive gain, inherently high digital bit conversion, and tight control over wavelength and temporal sampling.
Suppression of tissue autofluorescence and room light background signals are maximized through narrow band
filtering with each of two cameras, further processing the images for subtractive display. A unique patented
technology for ultrafast time-gated intensified camera work is utilized to further maximize the fluorescence to
ambient background, using specific detection that reaches the level of single photons per pixel. This system will
be finalized in hardware and software with time-gated LED lamps for fluorophore activation. System comparison
testing for the level of background suppression will be completed relative to other commercially available
systems, with a goal of 10x increase in contrast through enhanced background suppression. Molecular image
testing will utilize a fluorescent protein affibody that is being studied at microdoses, to image EGFR expression
in human head and neck tumors. A confirmation of the ability to image fluorescent affibody at picomolar
concentrations will be verified for maximal sensitivity. System development and testing is a collaborative project
between DoseOptics and Dartmouth, each of which have outstanding expertise in development of the technology
and pilot human trials, respectively. The team has a proven history of publishing their work, leading the field of
FGS, and delivering products that are commercially translated.
