The key to successful mesothelioma surgery is to remove as much of the cancer as possible. This is because leaving even a few cancer cells in the body can lead to the growth of new tumours. New intraoperative imaging, TumourGlow could help mesothelioma surgery be more successful in the future.
Why is this new technology so important?
Currently, mesothelioma surgery is difficult because the tumours are often very close to vital organs, and their irregular shape makes them hard to remove. It can also be difficult to differentiate the tumours from scar tissue or inflammation.
Whilst scans can help surgeons, PET scans unfortunately cannot distinguish between benign and cancerous nodules and they don’t show nodules which are smaller than a centimetre. This means that it can be difficult to remove all of the mesothelioma cancer during surgery.
To help increase the chance of removing all of the mesothelioma tumours, researchers at Abramson Cancer Centre at the University of Pennsylvania are working with intraoperative imaging using TumourGlow.
TumourGlow uses an injectable dye engineered to collect in malignant tissue. When viewed under near-infrared light, the dye glows and shows where the malignant cells are.
The study to test TumourGlow
Research has studied the use of TumourGlow with 20 patients. The patients were due to have either a pleural biopsy or a pleurectomy with decortication. 24 hours before their surgery, the patients were injected with TumourGlow. During the operation, lights were used to guide the surgeons to the clusters of mesothelioma cells. Any cells or tumours that were removed were then sent for pathology testing.
In total, 203 specimens were reviewed and 113 were found to be mesothelioma. All of the mesothelioma samples had high amounts of dye in them. There were no mesothelioma samples that did not contain high levels of dye.
Benign tissues were also removed for testing and they were found to have much lower levels of dye. As a result, they had a much dimmer glow under lighting than the cancerous cells.
The results of the study are promising. The intraoperative imaging increases the odds of removing more mesothelioma cells during surgery. This could be the difference between life and death for mesothelioma patients.
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Predina, Jarrod, “A Clinical Trial of TumorGlow® to Identify Residual Disease during Pleurectomy and Decortication”, July 17, 2018, Annals of Thoracic Surgery, Epub ahead of print
“Glowing Tumor Technology Helps Surgeons Remove Hidden Cancer Cells”, July 26, 2017, News Release, Penn Medicine News