Device helps surgeons see cancer cells during operations

Device helps surgeons see canc...
MD Julie Margenthaler wears the eyepiece during cancer surgery
MD Julie Margenthaler wears the eyepiece during cancer surgery
View 1 Image
MD Julie Margenthaler wears the eyepiece during cancer surgery
MD Julie Margenthaler wears the eyepiece during cancer surgery

When doctors are operating on a patient to remove a cancer, they face a major challenge: telling healthy and cancerous cells apart. But a new, as yet unnamed device being developed by researchers at Washington University in St. Louis' School of Medicine could provide a safe, affordable and portable solution.

The team's goggle-based device allows the surgeon to see the cancer cells, glowing blue. Tests have shown it could make visible tumors as small as 1 mm in diameter. To make the cells appear blue, the FDA-approved contrast agent indozyanine is injected into the tumor.

The compact system is battery-operated, wireless, wearable and most importantly, hands-free. A night vision viewer from which it was developed was retrofitted to provide near-infrared excitation and white light illumination simultaneously. The visual data captured by near-infrared (NIR) fluorescence is displayed directly on the eyepiece with adjustable amplification.

The wireless capability, adapted from a battery-operated radio frequency video transmitter, allows the system to transfer real-time video to a remote site, where the wearer's view can be displayed graphically. This enables a remote expert to observe what is happening during the operation from the point of view of the local surgeon, and provide expert feedback and image analysis. This way the system could be applied to point-of-care medical interventions, help generate real-time pathologic assessment of tissues, and even allow for remote medical consulting.

The new eyepiece could represent an improvement on current methods of intra-operative imaging. These are usually expensive, logistically complex, time-consuming and at times risky, as in cases when radioactive tracers are needed. These emit hazardous ionizing radiation to both patients and surgeons. The blue dyes used for visualizing sentinel lymph nodes with the naked eye, for example, can also cause adverse reactions.

The technology has been developed by a team led by Samuel Achilefu, a PhD professor of radiology and biomedical engineering at Washington University in St. Louis. Earlier in February, breast surgeon Julie Margenthaler, an associate professor of surgery at the university, performed a surgery wearing the glasses. “Imagine what it would mean if these glasses eliminated the need for follow-up surgery and the associated pain, inconvenience and anxiety," she said in a press statement.

Currently, surgeons usually remove the tumor and some neighboring tissue that may not include cancer cells. Once analyzed, and if cancer cells are found in the sample, then a second surgery is recommended to remove additional tissue that once again will be tested for cancer. In cases of breast cancer patients, between 20 and 25 percent of those who have lumps removed require a second surgery.

An article with details on the technology behind the device appeared in a recent edition of the Journal of Biomedical Optics.

Source: Washington University in St. Louis

Joel Detrow
Fantastic advancement!
This may be the same system that was described and demonstrated in a TED talk by its inventor, a pretty Asian-American medical doctor whose name I can't recall. Does anyone have the link?
I must deduct that the indozyanine only attaches to caner cells, and not "clean" cells? Can the same be introduced into the body, and scanned in some way (external scans) that would locate and identify cancers cells in a body? If that could be done, and systems designed in a way that would be portable and somehow relatively inexpensive, we will have a "star trek" type device that any doctor could easily and cheaply use to detect cancers in our bodies…. (You know, like "Doc" scanning someone with a hand-held device and making the diagnosis….)
COOL STUFF! (either way)
Paul Stregevsky, it was Quyen T. Nguyen, M.D., Professor of Surgery at UCSD. Here's the link:
Nice detective work, Takis; thanks!