Surgeons can 'hear' cancerous lesions with help of new dual-mode radiotracer
Researchers have developed a new radiotracer that will give providers unprecedented visualization of prostate tumor margins during surgery.
Not only does the tracer enhance tumor visibility, but its contents also would allow providers to “hear” where the tracer’s uptake has accumulated with the help of a Geiger counter. This is thanks to the use of 18F-organotrifluoroborates, which can be labeled with the isotope Fluorine-18 (18F), and fluorescein, a fluorescent dye used to enhance visualization of blood vessels and tumor margins.
These materials combine to create a dual-mode tracer that binds to PSMA. When used during surgery, it can help providers identify cancerous lesions that are not in their immediate vision.
“Precision medicine is increasingly being practiced and developed to address the sophisticated treatment methods for diseases like cancer,” senior author of a paper detailing the research, David M Perrin, PhD, a University of British Columbia chemist, noted in a news release. “Our tracer provides high-resolution visual guidance, but would also allow a surgeon to use a hand-held Geiger counter probes to ‘hear’ areas of high radiation density that would accumulate in cancerous tissue not immediately visible—whether it's a lymph node, or distant metastasis, or local invasion in the like the bowel or the gut.”
So far, the dual tracer has been tested in mice that had human tumors implanted inside them. That assessment highlighted the tracer’s potential to improve visualization of margins on imaging and during surgery. The team’s next steps are to conduct Good Manufacturing Practices assessments, toxicity and safety testing and validation studies, paving the way for human studies using the tracer.
Similar methods of tumor delineation are used in breast cancer via two separate injections of a radioactive tracer and methylene blue, but this latest work represents the first study of a PSMA-targeting dual tracer for prostate cancer. This latest tracer, however, requires just a single injection.
Larry Goldenberg, MD, a professor with the department of Urologic Sciences at UBC in prostate care, who was not involved in the study, expressed optimism for how dual tracer could improve patient outcomes.
"The implementation of dual mode fluorescent-PET tracers in the surgical field is an exciting new approach to maximize benefit and minimize harm associated with more extended lymph node removal as well as to decrease the rate of positive surgical margins of a radical prostatectomy,” Goldenberg said in the same release. “This novel approach has the potential to maximize local disease control and theoretically improve oncologic outcomes.”
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In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.