The Big Question
What if surgeries fixed problems flawlessly, the first time?
Every year, nearly 2 million Americans are newly diagnosed with cancer. For solid tumors, surgical removal is often the first option. Yet during surgery, it can be difficult to tell where a tumor ends and healthy tissue begins due to a lack of contrast. Multiple surgeries are often required to successfully remove an entire tumor.
Such tissue contrast challenges are not unique to cancer surgeries. Important anatomical structures such as nerves, blood vessels, and lymph ducts look like the normal, surrounding tissue, and are difficult for surgeons to visualize. Avoiding damage to these critical anatomical structures is a pressing problem for all surgeries. Unintended healthy tissue damage can lead to longer hospital stays, re-operation, pain, and potential trauma for patients. Corrective procedures and post-surgical treatment have an estimated total cost of more than $1 billion per year in the U.S.
The Current State
Many surgeries, including oncology, cardiology, and orthopedic procedures, deal with challenges in tissue visualization. Sometimes, during cancer surgeries, parts of the tumor’s edge can be analyzed. This, however, is time-consuming, uncertain, and not available to all patients and for all types of cancer. Detailed medical imaging is also sometimes available before surgery, but there are no tools that let surgeons clearly see nerves, blood vessels, and lymph ducts during the operation.
Precision Surgical Interventions (PSI) aims to help all surgical procedures reach their intended goal with no errors and no need for re-operation. The program aims to develop solutions to two major surgical problems: tumor edge visualization and critical anatomy visualization.
PSI seeks to develop technologies that will be used by surgeons during operations to visualize tumors’ edges, in order to increase chances of complete removal. Solutions may come in the form of bedside devices or devices that image inside the body, and will draw from technical disciplines that include chemistry, microscopy, biomedical engineering, and digital pathology.
PSI also seeks to develop devices that surgeons can use to clearly see critical anatomy in 3D while operating. PSI aims to leverage innovations in chemistry, optics, machine learning, and other disciplines to make sure surgeons can find and avoid hard-to-see nerves, blood vessels, and other structures, even if they are buried under other tissue. These tools promise to help enable surgical success in oncology and beyond.
The PSI Broad Agency Announcement (BAA) calls for proposals focused on cancer localization, healthy structure localization, and improving outcomes during surgery. One portion of the BAA focuses on cancer surgeries, while another applies to surgeries for any relevant condition. Teams from different fields with knowledge of oncology, surgery, imaging technology, and other disciplines are invited to apply their expertise to the visualization needs of surgeons, in service of improved patient outcomes.
Ileana Hancu, Ph.D.
Frequently Asked Questions
PSI anticipates that teaming will be necessary to achieve the goals of the program. Prospective performers are encouraged to form teams with varied technical expertise to submit a proposal to the PSI BAA. To facilitate this process, we have created a teaming page where prospective performers can share their profiles and learn more about other interested parties.
For Patients and Patient Groups
If you’re a patient, caregiver, or represent a patient advocacy group, please sign up below to receive future information from the PSI program about patient-specific events and updates. Please note, ARPA-H is a research funding agency and as such does not conduct its own clinical trials. If you have an interest in volunteering for a health research study, consider exploring opportunities at www.ClinicalTrials.gov, maintained by the National Institutes of Health.