Imaging goggles for fluorescence-guided surgery

The National Cancer Institute awarded The University of Texas Southwestern Medical Center $623,432 on May 7, 2026, under the Cancer Detection and Diagnosis Research program (CFDA 93.394) to develop enhancements to the Cancer Vision Goggle (CVG), a head-mounted fluorescence-guided surgery system designed to reduce positive margin rates in cancer resection.

The award funds three core improvements to the CVG platform: transitioning from monocular to stereoscopic vision to enhance tissue contour visualization and real-world alignment; integrating intraoperative ultrasound imaging to address subsurface tumor detection limitations prior to incision; and augmenting the system with external exoscope microscopic imaging capability. The CVG currently operates as a lightweight, untethered, hands-free surgical aid with real-time fluorescence signal visualization, initially developed for breast cancer and head and neck cancer procedures, with aspirations to expand across additional cancer types and non-cancerous applications. The work addresses critical gaps identified during preclinical and clinical testing to transform the system into a versatile tool across multiple clinical settings.

Performance occurs in Dallas, Texas. The period of performance runs through April 30, 2031. The award includes a sub-award to Tietronix Software Inc. (awarded July 11, 2026) for clinical software development and evaluation for the CVG and integration of ultrasound visualization combined with fluorescence-guided surgery.

Abstract

Despite advances in pre-operative diagnostic imaging and highly skilled surgeons, the positive margin rate (PMR) for HNC remains unacceptably high at 10-30%. Fluorescence-guided surgery (FGS) using cancer- targeted imaging agents highlights potential cancerous areas for immediate removal, reducing the risk of incomplete resections and subsequent rapid cancer recurrence. Previously, we've evolved the cancer vision goggle (CVG) FGS technology into a user-friendly, lightweight, head-mounted system that's untethered from cumbersome computers or displays, offering real-time monitoring of tissue and tumor locations and adjusting for positional changes during surgical manipulations. This innovation affords surgeons greater mobility and the convenience of hands-free operation with instantaneous fluorescence signal visualization, though weaknesses have been identified during our preclinical and clinical testing. The current CVG system, initially designed for breast cancer (BC) and head and neck cancer (HNC) surgeries, is now in use with aspirations to broaden its application across various cancer types and even non-cancerous procedures. Despite the system's success, our collaborative surgeons have pinpointed critical areas for improvement to further advance this technology. These enhancements are essential for transforming the CVG into a versatile tool across a range of clinical settings. To address these shortcomings in this academic-industrial partnership, we will: 1) transition from a monocular camera setup to a stereoscopic vision system. This will significantly improve the visualization of tissue contours and align the real and virtual worlds more accurately; 2) integrate intraoperative ultrasound to address the limitations of pre-incision, subsurface tumor detection, that will work in tandem with optical methods of the existing system; and 3) augment the CVG with external exoscope microscopic imaging capabilities, enabling surgeons to more closely examine areas of concern that are highlighted during the video stream. These targeted enhancements are expected to elevate the CVG's functionality, making IT an indispensable asset in the operating room.