Cancer is one of the leading public health challenges in the UK. Someone is diagnosed with the disease every two minutes. Cancer currently costs the UK £18.3B per annum in healthcare expenses and lost productivity. With predictions that by 2020 almost half of the population will be diagnosed with cancer within their lifetime, the health and economic implications for the UK are considerable. Surgery remains one of the primary treatment options for cancer patients, but is very often unsuccessful, largely due to the incomplete removal of cancerous tissue, or the cautious excision of healthy tissue. Surgery often fails because there is no way to accurately detect cancer in real-time during surgery. Surgeons are completely dependent on their naked eye and sense of touch to identify all of the cancerous tissue. With the move towards minimally-invasive, key-hole and robotic surgery, surgeons have now even lost their ability to use their sense of touch and their field of view is increasingly restricted. Numerous technologies have attempted to address the pressing medical need to detect cancer during surgery but none have proven sufficiently accurate and cost-effective. This project will rapidly advance the development of a miniaturised intra-operative cancer detection probe, EnLight, which is fully compatible with minimally invasive key-hole surgery and robotic surgical systems. The technology potentially offers rapid and high diagnostic performance for intra-operative cancer detection. Laboratory proof-of-concept for the probe has been achieved. This project will evaluate the clinical effectiveness of the technology for detecting cancer during prostate cancer surgery, which is the first priority cancer indication. At the conclusion, this project will deliver the necessary clinical data to establish safety and performance to help secure regulatory approval in the EU and US to initiate commercialisation and clinical translation.

Nearly 1 in 4 breast cancer patients in the UK will see their cancer return after surgery. The consequences include repeat operations, delayed adjuvant treatment, increased likelihood of distant recurrence, poorer cosmetic outcomes, emotional distress, and enormous financial cost. Breast cancer recurs after surgery primarily due to incomplete excision of the tumour or inadequate clearance of the surgical margins. Surgeons are unable to completely remove the cancer because the only tools they have to detect cancer during surgery are visual and tactile assessment. Consequently, there is a tremendous medical need for improved tools to detect cancer during surgery. Lightpoint Medical is developing a molecular imaging fibrescope to detect cancer in real-time during surgery, and thereby reduce the chance of cancer recurring. The technology is based on Cerenkov Luminescence Imaging (CLI), a ground-breaking imaging modality that can perform optical imaging of Positron Emission Tomography (PET) imaging agents. The fibrescope is a flexible fibre optic bundle that the surgeon can use to image inside the surgical cavity. Initial market research supported by the TSB revealed a high demand for Lightpoint's technology among oncology surgeons. In this project, we will interview 15 breast cancer surgeons to collect their in-depth feedback on the fibrescope’s design, usability, performance, and workflow integration. The feedback from the surgeons will be used to improve the fibrescope design before embarking on fullscale product development and clinical trials.

Surgery is the primary treatment option for most types of cancer, yet cancer frequently recurs after surgery. In the UK, almost 1 in 4 breast cancer patients will require re-operation after surgery. The consequences include delayed adjuvant treatment, increased likelihood of distant recurrence, poorer cosmetic and functional outcomes, emotional distress, and financial cost. Cancer frequently requires re-operation due to incomplete excision of the tumor or inadequate clearance of surgical margins. Cancerous tissue fails to be completely excised because, during surgery, the surgeon can only rely on the visual appearance of the tumor and palpation to differentiate malignant versus benign tissue. Consequently, there is a tremendous need for improved tools to detect cancerous tissue during surgery. Lightpoint Medical is seeking to assess the technical and commercial feasibility of developing an intra-operative molecular imaging camera and endoscope to diagnose cancer in real-time during surgery. Image-guided surgery will enable the surgeon to more accurately remove tumors, thereby reducing the likelihood of post-surgical recurrence. The camera and endoscope will employ a novel molecular imaging technology called Cerenkov Luminescence Imaging (CLI) that enables optical imaging of radiopharmaceuticals. The molecular sensitivity of CLI has the potential to provide the surgeon with a vastly improved tool for detecting malignant tissue during surgery. If the technology is deemed technically and commercially feasible for the clinic, this project will deliver prototypes of a CLI intra-operative camera and a CLI endoscope. The prototypes will be used for pre-clinical testing, testing in a surgical simulator, and improvements to the next phase of product development.

Each year, 45,000 people in the UK are diagnosed with breast cancer, and 12,000 people will die from the disease. Surgery is the primary treatment option for breast cancer, yet for 1 in 5 patients the tumor will recur following surgery. Cancerous tissue hidden in the borders of the tumor resection is the the main contributor to tumor recurrence following surgery. Consequently, there is a tremendous medical need to give surgeons better tools to detect cancerous tissue during surgery. Artemis Diagnostics LTD is developing a novel intra-operative molecular imaging video camera that will enable surgeons to "see" cancerous tissue in real-time during the operation and guide the resection accordingly. The camera can detect molecular signatures of cancer, thereby extending the diagnostic range of the surgeon's vision. Being able to see cancerous tissue during the operation will enable the surgeon to perform more accurate tumor resections. This will lessen the likelihood of tumor recurrence while preserving healthy tissue. In this market research project, we will collect surgeons' feedback on the camera device to refine the system design, estimate the adoption rate, and determine which surgical cases would most benefit from the technology.

Nearly 1 in 4 breast cancer patients in the UK will see their cancer return after surgery. The consequences include repeat operations, delayed adjuvant treatment, increased likelihood of distant recurrence, poorer cosmetic outcomes, emotional distress, and enormous financial cost to the NHS. Breast cancer recurs after surgery primarily due to incomplete excision of the tumour or inadequate clearance of the surgical margins. Surgeons are unable to completely remove the cancerous tissue because the only means they have to detect cancer during surgery are visual and tactile assessment. Consequently, there is a tremendous medical need for improved tools to detect cancer during surgery. Lightpoint Medical is developing a molecular imaging camera to analyse surgical specimens in real time during surgery. The technology is based on Cerenkov Luminescence Imaging (CLI), a ground-breaking imaging modality that can perform optical imaging of Positron Emission Tomography (PET) imaging agents. In this project we will undertake a pilot clinical trial of the CLI molecular imaging camera on breast cancer surgical specimens. The study will be conducted with our partners at Guy’s and St Thomas’ Hospital and King’s College, and will assess the camera's diagnostic performance compared to gold-standard pathology. The results will be used to plan the pivotal clinical trial, and design the next phase of the device.