Mini ‘Scope May Aid Cancer Surgery

A new, in vivo microscopic imaging technology has led to the development of a technique that may help improve outcomes of surgery to remove pancreatic cancer. The technique was the result of work performed by the INSERM research group at the Institut de Recherche contre les Cancers de l’Appareil Digestif (Institute of Research Against Digestive Cancer, or IRCAD).

Lead author Prof. Jacques Marescaux and his team at IRCAD used a system called probe-based confocal laser endomicroscopy (pCLE) – a miniaturized, flexible, fiber-optic microscope based on a Cellvizio probe made by Paris-based Mauna Kea Technologies – to aid in the identification of malignant tissue and metastases in the pancreas and surrounding lymph nodes during an operation.

“This new imaging method constitutes a very promising diagnostic tool which should be rapidly applied to humans in order to delineate clear margins for cancer resection,” Marescaux said. “Given the mortality associated with pancreatic cancer, it’s crucial that surgeons remove all malignant cells from the patient as completely and as early as possible. This new technique allows the surgeon to identify areas of interest, such as malignancies and metastases, in real time, and should help prevent the need for additional operations and may improve patient outcomes when applied in a clinical setting.”

Pancreatic cancer is one of the rare cancers for which chemotherapy and radiotherapy have disappointing results. The best patient outcomes are achieved with surgery in which the surgeon must remove all the cancerous cells, including those in the primary tumor, as well as those hidden in the surrounding pancreatic tissue and lymph nodes.

In this study, published in the November issue of the journal Gastroenterology, Cellvizio-based technology helped the IRCAD researchers detect cancerous cells in the pancreas and surrounding lymph nodes in laboratory rats. The study also showed that the team was able to identify very small metastases with Cellvizio; researchers initially missed these same metastases with traditional techniques and histopathological analysis. None of the areas deemed normal with Cellvizio were confirmed as cancerous with standard histology.

“We are very enthusiastic about the IRCAD team’s work and this publication in Gastroenterology,” said Sacha Loiseau, CEO of Mauna Kea Technologies. “While we continue to work with endoscopists to help them improve how they manage and treat patients with gastrointestinal and biliary diseases, we are also increasing our focus and effort to improve the detection of abnormal tissues which may be indicative of cancerous lesions during surgical procedures.”

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