Metalens stereoscopic optical palpation for imaging cancer mechanics

Abstract

Accurate intraoperative margin assessment is critical for complete resection of solid tumours. However, surgeons routinely rely on manual palpation, which is highly subjective and fundamentally limited by poor spatial resolution, and pre-operative imaging lacks real-time feedback. While emerging optical elastography techniques offer quantitative mechanical contrast, their reliance on bulky optical components necessitates cumbersome alignment and hinders integration into miniaturised surgical instruments. Here, we report metalens stereoscopic optical palpation (MSOP), a nanophotonic imaging platform leveraging a binocular metalens integrated with a single CMOS sensor to achieve high-fidelity, self-aligned elastography. By replacing complex bulk optics with a compact stereoscopic architecture, MSOP enables robust, high-contrast mapping of tissue surface stress. Following validation in heterogeneous silicone phantoms, we demonstrate MSOP's translational potential by characterising the mechanical signatures of malignancies in fresh mouse pancreatic cancer models, as well as excised human breast and liver specimens. By providing reliable, label-free mechanical contrast across diverse oncological landscapes, MSOP offers a compact tool for precise intraoperative margin delineation to reduce re-excision rates and improve surgical outcomes.