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New probe provides vital assist in brain cancer surgery
Date:7/24/2012

A new probe developed collaboratively at Norris Cotton Cancer Center and Dartmouth College's Thayer School of Engineering uses an innovative fluorescence-reading technology to help brain surgeons distinguish cancerous tissue from normal tissue. The probe tool, now already in use at the Cancer Center for brain surgery, may one day be used for surgeries for a variety of cancers.

Performing surgery to remove a brain tumor requires surgeons to walk a very fine line. If they leave tumor tissue behind, the tumor is likely to regrow; if they cut out too much normal tissue, they could cause permanent brain damage.

"Primary brain tumors look just like brain tissue," says Keith Paulsen, PhD, a professor of biomedical engineering at Thayer School of Engineering and a member of the Cancer Imaging and Radiobiology Research Program at Norris Cotton Cancer Center. "But if you look at them under a particular kind of light, they look much different."

To improve their ability to differentiate between tumor cells and healthy tissue, surgeons can have patients take an oral dose of the chemical 5-aminolevulinic acid (ALA). An enzyme metabolizes ALA, producing the fluorescent protein protoporphyrin IX (PpIX). Tumor cells have a higher metabolic rate than normal cells, so they accumulate more PpIXand therefore fluoresce, or "glow," when exposed to blue light.

But this method was thought to be not sensitive enough to highlight brain tumors that are less metabolically active, like low-grade gliomas. To address this problem, MD-PhD student Pablo Valdes, PhD, and his research mentorsDavid Roberts, MD, the chief of neurosurgery at Dartmouth-Hitchcock Medical Center, and Dr. Paulsenused a probe (which they helped develop) that combines violet-blue and white light to simultaneously analyze both the concentration of PpIX and four other tumor biomarkers: PpIX breakdown products, oxygen saturation, hemoglobin concentration, and irregularity of cell shape and
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Contact: Donna Dubuc
donna.m.dubuc@hitchcock.org
603-653-3615
Dartmouth-Hitchcock Medical Center
Source:Eurekalert

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