Bringing fluorescence imaging out of the dark

It’s not often that a new surgical imaging technology is inspired by pure darkness.

That is one way of looking at the origins of OnLume, a Morgridge Institute spinoff company that is working to bring a new generation of fluorescence image-guided surgery to hospitals everywhere.

Because fluorescence imaging is extremely sensitive to ambient light, physicians currently cannot use it on patients in real time during surgery without hurting the quality of the image. They have to interrupt the procedure and turn out the lights to see the fluorescent agents — which are critical tools for illuminating nerves and veins, and defining the precise location of diseased tissues.

OnLume has developed a novel system that removes the ambient light from the fluorescence guided procedure, all while the operating room environment remains bathed in light.  The company had a banner year in 2020, when it received Food and Drug Administration (FDA) approval, met its venture funding goals and launched its first clinical trial with a California company. And they are working closely with UW Health physicians to get expert feedback and data on the device.

“The surgeon response has been very positive,” says Adam Uselmann, co-founder and Chief Technology Officer of OnLume. “Especially with folks who are using competing technology that requires a darkened operating room, there’s definitely been a kind of ‘ah-ha’ moment, where the light bulb goes on. It’s been great to see.”

Adam Uselmann
Adam Uselmann

After Uselmann completed his medical physics PhD in early 2015, he co-founded OnLume with colleagues at Morgridge’s medical engineering lab, at the time directed by his adviser Thomas “Rock” Mackie. Uselmann landed a postdoctoral position at Morgridge in 2015 and began developing non-surgical applications of the technology in earnest. On nights and weekends, he worked on the OnLume business plan and other company details.

The technology had a broad range of Morgridge involvement, including co-inventors Mackie, Fab Lab Director Kevin Eliceiri, and scientist Andreas Velten. Morgridge also was a key collaborator on the company’s first Small Business Innovation Research (SBIR) grant in 2016.

“Working at Morgridge was very instrumental, not only in having the intersection of expertise and ideas, but the resources to prototype it and make it happen, and then also be able to file our IP with WARF,” Uselmann says.

“We coordinated with the Fab Lab on some of the first embodiments to demonstrate proof-of-concept for a WARF IP filing. We actually modified a vintage desk lamp with a 3D-printed assembly of LEDs that incorporated our transient lighting IP,” he adds. “We were able to demonstrate we could pick up fluorescence signals without loss of image quality, while still illuminating the scene brightly.”

Adds Fab Lab Director Kevin Eliceiri: “Seeing the evolution of OnLume has been very gratifying, not only in terms of its significant potential for surgical impact but also seeing the great talent that has driven this company. One of the great deliverables of the Morgridge mission is our talented trainees and seeing what they do is inspiring to all of us. I’m very excited for the future of Adam and OnLume. I believe fluorescence guided surgery has a bright future and OnLume is likely to be a significant player in this field.”

The company’s first clinical trial is with Alume Biosciences in San Diego, which develops technology to help protect nerves during head and neck surgeries. The company is also exploring applications in reconstructive surgery and will be pursuing the rapidly emerging field of fluorescence guided surgery for cancer.

“Our goal this year is getting the technology into the hands of as many surgeons as possible.”

Adam Uselmann

In cancer surgery, for example, physicians would be able to see the boundaries of residual cancer in real time, as they are resecting the cancer tissue. And with head and neck surgeries, “the goal is to literally light up those nerves so surgeons can avoid damaging sensitive tissues.”

“There are dozens of fluorescent agents currently in different stages of clinical trials,” Uselmann says. “The opportunities in this space will be really huge moving forward. It’s only the tip of the iceberg in terms of what will come as more cancer agents get approved by the FDA.”

The company has eight employees and are actively expanding in 2021. OnLume has two manufacturing partners with home bases in Wisconsin. “Our goal this year is getting the technology into the hands of as many surgeons as possible,” Uselmann says.

As a medical physics student, Uselmann was far removed from the fundamentals of starting and running a company. So in 2014 he enrolled in the UW–Madison business school’s Morgridge Entrepreneurial Bootcamp, launched by John Morgridge. The course set him on a path to where he is today.

“I recommend it to every graduate student I can because it was just a really transformative experience. It’s probably unlikely OnLume would have started the way it did without having gone through that experience.”