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Live imaging of lung cancer cells during surgery improves precision

Researchers discovered a way to make cancer cells glow visibly to the naked eye.

By Stephen Feller
Live imaging of lung cancer cells during surgery improves precision
Intraoperative imaging shows a lung adenocarcinoma glowing, showing doctors the exact location of tumor's cells. Photo by The Journal of Thoracic and Cardiovascular Surgery

PHILADELPHIA, July 29 (UPI) -- Researchers used a targeted molecular contrast agent to make tumors glow to the naked eye, making it easier to identify tumors during surgery.

During two surgeries that were part of a study testing the tumor identification method, doctors found secondary tumors they did not know were there.

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"This approach may allow surgeons to perform resections with confidence that the entire tumor burden has been eliminated. In the future, with improved devices and molecular contrast agents, this approach may reduce the local recurrence rate and improve intraoperative identification of metastatic cancer cells," said Dr. Sunil Singhal, of the Department of Surgery at the University of Pennsylvania Perelman School of Medicine, in a press release.

In the study, published in the Journal of Thoracic and Cardiovascular Surgery, researchers recruited 50 patients between the ages of 25 and 85 diagnosed with adenocarcinoma. The patients were given a fluorescent targeted molecular contrast agent four hours before surgery. In 92 percent of cases, cancer cells visibly glowed for doctors during surgery.

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Upon opening the chest cavity, researchers found that 14 percent of lung lesions could be seen glowing. The rest did the same after overlying tissue was opened and the tumor exposed. The glowing could be seen for anywhere from 5 to 15 minutes, allowing doctors to photograph tumors with specialized cameras before operating.

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In two cases, the contrast agent alerted doctors to tumors they did not know were there -- in one case, a secondary nodule was spotted, and in another cancer that was thought not to have metastasized was found in other locations of the patient's body.

"The use of a visible-wavelength fluorophore avoids ionizing radiation and confers no risk to the patient, surgeon, or operating room personnel. In our experience, only one patient had a mild allergic reaction to the contrast agent that was easily managed with diphenhydramine," Singhal said. "With miniaturization of imaging devices, this method will be particularly useful in minimally invasive surgery."

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