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Abstract: During head and neck cancer surgery, surgeons cannot check in real time if they have removed all the cancerous tissue. Instead margins are evaluated through pathological assessment several days after surgery. Positive margins (PMs) occur in 1–44% (12.8% median) of all oral squamous cell carcinoma (OSCC) resections and significantly increase postoperative risk of local recurrence and mortality. Patients with PMs commonly undergo additional adjuvant treatments that are expensive and worsen morbidities. An intraoperative device that enhances surgical margin visualization has the potential to provide immediate impact to patient outcomes.

This thesis aims to develop and evaluate an impedance-based device to accurately distinguish OSCC from healthy tissue in the oral cavity. This work is divided into five main parts in pursuit of this goal:

1. the initial device design and benchtop validation was performed;
2. the initial device design was then deployed in a clinical study for in vivo validation of its performance characterizing oral cancer;
3. a full system to visualize areas of OSCC during intraoperative use will be created with improvements to the device design including better depth sensing and fusion with EM tracking;
4. this system will be validated through a preclinical murine study;
5. the commercialization path for the technology developed in the thesis is developed to translate the impedance system into the clinical.

Thesis Committee: Ryan Halter (Chair), Ethan Murphy (Co-Chair), Michael Kokko, Joseph Paydarfar, and Emily Porter (McGill University)