A new technique that gives surgeons “unprecedented precision” has been developed, making it easier to remove potentially life-threatening cancerous tumours from children.
The pioneering technique, trialled in the UK on mice, is a potential game-changer for treating neuroblastoma, the most common form of cancer tumour found in children.
It was devised by surgeons at Great Ormond Street Hospital (GOSH) in London alongside engineers from the Wellcome/EPSRC Centre for Interventional and Surgical Sciences (Weiss) at University College London (UCL).
How it works
The new technique makes cancerous cells that resemble surrounding healthy tissue easier to identify. ‘Molecular imaging’ is used, whereby chemicals are injected into the bloodstream of the patient to act as imaging probes.
These chemicals are attracted to cancerous cells and once attached, the probes light up drawing attention to the tumour.
Dr Dale Waterhouse, from Weiss, told The National: “There are two parts to these molecular probes. The first part targets cancer, so when the probe is injected into the body, it specifically binds to cancer cells and not to healthy cells.
“The second part of the probe is a fluorescent dye — this emits fluorescent light, which we can detect with a specialised camera, informing us where the cancer cells are located.”
The technique, used in testing on mice, successfully revealed part of a tumour that had not been removed during surgery.
The team then wanted to test whether they could improve the visual quality of the images, by using short-wave infrared light (Swir), that has only recently become accessible to scientists through new technology.
Using a special high-definition camera to capture Swir fluorescence, surgeons were able to distinguish between cancerous tumours and healthy tissue.
'Unprecedented precision'
Neuroblastoma accounts for 8-10 per cent of all childhood cancers and around 15 per cent of childhood deaths from cancer. In about a third of patients, the cancer has already spread to other parts of the body at the time of diagnosis, making it harder to treat.
This new technique effectively illuminates the tumour, allowing surgeons to remove it with unprecedented precision.
According to Dr Waterhouse, short-wave infrared light enhances the contrast of the tumour by almost doubling it. He told The National that it “enables the surgeon to see the tumour boundaries more clearly, and thus operate more accurately”, and “penetrates deeper into tissue, potentially allowing us to find buried cancer residuals that might otherwise be left behind after surgery”.
New technique expected to be used soon
Scientists are now working to fast-track the technology into the operating theatre at GOSH within the next 12 months.
Dr Waterhouse said: “We are hoping to conduct a first-in-human pilot study by the end of the year. We are optimistic we will see similar results [to what we saw in mice] in humans later this year. If so, we will begin the process of duplicating our system so it can be tested in multiple hospitals.”
Unlike X-ray or magnetic resonance imaging, which focus on organs and bones, molecular imaging produces detailed pictures of biological processes and can be carried out during surgery, meaning clinical teams would not have to wait for biopsy or culture results when screening for diseases.
Dr Stefano Giuliani, consultant paediatric surgeon at GOSH and associate professor at UCL GOSH Institute of Child Health, said: “Surgery to remove neuroblastoma requires a delicate balance. Remove too little and the tumour 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 tumour, 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 tumours.”
