<strong>The bright points in the image of the brain scan are cancer cells detected using the probe; these cells are as far as one centimetre beyond what is detectable with MRI. Identifying and removing these residual cells will improve patient survival. </strong>
Leading engineers and brain cancer researchers in Montreal have teamed up to develop a unique cancer-detection tool that will improve the outcome of cancer patients undergoing brain cancer surgery – and that also has the potential to revolutionize the fight against all types of cancer.
One of the major problems surgeons face when performing surgery on patients suffering from brain cancer – particularly glioma, which makes up 80 per cent of primary brain cancers – is differentiating between healthy and diseased cells because both look virtually the same to the human eye, says Dr. Kevin Petrecca, chief of neurosurgery at the Montreal Neurological Institute and Hospital and co-senior author of a study published on the new technique in Science Translational Medicine.
The difficulty of distinguishing between good cells and bad is less relevant when operating on other types of cancers because surgeons are free to remove at least a bit of healthy tissue without compromising the host. However, in brain surgery, removing healthy tissue can have catastrophic consequences, including irreversible brain damage. Surgeons tend to err on the side of caution and remove as little tissue as possible, but that often leads to cancer cells remaining behind, which is frustrating for surgeons and potentially fatal for patients.
"Even when using state-of-the-art techniques we never remove enough, and the cancer invariably recurs right at the edge of where we were working," says Dr. Petrecca.
The new hand-held Raman spectroscopy probe will be a game changer for surgeons like Dr. Petrecca because it will allow them to distinguish between cells that should stay and those that have to go, all in real-time on a laptop while they are performing surgery. The probe works by directing laser light onto cells and then analyzing the light coming back through a spectrometer, explains Dr. Frédéric Leblond, professor in engineering physics at Polytechnique Montréal, and co-senior author of the study. "The remitted light provides a spectroscopic signal that can be interpreted to provide specific information about the molecular makeup of the interrogated tissue with an accuracy rate of 92 per cent," he says.
Although the probe was developed to help detect cancer in the brain, Dr. Petrecca says it can also be used to track down and remove cancers throughout the human body. "We've tested this on other types of cancers and have yet to find a situation where it does not work," he says. The probe is also expected to revolutionize screening techniques, leading to earlier detection and ultimately better outcomes for patients developing or suffering from cancer.
"Raman has the capacity to detect cancer in all different types of tissues and in all different kinds of backgrounds, and to do it quickly," says Dr. Petrecca. "Once these things become affordable we will be able to screen for cancers and develop responsive therapies at an earlier stage, thereby reducing suffering, improving outcomes and extending lives."
The Raman probe is a good example of what happens when engineers and medical researchers collaborate on finding solutions. The difficulty doctors have differentiating healthy brain cells from those afflicted by cancer was not solved until the engineers were invited to examine the problem.
"This really is the perfect example of collaborative translational medicine at work," says Dr. Petrecca. "There's no way I could have done this on my own, and there's no way the engineers could have done it on their own, but put the two together and you get a super interaction."
Dr. Leblond adds that an increasing number of engineers are looking to medicine as a specialty. "It's a trend that's been emerging over the past decade," he says. "It's not just important but essential that engineering and medicine are fully integrated, and the Raman probe is a good example of what can happen when they are."
"This really is the perfect example of collaborative translational medicine at work. There's no way I could have done this on my own, and there's no way the engineers could have done it on their own, but put the two together and you get a super interaction."
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