Light-guided cancer surgery has been in development for some time with varying degrees of success, from light therapy to glow-in-the-dark tumors and the development of compounds that can illuminate tumors.
Now, scientists are confident they’ve developed a new technique of molecular imaging that sees tumors lit by short-wave infrared light in such detail that surgeons can differentiate between the cancerous tumor and healthy tissue.
Researchers at the Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS) at University College London and surgeons at Great Ormond Street Hospital (GOSH) have developed a technique that sees chemicals injected during an operation that act like probes and attach to cancer cells. When they’re attached, they light up through fluorescence, which also lights up the tumor. In the study’s mice models, it revealed part of a tumor that hadn’t been removed during normal surgery.
The team has focused this technique on battling neuroblastoma, which is the most common type of solid tumor cancer in children, after brain tumors. Traditionally, treatment involves surgery to remove the malignant growth, but surrounding healthy tissue can be easily damaged in the process.
“Surgery to remove neuroblastoma requires a delicate balance,” said team leader Dr Stefano Giuliani, consultant pediatric surgeon at Great Ormond Street Hospital and associate professor at UCL. “Remove too little and the tumor might grow back, but remove too much and the surgeon risks damaging the surrounding blood vessels, nerves and other healthy organs. This technique effectively lights up the tumor, allowing surgeons to remove it with unprecedented precision. We hope to be able to translate this innovative technology into clinical practice at GOSH as soon as possible to benefit the largest number of children with cancerous tumors.”
The team used short-wave infrared (SWIR) light, which is invisible to the naked eye but has a longer wavelength than visible light, and it can penetrate deeper into tissue for more detailed imaging.
“This work shows that SWIR imaging, a technology first used for material inspection, can enhance the surgeon’s vision beyond the capabilities of the human eye, allowing more precise tumor surgery,” said Dr Dale Waterhouse from WEISS.
The development promises to deliver much better surgery outcomes for children with neuroblastoma, which accounts for up to 10% of all childhood cancers and 15% of childhood deaths from cancer. Around a third of patients have already had the tumors spread by the time of diagnosis. The team hopes this technique will help locate all the cancerous tumors present.
“Pediatric surgical oncology faces an ever-increasing need for novel technologies and devices that can help visualize tumors intraoperatively,” said Dr Laura Privitera, GOSH. “By using targeted fluorescence-guided surgery, we demonstrate the possibility of safely and specifically delineating tumor margins, allowing its differentiation from surrounding healthy tissue. Fluorescence-guided surgery is a game-changing innovation that will help surgeons to obtain safer and more complete resection.”
While the clinical trial featured mice models, the team is confident of rolling out the technology for pediatric surgery within the year.
The study was published in the journal Cancer Research.
Source: University College London via EurekAlert
