Nav: Home

Surgical probe seeks out where cancer ends and healthy tissue begins

September 16, 2015

CHAMPAIGN, Ill. - A new surgical tool that uses light to make sure surgeons removing cancerous tumors "got it all" was found to correlate well with traditional pathologists' diagnoses in a clinical study, showing that the tool could soon enable reliable, real-time guidance for surgeons.

The interdisciplinary research team led by Stephen Boppart, a University of Illinois professor of electrical and computer engineering and of bioengineering, performed the study on 35 patients with breast cancers at the Carle Foundation Hospital in Urbana, Illinois. The results appear in the journal Cancer Research.

One difficult but crucial determination for surgeons and tissue pathologists is figuring out where a tumor ends. A solid tumor may be easily identifiable, but the tissue around the main body of the tumor, known as the margin, may contain cancerous cells as well. Because of this, excess tissue surrounding the tumor is typically removed, but the question lingers of whether any cancer cells remain to re-emerge later as tumors.

"In almost all solid-tumor surgeries, there's a question of margins," said Dr. Boppart, who also is a medical doctor. "Typically, surgeons will remove the tissue mass that contains the tumor and will send it to the lab. The pathologist will process, section and stain the tissue, then examine the thin sections on microscope slides. They look at the structure of the cells and other features of the tissue. The diagnosis is made based on subjective interpretation and often other pathologists are consulted. This is what we call the gold standard for diagnosis."

The new device is a hand-held probe based on a technology called optical coherence tomography (OCT) that uses light to image tissue in real time. Cancer cells and normal tissue scatter light differently because they have different microstructural and molecular features, Boppart said, so OCT gives physicians a way to quantitatively measure the cellular feature of a tumor. Surgeons can pass the OCT wand over a section of tissue and see a video on a screen, with no special chemical stains or lengthy tissue processing required.

"In many cases, you can't tell the difference between cancer cells and normal tissue with the naked eye, but with OCT they're very different," said Boppart, who also is affiliated with the Beckman Institute for Advanced Science and Technology at the U. of I.

In the clinical study, surgeons treated patients according to the standard surgical procedure, but OCT data were collected from the margin of the tumor cavity and the margin of the removed tissue mass during surgery so that the results could be compared later. The study found that the OCT device analysis identified the differences between normal and cancerous tissue with 92 percent sensitivity and 92 percent specificity. They also found that the way that OCT spotted cancer in the removed tissue was closely correlated with the results from the postoperative pathology reports, which often came days later.

"For the first time, this study demonstrates the use of OCT for imaging tumor margins within the tumor cavity, in the patient, during surgery," Boppart said. "It is likely better to check to see if any residual tumor cells might be left behind, rather than checking the tissue mass that was taken out. Then, the surgeon can intervene immediately."

The researchers will continue clinical studies with the OCT device, looking at other types of solid-state tumors. Diagnostic Photonics, a start-up company Boppart co-founded that also collaborated on the study, is commercializing the OCT probe technology for broader use.

"Ultimately, new technological innovations like this in medicine and surgery are going to improve our health care and save lives. That's when this work will be most rewarding," Boppart said.
-end-
The National Institutes of Health supported this work.

Editor's notes: Editor's note: To reach Stephen Boppart, call 217-244-7479; email: boppart@illinois.edu.

The paper "Real-time imaging of the resection bed using a handheld probe to reduce incidence of microscopic positive margins in cancer surgery" is available online at http://cancerres.aacrjournals.org/content/75/18/3706.full.

University of Illinois at Urbana-Champaign

Related Cancer Cells Articles:

Cancer cells send signals boosting survival and drug resistance in other cancer cells
Researchers at University of California San Diego School of Medicine report that cancer cells appear to communicate to other cancer cells, activating an internal mechanism that boosts resistance to common chemotherapies and promotes tumor survival.
A protein that stem cells require could be a target in killing breast cancer cells
Researchers have identified a protein that must be present in order for mammary stem cells to perform their normal functions.
Single gene encourages growth of intestinal stem cells, supporting 'niche' cells -- and cancer
A gene previously identified as critical for tumor growth in many human cancers also maintains intestinal stem cells and encourages the growth of cells that support them, according to results of a study led by Johns Hopkins researchers.
Prostate cancer cells grow with malfunction of cholesterol control in cells
Advanced prostate cancer and high blood cholesterol have long been known to be connected, but it has been a chicken-or-egg problem.
Immune therapy scientists discover distinct cells that block cancer-fighting immune cells
Princess Margaret Cancer Centre scientists have discovered a distinct cell population in tumours that inhibits the body's immune response to fight cancer.
New system developed that can switch on immune cells to attack cancer cells
Researchers have developed an artificial structure that mimics the cell membrane, which can switch on immune cells to attack and destroy a designated target.
Hybrid immune cells in early-stage lung cancer spur anti-tumor T cells to action
Researchers have identified a unique subset of these cells that exhibit hybrid characteristics of two immune cell types -- neutrophils and antigen-presenting cells -- in samples from early-stage human lung cancers.
New analytical technology to quantify anti-cancer drugs inside cancer cells
University of Oklahoma researchers will apply a new analytical technology that could ultimately provide a powerful tool for improved treatment of cancer patients in Oklahoma and beyond.
Sleep hormone helps breast cancer drug kill more cancer cells
Tiny bubbles filled with the sleep hormone melatonin can make breast cancer treatment more effective, which means people need a lower dose, giving them less severe side effects.
Breast cancer tumor-initiating cells use mTOR signaling to recruit suppressor cells to promote tumor
Baylor College of Medicine researchers report a new mechanism that helps cancer cells engage myeloid-derived suppressor cells.

Related Cancer Cells Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Climate Crisis
There's no greater threat to humanity than climate change. What can we do to stop the worst consequences? This hour, TED speakers explore how we can save our planet and whether we can do it in time. Guests include climate activist Greta Thunberg, chemical engineer Jennifer Wilcox, research scientist Sean Davis, food innovator Bruce Friedrich, and psychologist Per Espen Stoknes.
Now Playing: Science for the People

#527 Honey I CRISPR'd the Kids
This week we're coming to you from Awesome Con in Washington, D.C. There, host Bethany Brookshire led a panel of three amazing guests to talk about the promise and perils of CRISPR, and what happens now that CRISPR babies have (maybe?) been born. Featuring science writer Tina Saey, molecular biologist Anne Simon, and bioethicist Alan Regenberg. A Nobel Prize winner argues banning CRISPR babies won’t work Geneticists push for a 5-year global ban on gene-edited babies A CRISPR spin-off causes unintended typos in DNA News of the first gene-edited babies ignited a firestorm The researcher who created CRISPR twins defends...