A technology that can light up cancerous cells during surgery promises better post-operative outcomes for patients.

The new technique precisely defines the boundaries of a cancer using chemistry, imaging technology and artificial intelligence by lighting up cancer tissue that is attached to a fluorescent agent.

It has been shown in previous research that artificial intelligence is highly effective – often more effective than human experts – when it comes to analysing medical images.

The research effort was led by Prof Donal O’Shea, Department of Chemistry at the Royal College of Surgeons in Ireland (RCSI) and published in the latest edition of Chemical Science.

The surgeons can use the technology to see lit up cancer issue through specialised cameras or microscopes, O’Shea said, and will not have to rely so heavily on their own experience when making decisions as to what tissue needs to be removed.

Tumours 

Currently, a surgical team can get access to a variety of different images of a patient’s tumour from technology such as CT scans, or MRI scans. These can help to locate the tumour and its size in advance, but in theatre, the surgeon is on her own.

“Quite often, depending on the tumour, they may be doing it by touch, by trying to feel the different tissues, by their experience, by visually looking at different tissues,” O’Shea said.

The new technology’s real benefit, he said, is that it can help the surgeon make decisions ‘on the spot’ as the operation takes place, and not have to rely so much on their experience alone.

“The way this works is that you would shine light on the [cancer] tissue, and if the fluorescent agent is in the tissue it will emit, or shine, light back at you at a different wavelength,” O’Shea said.

“It means you can take, or capture images, whether pictures or movies, from this fluorescent light which is being emitted from the tissue,” O’Shea said.

“When it is done clinically, or in the laboratory, there are special devices that shine the light, and essentially, there are cameras to capture the image,” O’Shea added.

The new technology can benefit the approximately 60 percent of people with solid cancer tumours – in the lung, breast, or prostate for example – who undergo surgery for their removal.

Success 

The success of these operations depends on how effectively the solid cancer is removed and how much healthy tissue remains.

“In most surgeries there isn’t a huge margin of healthy tissue,” O’Shea said. “If you can imagine it is in brain cancer, it is very, very small margins. In breast cancer similarly, there may not be a large amount of tissue that a surgeon wants to take.”

“It’s the surgical team’s decisions they are making in real time during the operations as to, do we take this portion of the tissue, or that portion of the tissue.”

The researchers aim to also use the technology to help surgeons identify whether a solid cancer has spread in a patient.

“If there was metastasis in a nearby lymph node perhaps we could detect that with our imaging agent during the surgery,” O’Shea said.

Prof O’Shea is collaborating with Prof Ronan Cahill, a colorectal surgeon in the Mater University Hospital and IBM Research in Dublin to get the technology into clinical trials in three years.