promise of better brain cancer surgery

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promise of better brain cancer surgery

Postby Teleny » Wed Jan 29, 2014 7:10 pm

Cutting out the actual tumour is the best way to improve the prospects for people with brain cancer, but it can be a fairly hit and miss process. That's because surgeons find it difficult to identify some cancerous tissues visually, and so tend to play safe by excising more than they need.
Here's a mini-breakthrough which should put an end to this.

Neuroscientists Use Lightwaves to Improve Brain Tumor Surgery

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First-of-its-kind research by the Innovation Institute at Henry Ford Hospital shows promise for developing a method of clearly identifying cancerous tissue during surgery on one of the most common and deadliest types of brain tumor.
When expanded upon by further research, the findings offer the potential of improved outcome for those undergoing surgery to remove glioblastoma multiforme (GBM), a tumor that attacks tissue around nerve cells in the brain.
The study is published in the February issue of Journal of Neuro-Oncology.

“Even with intensive treatment, including surgical removal of as much cancerous tissue as is currently possible combined with radiation and chemotherapy, the prognosis for GBM patients remains dismal,” says Steven N. Kalkanis, M.D., a neurosurgeon and co-director Henry Ford’s Hermelin Brain Tumor Center.
“For now, their average life expectancy is around 12 to 18 months,” says Dr. Kalkanis, lead author of the study.
GBM poses a particular problem for the surgeon. While some tumors have clearly defined edges, or margins, that differentiate it from normal brain tissue, GBM margins are diffuse, blending into healthy tissue. This leaves the neurosurgeon uncertain about successfully finding and removing the entire malignancy.
The Henry Ford team set out to develop a highly accurate, efficient and inexpensive tool to distinguish normal brain tissue from both GBM and necrotic (dead) tissue rapidly, in real time, in the operating room.
The researchers chose Raman spectroscopy, which measures scattered light to provide a wavelength “signature” for the material being studied. The developer, Indian physicist Sir C.V. Raman, won the 1930 Nobel Prize for Physics, and his spectroscopy has been used to remotely test industrial pollution in smokestack plumes, among other widely varied applications.
Although Raman was developed in 1930, it was only very recently that the processing technology was able to be condensed into a tiny space (such as would fit on an intraoperative probe). And in addition to advances in processing speed, results can now be available in a fraction of a second.
“We decided to take full advantage of these advancements, which lend themselves exceptionally well to a small, portable hand-held device, potentially yielding immediate results in real-time. When developed, it would be the first of its kind in the world for this sort of brain tumor application,” says Dr. Kalkanis.
Using 40 frozen sections of GBM-riddled brain tissue, the Henry Ford team aimed to develop a database of normal brain matter, GBM and necrotic tissue as identified by Raman spectroscopy, as well as a statistical analysis algorithm for providing rapid diagnosis of tumor margins during brain surgery.
After creating and testing their method, the researchers were able to distinguish the three types of tissue with up to 99.5 percent accuracy. Normal brain tissue was found to have increased lipid content, necrotic tissue had increased protein and nucleic acid content, and GMB tissue fell somewhere in between the two.
Teleny
 
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