ABSTRACT: The intersection of healthcare and biomedical research is at an inflection point with the convergence of the digital revolution, advances in imaging, nanotechnology, big data science, and precision or personalized medicine. There is a wealth of meaningful, but complex information that could be extracted from imaging data but is not optimally utilized for patient care. Cancer care exemplifies the current challenges which include early detection, accurate distinction of pre- neoplastic and neoplastic lesions, prediction of tumor aggressiveness, determining infiltrative tumor margins during surgical treatment, tracking tumor evolution/ metastasis pattern, recurrence, and potential acquired resistance to treatments over time. Major strides have been made in the personalization of cancer therapies such as immunotherapy, but the availability of specific, relevant, and timely medical data and information is of critical importance to realizing the full potential of precision medicine. Nowhere is this more acutely evident than during interventions in the operating and procedure rooms. Novel methods of image guidance, data integration, information extraction, and knowledge transfer are needed to enable clinicians to fully leverage the information available, especially before, during and after invasive procedures. We are excited to re-submit a proposal for a new P41 biomedical resource center (BTRC) called Advanced Technologies for NCIGT(AT-NCIGT) with 3 TRDs, 10 new collaborative and 10 new service projects, all of which aim to investigate develop and disseminate new technologies for image guided therapy (IGT). The 3 components are Imaging Cancer Heterogeneity for IGT, Deep Learning for IGT and Intraoperative devices for IGT. These new technologies alone and in combinations will allow for greater understanding of disease state, treatment guidance, integration/navigation and in-vivo monitoring of tissue responses and improve the precision of invasive procedures. Thus the overall goal of this proposal is to investigate, develop and disseminate novel technologies for extracting new tissue characteristics (technology research and development core TRD 1: Imaging cancer heterogeneity; analyze them and make them available through state-of-the-art algorithmic and data curation approaches (Deep Learning TRD 2); and enable precise tissue sampling surgical navigation and in-vivo tissue response through the results of novel Intraoperative devices (Intraoperative devices for IGT: TRD 3). In order to effectively disseminate all this new knowledge we have 10 new collaborative and 10 new service projects and will share these novel tools through our established mechanisms, from current BTRC- National Center for Image Guided Therapy (NCIGT), which continues to be dedicated to the innovating for IGT into interventional radiology, surgery, radiation oncology, and procedure-based medicine.

Project Narrative The Advanced Technologies-National Center for Image guided Therapy (AT-NCIGT) is a research and technology center with the mission of advancing patient care, by developing novel innovative tools for image guided Therapy (IGT). The three technologies encompass Imaging Cancer Heterogeneity, Deep learning and Intraoperative devices for image guided therapy which will be investigated both individually and in cross TR &D combinations. We will disseminate all technologies through a national network of collaborators, making these discoveries available to the larger medical community.