Dual-comb spatial offset optical coherence tomography: A new paradigm for image-guided cancer surgery in the oral cavity

Our overall aim is to investigate a new paradigm for image-guided cancer surgery in the oral cavity.

Cancer detection and tumor margin mapping in the oral cavity faces unique challenges in terms of accessing the tissue of interest, managing patient movement, and imaging sufficiently deep in the tissue to map out the margins with high spatial resolution and specificity. We aim to overcome these challenges using a new imaging paradigm based on a dual frequency comb light source and coherent optical receiver techniques combined with a breakthrough new imaging modality, spatial offset optical coherence tomography (SO-OCT). Through our synergistic approach, we aim to image >5mm deep in tissue with sub-cellular resolution, providing a 3-fold increase in imaging depth compared with existing methods and providing improved contrast between tumor and healthy tissue at depth. Additionally, our imaging platform will achieve at least a 10-fold increase in imaging speed compared with the fastest existing OCT systems, thereby overcoming another fundamental bottleneck. We will demonstrate the opportunities for future development of the platform by imaging ex vivo samples from human oral cancer patients. This platform will be unique for its ability to address all outstanding challenges for image guided cancer surgery in the oral cavity. This project requires a close collaboration between Technical University of Denmark (DTU: Optical imaging), University College London (UCL: light source and coherent receiver development), and Rigshospitalet (RIGS: clinical expertise).

Oral cancer is a significant healthcare burden with an estimated 62,000 new cases and 24,000 deaths annually in Europe alone. The main treatment is surgical removal, but small, isolated tumors can develop away from the main tumor site and can be missed during surgery. Incomplete removal of the tumor can have dire consequences for patients due to high risk of recurrence; on the other hand, surgeons want to remove as little tissue as possible to preserve the patient’s ability to eat and speak normally. Surgeons urgently need better guidance to improve the precision of these surgeries. In this project we aim to develop a groundbreaking new imaging platform which uses light to map out tumor margins with very high precision over a large depth range. Our platform aims to triple the imaging depth that can be achieved using existing methods. The result will be a new paradigm in image guided cancer surgery that will significantly improve the long-term quality of life for oral cancer patients.