Specialty: Head and Neck Surgery

Keywords: surgical margins, head and neck cancer, autofluorescence imaging

Background: Surgeons currently rely on pre-operative imaging, palpation, and their expertise to guide the initial resection of head and neck cancers (HNC), followed by frozen section analysis. However, this process is time-consuming and is subject to geographic sampling error, resulting in missed tumor. Dynamic optical contrast imaging (DOCI) differentiates tissue types by leveraging endogenous fluorophore autofluorescence.

Objective: This pilot study demonstrates DOCI’s ability to detect the true surgical margin and reduce recurrence in a murine head and neck squamous cell carcinoma (HNSCC) model.

Methods: 16 mice were injected with varying concentrations of SCC7, a murine HNSCC cell line, in the flanks. The injection site was surgically exposed and imaged with DOCI to track tumor development prior to closure. This imaging protocol was repeated for 1-3 weeks until a large, clinically significant tumor had developed. DOCI-guided surgical resection of the tumors was performed with margins sent for histopathological analysis. The surgical site was closed, and mice were monitored for recurrence.

Results: 5/16 mice (31.2%) underwent surgical resection with DOCI-confirmed negative margins, and 2/16 mice (12.5%) had positive margins on DOCI imaging prior to closure. None of the mice with DOCI-confirmed negative margins experienced recurrence within 8 weeks, while all mice with positive margins on DOCI experienced recurrence.

Conclusions: DOCI allows for the identification of positive surgical margins and reduces recurrence in a murine model of HNSCC.