New operating technique safe for cancer operations

Fluorescence imaging, where fluorescent dyes are used in cancer operations, is a new technique that can be used in treating various types of cancer. As the tumour tissue lights up, surgeons are better able to see which tissue still contains cancer cells. This is the result of research conducted by medical researcher Lucy Crane of the University Medical Center Groningen. She will be awarded a PhD on 26 January 2011 by the University of Groningen.

In February 2009, UMCG surgeons used this technique for the first time in the Netherlands on patients with breast cancer. Crane conducted a number of early clinical studies in her research on patients with cervical cancer, vulvar carcinoma and ovarian carcinoma. The fluorescence imaging means that the lymph node or tumour lights up, which enables the surgeon to see exactly what tissue must be removed. A fluorescent chemical is used to this end, which can be administered locally or intravenously using a drip. Such contrast dyes can be specific or non-specific. Non-specific fluorescent dyes do not bind specifically to certain cells or organs and are mainly used to show anatomical structures such as lymphatic vessels and lymph nodes. Tumour-specific dyes bind specifically to tumour cells and can be used to detect whether a tumour has metastatized, or to see whether there is still any tumour tissue left in the excision margins.

Crane’s research shows that the technique can be safely applied in treating cervical cancer, vulvar carcinoma and ovarian carcinoma. Early results confirm that the technique is safe and versatile, although there is room for improvement with regard to user-friendliness and adaptability. These could perhaps be improved with more flexible camera systems or with fluorescent dyes that light up somewhat more during the operation.

The research also showed that at this point there is no generally applicable dye available that targets cancer. The reason is that different types of cancer often have varying tumour-specific characteristics. Every type of cancer needs to be further investigated as to which dye works the best and which tumour characteristic it targets. Crane describes in her research a new scoring system used to determine the optimum tumour-specific dye in order to make the best choice.

Ms. L.M.A. (Lucy) Crane (Groningen, 1983) studied Medicine at the University of Groningen. She conducted her research at the Department of Surgery of the UMCG, in close cooperation with the Department of Gynaecology of the Technische Universität München. Her thesis is entitled ‘Intraoperative fluorescence imaging in cancer’. Crane will receive a PhD in Medical Sciences and was supervised by Prof. T. Wiggers and Prof. A.G.J. van der Zee.