A new technology can quickly determine if a tumour has been fully removed in surgery before the patient has left the operating theatre.

The system, which combines laser scanning microscopy and fluorescent tumour markers, can help doctors detect any remaining cancer cells immediately after operations.

Developed at the Fraunhofer Centre for Micro-Electronic and Optical Systems for Biomedicine in Erfurt, Germany, the LSC-Onco technology aims to provide a quick and reliable solution for surgeons who need to ensure that all cancerous cells are removed, with the minimum of damage to surrounding tissue.

“A fluorescent marker applied beforehand allows doctors to see any cancer cells that may be left behind after the incision,” said centre head Michael Scholles. “Then these cells can be completely removed, with great precision.”

Fraunhofer experts developed the tried and tested concept of a laser scanning microscope further, using a microscanner mirror manufactured with MEMS (micro-electro-mechanical systems) technology. Inside the microscope, the mirror oscillates several thousand times per second, directing blue laser light with a wavelength of 488 nanometres over the affected area point-by-point.

The mirror simultaneously directs the fluorescent light emitted by the tissue towards a highly sensitive photodetector. The signals from the photodetector can then be used to construct a two-dimensional image. Images can also be recorded on different planes, so that tumour cells beneath the surface also become visible.

“This means that, for the first time, a powerful, portable laser scanning microscope that can be positioned right next to the patient in the operating theatre is a feasible reality,” said Scholles.

The system represents “a huge step forward” compared to current practices, the team said. Surgeons generally take tissue samples from the edges of the wound following the removal of a tumour and send the samples to a hospital laboratory, which provides a diagnosis as to whether the sample cells were cancerous after a few minutes. If so, the surgeon then has to cut away more tissue. This method is very time-consuming, which adds to the strain on the patient undergoing the operation.

“With LSC-Onco, all these steps can be carried out in one go during the operation, and what’s more, the precision is much greater. It also protects the surrounding tissue, because you can see exactly where the healthy tissue starts on the microscope display. And now, waiting for lab tests results is a thing of the past,” said Scholles.

The team now aims to bring the technology into medical practice.

The project involved researchers from the Fraunhofer Institute for Photonic Microsystems in Dresden and the Fraunhofer Institute for Cell Therapy and Immunology in Leipzig.

Extracted from IMechE Professional Engineering

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