Optical Imaging Research at the Head and Neck Cancer Research Program

Surgical resection of cancers in functionally sensitive areas such as the larynx, tongue, throat, and palate continues to challenge surgeons around the world. They confront a delicate balance when removing malignant tissue: if too much is removed, it may negatively impact the patient’s quality of life, and if too little is removed, the cancer will likely reoccur. A facet significantly contributing to this decision-making process is visibility. Surgeons often have difficulty visualizing the exact extent of the cancer, as it is not possible to see subtle cellular changes in the surrounding tissue during surgery.

This obstacle prompted scientists at the Head and Neck Cancer Research Program at the Icahn School of Medicine at Mount Sinai to launch the Optical Imaging Program and explore the use of new optical technologies, such as high- resolution microendoscopy (HRME). The goal of the Program is to increase surgeons’ operative margin control to improve the rate of clear resections in vivo, while preserving normal tissue.

Advances in Optical Imaging for Head and Neck Cancers

The Optical Imaging Program was initiated through funding from an NIH Bioengineering Research Partnership (Richards-Kortum at Rice University), the ReMission Foundation and the Ronald I. Dozoretz Foundation. This generous support has resulted in the following advances:

Development of New Optical Imaging Technology

Given the limitations of currently available optical imaging systems, a collaboration with the Rensselaer Polytechnic Institute was formed with the goal of developing, validating and preparing for deployment in the operating room a novel multi-modality optical imaging platform. This collaboration was awarded additional funding from the Tisch Cancer Institute and will combine a variety of technologies for the real time assessment of intraoperative tumors, delivered via currently available robotic systems.

Local and Global Expansion of the Optical Imaging Team

In 2019, we added Jason Smith, PhD to the RPI/MSH/iCube collaborative team for this project. He was awarded a fellowship from the Eiffel Excellence Scholarship Program, which was established by the French Ministry for Europe and Foreign Affairs to enable French higher education institutions to attract top foreign students to enroll in their masters and PhD programs. Within this fellowship, Jason will be supported to spend 12 months in France working on the optical imaging collaboration.

This fellowship award is rooted in a collaborative program between Drs. Sylvain Gioux’s, Xavier Intes’ and Brett Miles’ labs. This collaboration is well-established and productive, as demonstrated by the securing of competitive funding (ISMMS/RPI seed fund: “Novel Platform for Optically-Guided Head and Neck Robotic Surgery”; PIs: Intes, X.; Gioux, S.; Miles, B.) and a co-authored publication (JP. Angelo, et al, Journal of Biomedical Optics 24(7), 071602 (2018)). Jason’s PhD project is highly interdisciplinary and aims at implementing structured light illumination for real time functional imaging in an endoscope imaging (Dr. Gioux) fused with molecular optical imaging (fluorescence lifetime imaging) and augmented with Deep learning (Intes) for real time head and neck optical surgery (Dr. Miles – ISMMS).

The development of a collaborative team regarding oral dysplastic lesions also occurred in 2019, along with forming a working group including scientists from the Tisch Cancer Institute, Dr. Brett Miles from the Department of Otolaryngology, Dr. Michael Turner of the Division of Oral and Maxillofacial Surgery and a new faculty member of the Mount Sinai Health System, Brandon Veremis, DDS of the Department of Pathology, Division of Oral Pathology.

Dr. Veremis will act as a key supporting investigator regarding oral pathology, the progression of oral lesions to malignancy, and is currently actively participating in the optical imaging program related to our work in optical coherence tomography. In addition to his expertise in oral pathology, Dr. Veremis also brings significant expertise in machine learning, which will be critical in future research efforts related to optical imaging systems of the future.