CCIL members partner with research physicians to improve minimally invasive imaging for lung cancer treatment

Cancer Center at Illinois (CCIL) Program Leader Viktor Gruev and CCIL member Shuming Nie are leading a multi-institutional partnership to improve minimally invasive imaging technology for lung cancer treatment.

The implications of this new technology are significant as lung cancer is the leading cause of cancer death in the U.S. More people die of lung cancer than of colon, breast, and prostate cancers combined, according to the American Cancer Society.

For this project, Gruev and Nie, both Grainger College of Engineering professors, are collaborating with Phillip Low, a prominent tumor targeting probe researcher at Purdue University, Dr. Sunil Singhal, a renowned thoracic surgeon and research physician from University of Pennsylvania, and Johnson & Johnson. The team is working to enhance the Monarch™ intraoperative imaging system used in bronchoscopy to find small lung nodules. While impressive and currently useful in lung cancer surgical procedures, Monarch™ comes with a steep price tag, a hefty form factor, and limited imaging capabilities.

“The current Monarch bronchoscope uses a bulky optical stack—dual camera and a beamsplitter—that’s difficult to align, drifts over time, and limits near-infrared (NIR) fluorescence sensitivity. We saw an opportunity to replace it with our single-sensor, low-noise HDR imaging system to achieve smaller form factor, better mechanical stability, and much higher sensitivity for fluorescence-guided navigation, making Monarch more accessible, user-friendly, and effective at visualizing every cancer biomarker,” said Zhongmin Zhu, a doctoral student who has invested nearly a decade in the novel imaging technology emerging from Gruev’s lab.

“How can we make more sensitive cameras? What’s the smallest fluorescence signal we can detect? How can we optimize current surgical technology to be as minimally invasive as possible, while maximizing biomarker detection? And how can we serve both clinicians and patients with cancer in this effort?” These are questions guiding our research,” said Gruev. “Our collaboration with research physicians is critical in this endeavor. We come to the operating room to learn from physicians, and we also help open their imaginations to the possibilities inherent in the frontier innovations we are developing in our labs.”

Gruev and Nie have collaborated on numerous projects in the past, representing a dynamic “cancer engineering” duo whose bioinspired imaging technology is changing the cancer diagnostic and cancer treatment landscape.

“As engineers working within the Cancer Center at Illinois research ecosystem, we are able to build a bridge with industry partners like Johnson & Johnson and research physicians at a NCI-designated cancer center in a way that really pushes our tech forward to improve the lives of those living with lung cancer,” added Gruev.

At present, the research team’s new camera has improved Monarch’s imaging sensitivity by an order of magnitude—10 times what it was previously able to see. This means smaller tumors detected, which is significant for those living with lung cancer.

“This collaboration presented a unique attempt to bring true low-noise, high-dynamic-range RGB–NIR fluorescence imaging into a bronchoscope using a single sensor,” said Zhu. “We are enabling simultaneous detection of bright visible structure and extremely dim NIR tumor-targeted signal (indocyanine green down to picomolar range) without beamsplitters, misalignment, or separate cameras—something standard scopes simply cannot do.”

This project demonstrates how Gruev and Nie’s labs are also pushing the frontiers of integrating their advanced camera technology with robotics and AI for real-time data analysis and decision making. “By generating and processing massive multispectral imaging data on ‘edge’ computing devices in the operating room, our edge-AI approach minimizes latency, enhances privacy, and reduces dependence on centralized cloud computation, all of which are critical for time-sensitive and data intensive procedures such as robotic-asissted bronchoscopy and image-guided cancer surgery,” said Nie.

The collaborative research team first employed canine trials on companion animals at Penn’s Abramson Cancer Center and are now engaged in human trials at the same location, guided by Dr. Singhal. “This is a mutually beneficial collaboration. We are helping physicians improve their treatment of cancer, and they are helping us focus our research efforts,” added Gruev.

“Our hope is to visualize margins, lymphatic paths, or suspicious lesions with higher sensitivity and stability inside the lung, physicians get earlier detection, better navigation, and more confident biopsies. That translates to fewer missed lesions, fewer repeat procedures, and more accurate staging—especially for small or hard-to-reach nodules.,” said Zhu, who has made frequent research visits to Penn’s operating room to help optimize their lab’s new tech.

As the collaboration moves forward, Gruev and Nie’s team envisons an imaging system with complete mechanical and optical integration—a system that can characterize, inside the bronchoscope channel, the smallest tumor size or concentration of biomarkers reliably distinguished from background noise or normal tissue. They aim to ensure the system can validate dynamic range of light under clinical illumination and also be capable of running benchtop and ex-vivo studies on patient tissue.

“Ultimately, our goal is a deployable integrated module that Johnson & Johnson can take into pre-clinical and clinical evaluation: a smaller, more robust bronchoscope with built-in fluorescence guidance for early lung-cancer detection,” said Zhu.

Editor’s notes:

Viktor Gruev is Co-Leader of the Cancer Technology and Data Science Program at the Cancer Center at Illinois and Dunning Endowed Faculty Scholar and Professor in the Department of Electrical & Computer Engineering. Gruev is also an affiliate of the Beckman Institute. To reach him, email vgruev@illinois.edu.

Shuming Nie is W. W. Grainger Chair and Professor in the Department of Bioengineering, and is an affiliate of the Beckman Institute, Micro/Nanotechnology Lab, and the Carl R. Woese Institute for Genomic Biology. To reach him, email nies@illinois.edu.

This research was supported by merit-based funding from the National Cancer Institute.

This story was written by Jonathan King, CCIL Communications Specialist.