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Murali RaviMedical Instrumentation
Clinically validated2017-2023

Dual-Modality Intraoperative Cancer Navigation

A first-of-its-kind handheld probe that lets a surgeon confirm cancer while the patient is still on the table.

A surgeon removing a tumour has historically had to wait three to four days for histopathology to confirm whether the margin was clean. SAIGC-Torch collapses that wait to the length of the operation. It combines indocyanine green fluorescence with Technetium-99m gamma detection in a single completely handheld device: fluorescence to see the margin, gamma to find the sentinel node.

0%

successful detection in oral, throat and breast cancer trials

ICG fluorescence excitation
780 nm
Technetium-99m gamma detection
140 keV
Wait for validation (was 3-4)
0 days
Histopathology correlation
100%
SURGICAL FIELDTUMOUR MARGINSENTINEL NODEOPTICAL780 nmGAMMA140 keVSAIGC-TORCHICG FLUORESCENCEWhere does the tumour end?⁹⁹ᵐTc GAMMAWhere has it spread?COMPLEMENTARY, NOT REDUNDANT: FLUORESCENCE READS THE VISIBLE SURFACE MARGIN; GAMMA REACHES DEPTH AND METABOLIC ACTIVITY.CHANNEL 01: OPTICALIndocyanine GreenExcited at 780 nm · high sensitivityCHANNEL 02: NUCLEARTechnetium-99m140 keV · nodal & metabolic

Summary

What the work set out to do, and the reasoning that shaped it.

SAIGC-Torch is a first-of-its-kind, completely handheld navigational probe designed to assist surgeons in the real-time identification of cancerous tissues during surgery. Developed indigenously, it provides a combined-modality approach by integrating fluorescence and gamma imaging for superior surgical validation.

The two modalities answer different questions. Indocyanine green fluorescence, excited at 780 nm, allows surgeons to visualise tumour margins with high sensitivity: where does the tumour end. Gamma imaging, detecting Technetium-99m at 140 keV, localises sentinel nodes and monitors metabolic tumour activity: where has it gone.

Every component: the shielding technology, the scintillators, and the AI-driven detection software: was developed at the Sri Sathya Sai Institute of Higher Learning.

Impact

What changed as a result.

01

In trials involving oral, throat and breast cancer, the device achieved 100% successful detection, correlating perfectly with gold-standard histopathology results.

02

Unlike bulky large field-of-view cameras, SAIGC-Torch is portable and provides live validation within the operating theatre: eliminating the three-to-four-day wait typical of traditional reports.

03

The device represents a fully indigenous capability: shielding, scintillators and detection software all developed in-house.

Figures

The work, drawn.

Purpose-built diagrams: each one carries an idea that prose alone would take a page to deliver.

SURGICAL FIELDTUMOUR MARGINSENTINEL NODEOPTICAL780 nmGAMMA140 keVSAIGC-TORCHICG FLUORESCENCEWhere does the tumour end?⁹⁹ᵐTc GAMMAWhere has it spread?COMPLEMENTARY, NOT REDUNDANT: FLUORESCENCE READS THE VISIBLE SURFACE MARGIN; GAMMA REACHES DEPTH AND METABOLIC ACTIVITY.CHANNEL 01: OPTICALIndocyanine GreenExcited at 780 nm · high sensitivityCHANNEL 02: NUCLEARTechnetium-99m140 keV · nodal & metabolic
01

Two channels, one probe

ICG fluorescence at 780 nm delineates the margin; ⁹⁹ᵐTc gamma at 140 keV finds the node. Neither modality alone is sufficient.

OPTICALGAMMAINDIGENOUS SHIELDINGDetector apertureDual-channel entrance windowSingle-hand operationThe constraint that drives every other decisionDEVELOPED IN-HOUSE AT SSSIHLShielding technologyScintillatorsAI-driven detection softwareCLINICAL APPLICATIONSentinel Lymph NodeNavigation SurgeryDAE-BRNS · 2017-2023
02

Handheld form factor

Completely handheld: the constraint that determines every other design decision in the instrument.

CONVENTIONAL PATHWAYExcisionDay 0Specimen sentDay 0HistopathologyDay 1-3Report returnsDay 3-4Re-operate?If margin +3-4 DAY WAITWITH SAIGC-TORCHICG + ⁹⁹ᵐTc administeredPre-opProbe scan in theatreIntra-opLive validationSecondsMargin confirmedSame procedureDECISION MADE DURING SURGERYThe surgeon stops guessing and starts confirming.LIVE VALIDATION INSIDE THE OPERATING THEATRE REPLACES THE POST-OPERATIVE REPORT CYCLE.
03

Intraoperative workflow

Live validation inside the theatre replaces the three-to-four-day histopathology wait with a decision made during the procedure.

TRIAL OUTCOMES: DETECTION VERSUS GOLD-STANDARD HISTOPATHOLOGYTRIAL 01OralCANCER100%SUCCESSFUL DETECTIONTRIAL 02ThroatCANCER100%SUCCESSFUL DETECTIONTRIAL 03BreastCANCER100%SUCCESSFUL DETECTIONCORRELATIONPerfect agreement with gold-standard histopathology results.The benchmark that separates a research instrument from a clinical one.
04

Trial outcomes

Oral, throat and breast cancer trials: 100% successful detection, correlated against gold-standard histopathology.

Methods

How it was done.

Fluorescence channel

Indocyanine green (ICG) excited at 780 nm provides high-sensitivity visualisation of tumour margins in the surgical field.

Gamma channel

Technetium-99m detection at 140 keV localises sentinel nodes and monitors metabolic tumour activity, giving depth information that optical methods cannot reach.

Combined-modality validation

The two channels are complementary rather than redundant: fluorescence delineates the visible margin, gamma confirms nodal involvement. Agreement between them is what produces surgical confidence in real time.

Indigenous shielding and detection

Shielding technology, scintillators and AI-driven detection software were all developed at SSSIHL rather than sourced: a requirement for both cost control and design freedom.

Specifications

The numbers.

Modalities
Fluorescence + GammaCombined in one handheld probe
Fluorescence agent
Indocyanine Green (ICG)
Excitation wavelength
780 nm
Radioisotope
Technetium-99m (⁹⁹ᵐTc)
Gamma energy
140 keV
Form factor
Completely handheld
Clinical application
Sentinel Lymph Node Navigation Surgery
Cancers trialled
Oral, throat, breast

Development timeline

From simulation to the clinic.

2017

Project sanctioned

DAE-BRNS awards ₹108 Lakhs for the design and development of a gamma-fluorescence dual imaging intraoperative probe. Dr. Ravi serves as Principal Investigator.

Design

Dual-channel architecture

Optical excitation and emission path for ICG at 780 nm integrated alongside a gamma detection channel tuned to 140 keV, within a single handheld envelope.

Build

Indigenous component development

Shielding technology, scintillators and AI-driven detection software developed in-house at SSSIHL.

Trial

Clinical validation

Trials in oral, throat and breast cancer. 100% successful detection, correlating with gold-standard histopathology.

2023

Project completion

Six-year programme concludes with a portable probe delivering live validation inside the operating theatre.

Outcomes

  • A first-of-its-kind completely handheld dual-modality navigational probe
  • 100% successful detection in oral, throat and breast cancer trials
  • Perfect correlation with gold-standard histopathology
  • Elimination of the 3-4 day wait for traditional reports
  • Fully indigenous shielding, scintillator and detection software stack

Collaborators & support

  • Sri Sathya Sai Institute of Higher Learning
  • DAE-BRNS (Board of Research in Nuclear Sciences)

Funded under

DAE-BRNS · INR 108 Lakhs

2017-2023 · Principal Investigator