Clinical Study Shows Fluorescent Dye Can Localize Tumors During Surgery in Real-time
An experimental cancer imaging tool that makes tumors glow brightly during surgery has shown promise again in a new Penn Medicine clinical study, this time in patients with brain cancer. The fluorescent dye technique, originally developed by surgeons at the Penn Center for Precision Surgery to treat lung cancer, illuminated brain tumors in real-time during surgery, helping physicians distinguish between healthy and cancerous tissue. Each year, over 15,000 people in the United States undergo surgeries to remove brain tumors.
Findings from the pilot study, led by first author John Y.K. Lee, MD, MSCE, an associate professor of Neurosurgery in the Perelman School of Medicine at the University of Pennsylvania, and co-director of the Center for Precision Surgery, were reported in this week in Neurosurgery.
A big challenge with brain surgery is ensuring the entire tumor is removed. It is difficult to identify the margins of the tumor with current approaches. Cancer tissue not visible to the naked eye or felt by fingers is often missed during tumor removal, leading to recurrence in some patients – about 20 to 50 percent.
Penn’s approach, which relies on an injectable dye that accumulates in cancerous tissues more so than normal tissues, may help change that.
“Fluorescent contrast agents take visualization to a whole new level,” Lee said. “It has the potential for real-time imaging, identification of disease, and most importantly, precise detection of the tumor’s margins. With this, we know better where to cut.”
The study also includes co-author, Sunil Singhal, MD, an associate professor of Surgery, and co-director the Center for Precision Surgery at Penn’s Abramson Cancer Center, who first started work on this approach in his lab nearly 10 years ago.
The technique uses near-infrared, or NIR, imaging and the contrasting agent indocyanine green (ICG), which fluoresces a bright green under NIR light. ICG was developed during World War II as a dye in photography and, in 1958, it was approved by the U.S. Food and Drug Administration (FDA) for use in medicine, primarily in liver diagnostics and later in cardiology.
However, for this study, researchers used a modified version of ICG at a higher concentration delivered intravenously about 24 hours before surgery to ensure margins were included. This is the first time, to the authors knowledge, that this delayed imaging of ICG has been used to visualize brain tumors.
Patients enrolled in the clinical study were between the ages of 20 and 81 with a diagnosis of a solitary brain tumor and a presumed glioma based on imaging or prior surgery or biopsy.
Twelve of the 15 tumors demonstrated strong intraoperative fluorescence. The lack of glow in the three remaining tumors could potentially be due to their disease grade and timing of the injection, the authors suggested.
Eight of the 15 patients demonstrated a visible glow through the dura, a thick membrane on the meninges of the brain, was opened, demonstrating the technology’s ability to see deeply within the brain before the tumor is exposed. Once opened, all tumors were picked up by NIR imaging.
The researchers also studied the surgical margins using neuropathology and magnetic resonance imaging, (MRI) to assess the accuracy and precision of NIR fluorescence in identifying tumor tissue.
Of the 71 specimens collected from MRI-enhanced tumors and their surgical margins, 61 (85.9 percent) fluoresced and 51 of these (71.8 percent) were classified as glioma tissue.
Of the 12 MRI-enhancing gliomas, four patients had biopsy specimens that were both non-fluorescent and negative for tumor, which matched the gross total resection seen on their MRI. In contrast, 8 patients had residual fluorescent signal in the resection cavity. Only 3 of these patients showed gross total resection on MRI. This suggests a benefit of true-negative NIR signal after resection, the authors said.
Over the past three plus years, Singhal, Lee, and their colleagues have performed more than 300 surgeries with the imaging tool in patients with various types of cancer, including lung, brain, bladder and breast.
“This technique, if approved by the FDA, may offer great promise to physicians and patients,” Singhal said. “It’s a strategy that could allow greater precision across many different cancer types, help with early detection, and hopefully better treatment success.”
Learn more: Glowing Tumors Help Penn Surgeons Cut Out Brain Cancer with Precision
The Latest on: Glowing Tumor Technology
[google_news title=”” keyword=”Glowing Tumor Technology” num_posts=”10″ blurb_length=”0″ show_thumb=”left”]
via Google News
The Latest on: Glowing Tumor Technology
- New views of esophagus cancer by MAGICon May 8, 2024 at 11:05 am
MAGIC was tested by imaging swine esophagus both ex vivo and in vivo. The dual-wavelength OCT system successfully revealed fine tissue microarchitecture as well as the deeper tissue details required ...
- Getting to know the enzymes behind cell communication—and tumor growthon May 8, 2024 at 9:10 am
In the human body, molecules known as kinases propagate signals within and between cells, relaying signals that allow cells to respond to changes in the environment. However, there are hundreds of ...
- AI-driven model identifies potent cancer-killing immune cells for personalized immunotherapyon May 7, 2024 at 9:46 pm
Using artificial intelligence, Ludwig Cancer Research scientists have developed a powerful predictive model for identifying the most potent cancer killing immune cells for use in cancer ...
- Researchers use foundation models to discover new cancer imaging biomarkerson May 7, 2024 at 1:25 pm
Researchers have harnessed the technology behind foundation models, which power tools like ChatGPT, to discover new cancer imaging biomarkers that could transform how patterns are identified from ...
- Scientists Reveal Cancer's Atomic Secrets—'Whole New Layer to Medicine'on May 7, 2024 at 5:44 am
By studying these ratios in yeast and mouse liver cells, the team found that cells that were growing extremely fast, similar to cancer cells, contained a noticeably higher ratio of hydrogen to ...
- Photocure: Bladder Cancer: Long-Term Benefits of Blue Light Cystoscopy and Enhanced Detection with HD Technology Unveiled at AUA 2024on May 7, 2024 at 12:29 am
Photocure ASA (OSE: PHO), the Bladder Cancer Company, announces its participation in the congress, and two abstract presentations at the AUA 2024: the ...
- MIT Technology Reviewon May 5, 2024 at 10:27 am
After years of lackluster results, cancer vaccines seem poised for success ... Plus a wild, weird history of brainwashing; designing cheese with AI; and glow-in-the dark petunias. Researchers are ...
- Researchers Track “Doubling” in Origin of Cancer Cellson May 2, 2024 at 5:00 pm
Subscribe to Technology Networks’ daily newsletter, delivering breaking science news straight to your inbox every day. Subscribe for FREE “An enduring question among scientists in the cancer field ...
- Cancer jab marks huge breakthrough in battle against deadly brain tumourson May 1, 2024 at 8:00 am
A new personalised cancer jab triggers a ‘fierce’ immune response to fight deadly brain tumours, say scientists. In world-first human trials, researchers revealed that their revolutionary mRNA cancer ...
via Bing News