Five New Grants Awarded in ACROBATIC’s August 2025 Call

In the most recent funding round with a deadline on 22 August 2025, ACROBATIC received a total of nine applications.
Following a competitive evaluation process, five new grants have been awarded to research projects that will advance knowledge and innovation in cancer surgery and related fields.

Below is an overview of the grantees and their projects:

WP 2.18
Principal Investigator: Trine Tramm, Department of Pathology, Aarhus University Hospital, and Department of Clinical Medicine, Aarhus University, Denmark
Grant awarded to: Postdoctoral Researcher Danny Mortensen
Title: Towards preventing reoperations in breast cancer patients with intraoperative surgical margin assessment using spectral microCT

Abstract:
Introduction
In Denmark, 18% of patients undergoing breast-conserving surgery (BCS) for breast cancer require reoperation due to inadequate surgical margins. This need is determined after microscopic examination at the Department of Pathology, which takes several days. Ideally, the evaluation should occur during surgery to allow immediate removal of additional tissue when needed.
Spectral microCT is a novel imaging technique utilising the energy-dependent absorption of X-rays, which may improve intraoperative margin evaluation and reduce reoperation rates.
Materials and methods
A prospective cohort (n = 200) undergoing BCS is currently being scanned perioperatively with spectral microCT and subsequently processed at Pathology. The extent of breast cancer, precursor lesions, and normal glandular tissue will be annotated on digitised histology slides and transferred to the imaging data. This dataset will be used to develop an artificial intelligence (AI)-based classification model for tumour detection from spectral microCT images, trained using histology. The trained model will be validated in a prospective cohort (n = 160), where its performance in delineating tumour and determining margin distance will be compared to final pathology assessment.
Results
Patient enrolment started 01.02.2025. Currently, 62 patient specimens have been scanned, and registration of the histological data onto the images is ongoing. Development of the AI tool requires assistance of a postdoc with AI and deep learning experience.
Conclusion
This study will provide clinically relevant insight into the performance of spectral microCT for intraoperative surgical margin assessment for breast cancer patients, a tool that may reduce the number of reoperations.

WP 2.22
Principal Investigator: Tine Engberg Damsgaard, Department of Plastic Surgery, University Hospital of Southern Denmark (SLB-Vejle) and Odense University Hospital
Grant awarded to: One-year PhD fellowship from the Department of Clinical Research, University of Southern Denmark to PhD student Ida Bjørnsted Dengsø
Title: ICG-SENSI-Breast: Quantifying Perfusion and Predicting Sensation Towards Functional Excellence in Breast Reconstruction

Abstract:
Breast reconstructive surgery is an integral component of today’s breast cancer treatment. Postoperative complications related to inadequate tissue perfusion are a key limitation, with implications to both oncological treatment pathways and long-term functional outcomes. Similarly, breast sensation is often significantly reduced or absent after reconstructive surgery, with consequences for psychosocial well-being.
This project, ICG-SENSI-Breast, addresses these challenges through two interrelated work packages (WP). The first aims to establish validated perfusion thresholds for Indocyanine Green Angiography (ICG-A) systems currently in clinical use. A standardized, quantitative assessment of tissue viability is expected to reduce postoperative complications such as tissue necrosis and thereby avoid delays in adjuvant therapy.
The second investigates determinants of sensory recovery, including tissue flap thickness and tissue perfusion, and examines their relationship with patient-reported outcomes.
A prospective cohort of 300–400 patients undergoing breast reconstruction or oncoplastic breast-conserving surgery will be enrolled across two high-volume centers. Perfusion data will be systematically linked to both short-term surgical complications (WP1) and long-term sensory outcomes (WP2), thereby providing a comprehensive understanding of factors influencing reconstructive success.
By integrating clinical, functional, and patient-reported data within a single cohort, ICG-SENSI-Breast will generate evidence to guide surgical decision-making, reduce complication rates, and enhance sensory recovery. The findings will directly inform national breast reconstruction practice and provide the foundation for subsequent interventional studies on neurotization aiming to enhance sensory recovery.

WP 2.28
Principal Investigator: Charles Vesteghem, Center for Clinical Data Science (CLINDA), Aalborg University & Aalborg University Hospital, and Clinical Cancer Research Centre, Aalborg University Hospital, Denmark
Grant awarded to: Postdoctoral Researcher Signe Bjerregaard Michelsen
Title: Solid Tumour Resectability and Operability Decision Support Using Multimodal AI (STROMA)

Abstract:
Complete surgical resection (R0) is crucial for improving survival and quality of life in patients with malignant solid tumours. However, preoperative assessment of resectability and operability remains challenging, despite advances in imaging and multidisciplinary team (MDT) evaluation. Incomplete resections significantly increase recurrence risk, while inaccurate operability assessments may deny patients curative treatment or expose them to surgical risk.
This project aims to develop and evaluate artificial intelligence (AI)-based decision-support tools combining imaging and electronic health registry data to improve preoperative prediction of resectability and operability in cancer patients. The primary objective is an AI model for colorectal cancer resectability using retrospective data. Secondary aims include assessing operability in colorectal cancer and extending models to ovarian cancer, sarcoma, breast cancer, and bladder cancer, with the goal of a generic predictive framework for solid tumours as well as conducting a prospective validation.
The study will use multimodal AI methods integrating structured data (e.g., laboratory results, comorbidities), unstructured data (clinical notes, reports), and imaging (CT, MRI, PET, ultrasound). Development will proceed from regional pilot cohorts to national datasets, applying transfer learning for cross-cancer applicability. Data will be processed within secure high-performance computing environments, with prospective validation planned in a randomised clinical design.
Leveraging Denmark’s comprehensive, population-wide health data, the project strives to enhance MDT decision-making, reduce unnecessary surgeries, improve surgical margins, and ultimately optimise patient outcomes. Successful implementation may support regulatory approval and provide a transferable methodology for AI-based surgical decision support across multiple cancer types.

WP 2.29
Principal Investigator: Pernille Tine Jensen, Aarhus University & Aarhus University Hospital, Department of Gynaecology and Obstetrics, Denmark
Grant awarded to: One-year PhD fellowship from the Department of Clinical Medicine, Aarhus University to PhD student Mette-Julie Töffner Rasmussen
Title: A National Randomized Controlled Trial Investigating the Impact of Mobilization Restrictions on Wound Complications and Quality of Life Following Vulvar Cancer Surgery – DaVulvaMob

Abstract:
Background: The standard treatment of vulvar cancer (VC) is up-front surgery with or without flap reconstruction and inguinofemoral lymph node dissection. Surgical treatment is associated with a high rate of postoperative morbidity; particularly surgical wound complications (SWCs). Current postoperative recommendations include restricted mobilization. However, immobilization entails risk of SWCs, thromboembolism, infection, and muscle atrophy. There is no evidence supporting restricted mobilization compared to early mobilization; in contrast, early mobilization is in general recommended after surgery according to Enhanced Recovery after Surgery (ERAS) programs.
Aim: This study, DaVulvaMob, evaluates the effect of non-restricted vs restricted mobilization on postoperative SWCs, severe complications, and quality of life following surgery for VC.
Methods: This is a randomised controlled non-inferiority trial. Women undergoing up-front surgery for VC (primary or relapse) are eligible. The women are randomly assigned to either group: unrestricted mobilization (intervention) vs restricted mobilization according to guidelines (standard). The primary endpoint is SWCs as assessed by a validated wound assessment tool. The study is a national multicentre study and includes patients from all regions of Denmark in close collaboration with home care services. A power calculation demands 95 patients in each group to show non-inferiority with a margin of 20%, a level of significance of 5% and power of 80%, and a drop-out rate of 20%.
Perspectives: DaVulvaMob contributes to the development of evidence-based recommendations for postoperative mobilization in VC patients. It contributes to the future transformation of the Danish healthcare system and results are expected to change clinical practice.

WP 3.10
Principal Investigator: Ninna Aggerholm Pedersen, Department of Oncology, Aarhus University Hospital, and Department of Clinical Medicine, Aarhus University, Denmark
Grant awarded to: PhD student Joanna Vitfell-Rasmussen
Title: A National Prospective Observational Study of Circulating Tumour DNA, Exosomes and Quality of Life in Sarcomas

Abstract:
Background: Currently, no validated biomarker exists for detecting relapse or disease progression in patients with sarcoma. Although circulating tumour DNA (ctDNA) has shown promise, large-scale prospective studies are lacking. The CIRQUESARC study is a national, prospective biomarker study evaluating the association between plasma ctDNA and disease progression or relapse in patients with sarcoma.
Aim: To determine whether plasma ctDNA is associated with disease progression, increased risk of relapse, or overall survival in patients with sarcoma.
Methods: Patients were enrolled into three distinct cohorts—study 1, study 2, and a pilot study—from the Departments of Oncology at Herlev and Aarhus University Hospitals, and the Departments of Orthopaedics at Rigshospitalet and Aarhus University Hospital. Recruitment began in June 2022 and concluded in March 2025. Tumour tissue and plasma samples are still being collected. DNA sequencing is performed using the TruSight Oncology 500 (TSO500) ctDNA assay from Illumina, applied to both tumour tissue and plasma samples, in conjunction with digital droplet PCR (ddPCR).
Preliminary Results: Study 1 has enrolled 55 patients undergoing first-line doxorubicin-based chemotherapy. Study 2 has enrolled 30 patients scheduled for radical surgery and the pilot study has enrolled 20 patients with metastatic sarcoma and known mutations or translocations. Plasma ctDNA has so far been detected in approximately 70% of patients across all cohorts and in 92% of those with progressive disease.
Conclusion: Plasma ctDNA is detectable in patients with sarcoma using the TSO500 ctDNA assay and ddPCR, supporting its potential as a biomarker for disease monitoring.

ACROBATIC congratulates all recipients of this funding round and looks forward to following the progress and impact of these important research projects.