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The Department of Health and Human Services’ Advanced Research Projects Agency for Health (ARPA-H), proposed by President Joe Biden and Vice President Kamala Harris and formed in 2022 after Congress earmarked $1 billion in funding for its first three years, has announced its latest round of awards focused on medical device technology to treat solid tumors.

Last week, the president and first lady announced up to $150 million in ARPA-H awards to “allow surgeons to provide more successful tumor-removal surgeries for people facing cancer,” according to a White House briefing. “These awards will support researchers from eight teams across the country who are pursuing innovative ideas as part of ARPA-H’s Precision Surgical Interventions (PSI) program.”

The funds will go to eight groups:

ARPA-H said the awardees were selected to develop methods and technology to improve cancer detection and increase visibility of critical anatomical structures during surgery. Its PSI program is split into two cancer localization technical areas (1-A and 1-B) and a healthy structure localization technical area (two).

1-A awardees

Those awarded in this technical area will focus on the visualization of the surface of excised tumors, identifying whether there are clear margins or if cancer cells are still present. If clear margins have not been identified, surgeons will be able to remove additional tissue prior to procedure completion.

“The performers will use different microscopy techniques to visualize the surface of the removed tissue with sub-cellular resolution,” according to ARPA-H. “All images will be read and classified automatically, without the need to have pathologists in the operating room.”

Tulane University, with a total award of up to $22.9 million, will focus on building an imaging system with a large aperture camera and structured illumination microscopy that uses a technique of patterned light to obtain high resolution imaging in three dimensions. The system will take advantage of light wave interference patterns to take image entire excised tumors. Additionally, the team will create an AI algorithm to “automatically identify cancerous cells for fast data classification,” according to the department’s press release.

Rice University, awarded up to $18 million, will build a novel microscope that uses ultraviolet epifluorescence to image tumor slices and create fluorescent stains that label cells and cellular components. This, along with an automated AI algorithm, will transform the images into ones that look similar to conventional pathology. Once transformed, Rice’s team will develop an automated pathology algorithm to classify the imaged cells.

The University of Washington, with a stipend of up to $21 million, will develop a microscopy system that will enable surgeons to image the entire surface of a tumor by placing it on a lightsheet scanner. They will also create algorithms to pseudo-stain the resulting images to that samples don’t need to be dying in the operating room. Instead, these AI methods “will take a greyscale image and render it similar to conventional pathology images in order to better classify it,” according to ARPA-H.

1-B awardees

These awardees will focus on identifying microscopic cancer remnants inside a patient to help surgeons end the procedure with clear margins.

The University of California, San Francisco, with an award of up to $15.1 million, will invent a microscope that uses an optical array pressed into the cavity’s surface where each pixel is its own multicolor microscope. The team will also develop a multi-cancer dying agent that activates differently based on tumor enzyme activity.

The University of Illinois Urbana-Champaign, awarded up to $32.6 million, will optimize optical coherence tomography techniques to identify suspicious tissue structures in the surgical cavity, then image the tissue region with nonlinear optics, giving a multilayered view of the cells’ metabolism and structural makeup.

Johns Hopkins University, which will also make an appearance in technical area two and has been given a total award of up to $20.9 million, will use some of the money to develop a novel non-contact, photoacoustic endoscope to provide “a more colorful view of the surgical field without altering the surgeons’ workflow,” according to the department release. “They will also develop a multi-cancer fluorescent contrast agent.”

Technical area two awardees

These award recipients will focus on making critical anatomy more visible to surgeons.

Dartmouth College, awarded up to $31.3 million, will create a laparoscope-integrating imaging solution that ARPA-H said could be especially helpful in prostate cancer surgeries. In tandem, the team will use nerve-dyeing and ureter-dyeing contrast agents, as well as vascular dyes, to fluoresce the critical anatomical structures. They will then map and visualize the 3D shape and depth of the structures, according to the press release.

In its second mention on this list, Johns Hopkins will use existing fluorescent dyes in combination with a novel photoacoustic endoscope to visualize anatomical structures. The endoscope will have the ability to look deep into human tissue to show hidden blood vessels and nerves so that they are not accidentally cut in surgery.

Cision Vision, with a total award of up to $22.3 million, will put its stipend to work by using shortwave infrared and hyperspectral images to help surgeons visualize vessels, nerves, and lymphatic structures. Reportedly going beyond the customary red, green, and blue, hyperspectral imaging is enhanced by AI algorithms, allowing the team to distinguish between tissue types without administering dyes.

Mandates

ARPA-H PSI program mandates include that all awardees must design its solutions to be compatible with all users, ie. designing a tool to fits different hand sizes. Additionally, all participants must be committed to equitable access and the development of medical devices that will be useable in virtually any hospital prioritize lower-cost solutions in their designs, and test devices in a rural hospital during the program. The devices will also have to be validated in patient populations that reflect pertinent disease demographics.

“With PSI, we aim to reduce surgical errors significantly and achieve better health outcomes across cancer and other diseases,” said Renee Wegrzyn, PhD, ARPA-H director. “Surgical procedures are often the first treatment option for some two million Americans diagnosed with cancer each year. This lack of precision can lead to repeat surgeries, harder recoveries, cancer recurrence, and higher health care costs. Our hope is to advance cancer surgery so that we remove cancer the first time and every time.” 

Article source: MDDI