Hand-held cancer detector
A new, hand-held Raman spectroscopic probe technique developed by scientists at Montreal Neurological Institute and Hospital, and Polytechnique Montréal, Canada, could allow surgeons to home in on almost all brain cancer cells.
A collaboration between “The Neuro” at McGill University, the MUHC and Polytechnique Montréal has led to a powerful new intraoperative probe being used for detecting cancer cells. The device should allow surgeons to detect with precision virtually every invasive brain cancer cell in real time during surgery.
“Often it is impossible to visually distinguish cancer from normal brain, so invasive brain cancer cells frequently remain after surgery, leading to cancer recurrence and a worse prognosis,” explains Kevin Petrecca, Chief of Neurosurgery and brain cancer researcher at The Neuro, and co-senior author of a study published in Science Translational Medicine describing the new technology and outlining how it could improve patient outcomes.
The Raman probe was designed and developed in partnership with Frédéric Leblond of Polytechnique Montréal, who is co-senior author. “The emitted light provides a spectroscopic signal that can be interpreted to provide specific information about the molecular makeup of the interrogated tissue,” explains Leblond. “The Raman probe has a greater than 92% accuracy in identifying cancer cells that have invaded into normal brain.” Sensitivity is 93% the team reports and specificity 91%.
The team has tested the probe on patients with grade 2, 3 and 4 gliomas; these are highly invasive brain cancers. “We showed that the probe is equally capable of detecting invasive cancer cells from all grades of invasive gliomas,” explains Petrecca. “There is strong evidence that the extent of tumour removal affects prognosis for all grades of invasive gliomas.” Until now, no technology had existed that could safely distinguish between healthy and malignant cells either pre-operatively or during surgery.
Now that initial proof of principle has been undertaken by the researchers, the next step is to establish a clinical trial in order to show whether or not the system improves patient outcomes. The clinical trial will be carried out at the Montreal Neurological Institute and Hospital and will launch with patients who have newly diagnosed and recurrent glioblastoma.
“This Raman-based probe enabled detection of the previously undetectable diffusely invasive brain cancer cells at cellular resolution in patients with grade 2 to 4 gliomas. This intraoperative technology may therefore be able to classify cell populations in real time, making it an ideal guide for surgical resection and decision-making,” the team concludes in their Sci Transl Med paper. “Our next step is to gain regulatory approval to test this technology in a clinical trial,” Petrecca told SpectroscopyNOW.
Alongside Petrecca and Leblond, worked Kelvin Mok and Michael Jermyn of The Neuro and Polytechnique Montréal and Jeanne Mercier, Joannie Desroches, Julien Pichette, Karl Saint-Arnaud, Liane Bernstein, Marie-Christine Guiot, with support from the Fonds de recherche du Québec–Nature et technologies, the Natural Sciences and Engineering Research Council of Canada and the Groupe de recherche en sciences et technologies biomédicales.