Press release December 19 2012: CTMM, LUMC, Quest Medical Imaging
Unique camera system for cancer operations is an international breakthrough
Leiden University Medical Center (LUMC) is the first in Europe to use a CE approved camera system that uses fluorescence to make tumours in cancer patients visible during surgery. Lead researcher, Professor Clemens Löwik of the LUMC, speaks of an 'international breakthrough'. The images allow the surgeon to accurately cut away the affected tumour tissue. The camera technique was developed by the Dutch company Quest Medical Imaging BV in cooperation with a team of researchers from the LUMC, under the umbrella of the public-private partnership CTMM (Center for Translational Molecular Medicine).
Using this camera technique, patients are injected with a fluorescent material that passes via the blood vessels into the liver. Once there, it precisely forms a green ring around the tumour that is clearly visible through the camera. During surgery, the surgeon can then carefully cut away the affected tissue. This is hugely different to currently accepted techniques. Meanwhile, the first cancer patient with metastases in the liver is successfully operated on using the system. Investigations are now underway to see if small metastases that would otherwise be missed can be found using the camera.
Worldwide, also under the banner of CTMM, challenging work was done on the development of fluorescent materials that, in combination with the new camera system, make tumours visible. In this case, the fluorescent materials are associated with particles that specifically attach to tumour cells. “This way we expect to be able to intervene quickly and efficiently. That's important for the patient and helps to save costs for the health care system, because it is envisaged that the number of repeat operations will decrease," said lead researcher, Professor Clemens Löwik of the LUMC. The camera system has a CE approval, allowing it to be used in hospital practice. Until now, there was no CE-approved system that allowed surgeons to see both the colour image and the pixel-to-pixel co-registered fluorescent overlay. Both images are needed in order to operate effectively. Now there exists a camera that can be installed in every hospital, allowing the technique to be widely used.
What is unique about the camera system is that it is extremely sensitive and allows both visible light and near-infrared light (the fluorescence image) to be observed. The system is equally suitable for use in keyhole surgery. “During such operations the surgeon cannot feel the tumour tissue, so that feeling is now replaced by the fluorescence," explains Richard Meester, CEO of Quest Medical Imaging. “We have therefore also made the camera suitable for this increasingly common type of surgery." Using the technology, the sentinel lymph node (the first lymph node into which a tumour drains) can also be detected. In the event of metastases, tumour cells collect here first. It is therefore very important to locate sentinel lymph nodes and see whether or not they contain tumour cells.
To quickly find the sentinel lymph node, a fluorescent material is injected close to the tumour. The fluorescent material then passes via the lymph vessels to the sentinel lymph node, where it temporarily accumulates. After making a small incision, the surgeon can easily find the luminous mass and remove it for further pathological inspection.
CTMM is a public-private partnership. The development of the camera took place within the MUSIS research project, one of the 22 CTMM projects. Within the MUSIS project, the following partners work closely together: Leiden University Medical Center, Quest Medical Imaging, ARA, Percuros, Luminostix, DEAM, TU Delft, Erasmus Medical Center and Westburg. The Dutch government contributes EUR 4.6 million to the total MUSIS research project budget of EUR 9.2 million.