Experts have developed a next-generation intraoperative imaging platform using engineered beneficial bacteria that emit fluorescence specifically at tumour sites.
The bacteria-based contrast agent lights up tumours like a neon sign during surgery, enabling more precise resection and reducing the risk of recurrence.
Accurate tumour removal remains a critical challenge in cancer surgery, with breast cancer margins reaching up to 35%, often leading to reoperations and higher recurrence risks.
Traditional preoperative imaging and ultrasound frequently fall short in delineating tumour boundaries, leaving surgeons reliant on experience alone.
Now this technological advancement promises to enhance tumour visualisation during surgery, addressing a vital need in surgical oncology.
The collaborative research team was led by Dr SeungBeum Suh (Centre for Bionics) and Dr Sehoon Kim (Centre for Chemical and Biological Convergence) at the Korea Institute of Science and Technology (KIST, President Sang-Rok Oh), along with Professor Hyo-Jin Lee at Chungnam National University Hospital.
They engineered a fluorescent bacterial system that specifically activates within tumour tissue, enabling surgeons to identify tumour locations and margins in real time.
The fluorescent signal stays stable in vivo for more than 72 hours and clearly highlights tumour regions, even within complex internal organs.
Like illuminating a building on a map, this enables intuitive visual identification of tumours with the naked eye during surgery, even under standard surgical lighting, thereby reducing surgical burden.
In contrast to conventional contrast agents that must be developed individually for each cancer type, this new platform exploits two common tumour microenvironment features – hypoxia and immune evasion – making it broadly applicable across multiple solid tumours.
The fluorescence intensity is approximately five times stronger than conventional agents, and the system operates in the near-infrared spectrum, ensuring compatibility with existing surgical endoscopes and imaging equipment.
It can also be integrated with surgical robots and intraoperative imaging systems to enhance surgical precision and reduce procedure time.
Its ability to interface with widely used fluorescence-guided surgical systems in hospitals further enhances its clinical and commercial potential.
The research team aims to expand this bacterial platform into an integrated cancer treatment system combining diagnosis, surgery, and therapy.
The engineered bacteria, capable of autonomously locating tumours, may also serve as carriers for anticancer drugs or therapeutic proteins. To this end, the team is advancing the platform through integration with medical imaging devices, precision drug delivery systems, and comprehensive safety assessments for clinical application.
Dr Suh of KIST said: ‘This study demonstrates a novel approach whereby bacteria autonomously locate tumours and emit fluorescent signals, enabling real-time identification of tumour location and boundaries during surgery. Its applicability across a range of solid tumours positions it as a potential new standard for precision surgical imaging.’
