Surgeons have successfully performed the first procedure in the US to use the latest generation of intraoperative PET (positron emission tomography) and CT (computed tomography) technology.
The team at Vanderbilt University Medical Centre’s Department of Otolaryngology-Head and Neck Surgery was led by Michael Topf [pictured], associate professor of Otolaryngology-Head and Neck Surgery.
The surgeries were part of a study that seeks to demonstrate the long-term viability of the procedure using a device developed by the Belgium-based surgical technology company, Xeos. As part of the study, up to 50 patients will undergo surgery with the support of the Aura 10 scanner.
During each surgery, the scanner is brought into the operating room to image a resected tumour. PET-CT combines the functional information gained through PET with the structural details obtained from a CT scan, aiding in the accurate staging, assessment of therapy response and early detection of recurrent disease.
The scanner provides surgeons with an immediate, real-time view of the specimen, enabling them to assess the success of the resection in achieving a negative margin.
Topf explained that during surgery, a patient receives a low dose of fluorodeoxyglucose (FDG), the radiopharmaceutical substance that helps highlight the tumour in a PET scan. As soon as the cancer is removed, it is placed in the scanner for margin analysis.
He explained: ‘We’re actively investigating both the feasibility of using this approach in the operating room during head and neck cancer surgery and whether it can accurately show cancer margins compared to the “gold standard” of microscopic analysis.’
Nicole Jones, research coordinator IV in the otolaryngology research laboratory, explained that the gold standard for cancer resection surgeries involves sending the specimen to the pathology lab for initial review.
However, a full analysis of the resected tissue might not be available for several days. With the help of the intraoperative imaging device, critical information about the surgery’s success in achieving a negative margin could be available in a matter of minutes.
She said: ‘The potential impact for patients and surgeons in real-time care is profound. Instead of the surgeon having to leave the OR and go to the pathology lab, everything is done in real time. This is an incredibly exciting milestone, and we hope this innovation will lead to transformative results down the road and will eventually be widely used in clinical settings.’
Topf said the opportunity to participate in clinical research – and doing so without requiring more than one hospital visit – is an appealing way to contribute to science.
He added: ‘For patients, it’s an exciting opportunity to participate in cutting-edge research and use a device that may allow a surgeon to have increased confidence in their ability to remove cancer, which is very attractive.’
