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NIH grant 1R44CA314780-01: Advanced Surgical Guidance with Image Updating
Institute: {'code': 'CA', 'abbreviation': 'NCI', 'name': 'National Cancer Institute', 'admin_org_id': '12500008', 'admin_funding_url': ''}. PI: DAVID W ROBERTS. Award: $982300.
Start: 2026-09-18T00:00:00.
Project Summary
Nearly 17,000 people in the U.S. will die from brain tumors this year. Surgery, particularly complete resection, is
strongly linked to survival, and image-guidance has expanded the number of patients eligible for surgery (~80%
in the 2000s vs. 50–60% in the 1990s). Yet, these technologies have stagnated for two decades and still fail to
account for brain shift. InSight Surgical Technologies (IST) is commercializing I2Update™, an autonomous
intraoperative image-updating platform based on Dartmouth innovations and IP (licensed to IST). Dartmouth’s
most recent autonomous prototype proved feasibility but was too slow (~3 min), whereas IST has reduced
computations from minutes to seconds and built its own navigation system, although final/full
optimization/acceleration and regulatory validation remain. Integrating intraoperative ultrasound (iUS) into this
system provides major commercial and clinical value, offering future product expansion and, critically, depth
validation of I2Update™ accuracy when based on iSV. Although I2Update™ is widely recognized as a very
attractive solution to brain shift, its subsurface accuracy is not fully validated: Dartmouth has shown strong
agreement with intraoperative MRI (iMR) in some cases but inconsistencies in others due to brain shift during
iMR preparation of the surgical field (~2/3 of cases), while animal studies show high fidelity but less relevance
to human surgery because of reduced deformation and brain size/scale. This project will develop and integrate
iUS acquisition and processing for fiducial-less patient registration and autonomous image updating, and use
coregistered iUS for subsurface validation of I2Update™; thus, even if commercialization milestones for iUS are
not fully achieved, the key question of depth accuracy of I2Update™ when based on iSV will be addressed.
Specific aims are to complete IST’s navigation system and fully accelerate its GPU-enabled I2Update™ pipeline,
develop and incorporate autonomous fiducial-less iUS patient registration and displacement mapping, and
conduct clinical feasibility studies to assess usability and accuracy of these technology advances. Completion of
Phase II will finalize IST’s navigation system and fully accelerated I2Update™, validate its depth performance
when based on iSV, and prepare for future product releases incorporating autonomous fiducial-less iUS patient
registration and image-updating.document fetched 2026-09-27 02:45