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The literature articulates the importance of advancing novel solutions which enable clinicians to intraoperatively resolve pathological tissue from healthy tissue in situ in order to guide the accuracy and efficiency of surgical tumor resection. A method which non-invasively provides real-time delineation of cancer margins has great potential to improve clinical outcomes by accelerating surgical procedural times, ensuring complete tumor resection, and by enabling more conservative resection approaches which preserves healthy tissue. Autofluorescence lifetime imaging is a powerful technique which holds great promise in addressing this clinically unmet need. Using a custom built, fiber-optic based, multi-spectral time-resolved fluorescence spectroscopy (ms-TRFS) instrument (excitation 355 nm) applied to cancer within head & neck anatomy, our preliminary results from 13 human patients indicate that tumor vs. healthy tissue regions (confirmed via histology) can be distinguished on the basis of lifetime and intensity ratio for both in vivo (pre-resection) and ex vivo (post-resection) applications. Each of the three major ms-TRFS spectral bands demonstrate highly conserved lifetime and intensity ratio trends within specific tissue types (palate, palatine tonsil, lingual tonsil, & base of tongue) for cancerous regions when juxtaposed to neighboring healthy peripheral tissue. Current results demonstrate distinct lifetime and intensity ratio results when comparing across tissue types. Collectively, our initial data suggests that time-resolved autofluorescence could serve as a valuable tool for providing real-time intraoperative diagnosis and surgical guidance during robot-assisted cancer removal in otolaryngologic applications.
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