Recently, the NCI awarded over $6.3 million in grants to Laura Marcu, UC Davis professor of biomedical engineering and a pioneer in developing the FLIm technology. The funding supports her exploration of the clinical utility of FLIm in identifying tumors in patients with cancer. Advances in FLIm technology and the innovative approaches developed in the Marcu lab enabled initiation of large clinical studies with patients undergoing surgical procedures for cancer removal.

“We see great prospects from using FLIm in detecting and operating on cancerous tumors,” Marcu said. “FLIm may allow for more cures with fewer long-term side effects and may help surgeons find early cancer growth not detected using regular pathology.”

What is FLIm and how does it work?

FLIm allows surgeons to visually spot and more precisely remove malignant tumors. It captures and analyzes the intrinsic light emitted by tissues. The light indicates the presence or absence of abnormalities that would signal the presence of cancerous cells. FLIm provides visual and quantitative data with precise measurements of this autofluorescence light.

FLIm seamlessly integrates with existing imaging techniques used in neurosurgery and robotic surgery. It is a significantly less expensive alternative to intraoperative MRI, and a more convenient and safer diagnostic tool than dye-based imaging.

During brain cancer surgeries, neurosurgeons need to identify and remove malignant tumors intertwined with normal, functional brain tissues. To distinguish the good from the bad, surgeons use assistive imaging technologies, ranging from large, expensive intraoperative MRIs to microscopic dye-based imaging tools.

These commercially available imaging tools generally are inefficient at detecting less-aggressive tumors. They require significant pre-surgical planning, special operating room setup and the administration of potentially toxic dyes to patients.

Laura MarcuMarcu partnered with UC Davis neurosurgeon Orin Bloch to explore FLIm as a better, safer and more precise imaging technology in identifying cancerous cells in the brain. They were awarded a $3.1 million grant from NCI to test and validate FLIm as a tool for instant tumor tissue identification during brain surgeries.

“We believe the use of FLIm in brain cancer surgeries will advance the field and improve the survival chances for patients with brain cancer,” Bloch added.

While FLlm is still being tested for use in brain cancer surgeries, the technology has already proven effective in head and neck cancer surgeries.

UC Davis is a pioneer in FLIm application to head and neck surgeries

In transoral robotic surgery (TORS), surgeons use robot arms to work from within a patient’s mouth to extract hard-to-reach tumors during head and neck surgeries. The procedure saves patients from external incisions in the neck and jaw that can leave them with permanent scarring and difficulties in eating, speaking and swallowing.

In collaboration with Intuitive Surgical Inc., Marcu and her team added FLIm technology to the da Vinci robotic surgical system to better identify tumors during TORS. Marcu, who pioneered the research in the head and neck surgeries, collaborated with D. Gregory Farwell, professor and chair of the UC Davis Department of Otolaryngology — Head and Neck Surgery, and head and neck surgeons Arnaud Fassett Bewley, Andrew Birkeland and Marianne Abouyared.

In April 2021, the team was awarded a $3.2 million grant from NCI to continue its research on FLIm technology use in head and neck surgeries. In 2014, they were granted a research award to develop a FLIm technology prototype for these surgeries. They made such significant advances in their initial study, with more than 100 patients enrolled, that they were awarded the new grant to scale up their research to include clinical studies with 200 additional patients.

“We already saw promising results in identifying cancerous tissues during head and neck surgeries, and we are now exploring use of FLIm in brain cancer surgeries,” said Marcu. “This UC Davis homegrown technology might become the next standard of care, adopted widely in cancer surgeries.”