A new technique that combines highly detailed, real-time images of the inside of the body with infrared light has been used for the first time during surgery to differentiate between cancerous growths and healthy tissue.
The groundbreaking technique, demonstrated in mice, was developed by engineers at University College London’s Surgical WEISS center and surgeons at Great Ormond Street Hospital (GOSH), the university said. in a press release.
Researchers say the development could have implications for the treatment of neuroblastoma, the most common form of childhood solid tumors aside from brain tumors. Standard treatment usually consists of surgery to completely remove the cancer cells, which are difficult to see because they resemble surrounding healthy tissue.
The method
During the surgery, the UCL and GOSH scientists used a technique called “molecular imaging,” which involves injecting chemicals into the bloodstream that act as imaging probes. These chemicals are attracted to cancer cells in the body, and once attached, the probes light up through a process called “fluorescence,” which in turn causes the tumor to light up. The technique, used in preclinical testing in mice, successfully revealed part of a tumor that had not been removed during surgery.
Next, the team wanted to test whether they could improve the visual quality of the images by using a “new” type of light, short wave infrared light (SWIR), which has only recently become accessible to scientists thanks to new technology.
To do this, they used a special high-definition camera to capture SWIR fluorescence. SWIR is invisible to the naked eye and has a longer wavelength than visible light, allowing it to penetrate deeper into tissue and produce sharper, more detailed images. Using this technique, the surgeons were able to distinguish between cancerous growths and healthy tissue during preclinical testing.
Better treatment
Neuroblastoma is an aggressive childhood cancer and is responsible for about 15 percent of childhood cancer deaths. In about a third of patients, the cancer has already spread to other parts of the body at the time of diagnosis, making it more difficult to treat.
Team leader Dr. Stefano Giuliani, pediatric surgeon at Great Ormond Street Hospital: “Surgery to remove neuroblastoma requires a delicate balance. Remove too little and the tumor may grow back, but remove too much and the surgeon risks damaging surrounding blood vessels, nerves and other healthy organs. The technique effectively illuminates the tumor, allowing surgeons to remove it with unprecedented precision. We hope to be able to apply this innovative technology in GOSH clinical practice as soon as possible, so that as many children as possible with a cancerous tumor can benefit from it.”
Unlike X-rays or magnetic resonance imaging (MRI), which focus on organs and bones, molecular imaging produces detailed pictures of biological processes and can be performed live during surgery, meaning clinical teams don’t have to wait for biopsy results. or culture results in disease screening.
New technologies needed
Dr. Laura Privitera from UCL: “Pediatric surgical oncology is facing an increasing need for new technologies and devices that can help visualize tumors intraoperatively. By using targeted fluorescence-guided surgery, we demonstrate the ability to safely and specifically delineate tumor margins so that they can be distinguished from surrounding healthy tissue. Fluorescence-guided surgery is a breakthrough innovation that will help surgeons perform safer and more complete resections.” Scientists from GOSH and UCL WEISS are now working to accelerate the technology’s introduction into GOSH’s operating room for the benefit of children with cancerous tumors over the next 12 months.