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Determination of Tumor Margins-IDX

IP.com Disclosure Number: IPCOM000183103D
Published in the IP.com Journal: Volume 9 Issue 5B (2009-05-27)
Included in the Prior Art Database: 2009-May-27
Document File: 3 page(s) / 272K

Publishing Venue

Siemens

Related People

Juergen Carstens: CONTACT

Abstract

The status of tumor margins is important for long-term survival. If the margins are positive, the probability for recurrence of the cancer increases. Conventional tumor surgery is performed with a safe tissue-margin to ensure the complete removal of the tumor. For example, in breast interventions, i.e. lumpectomy or open surgery, not only the tumor has to be removed but also a layer around the malignant lesion that does not contain any cancerous cells. This layer is called safety margin and consists of a few centimeter tissue material. During the intervention, the excised tissue is investigated by histological methods (immunohistochemistry, microscope) to see whether the margin of the excised tissue is free of tumor cells. If not, the surgery is continued and the procedure of probing the tissue is repeated.

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Determination of Tumor Margins-IDX

Idea: Dr. Marcus Pfister, DE-Erlangen; Dr. Arne Hengerer, DE-Erlangen; Dr. Thomas Mertelmeier, DE-Erlangen; Dr. Sven Meyburg, DE-Erlangen; Dr. Andrea Lichte, DE-Marburg; Dr. Christoph Petry, DE-Cologne; Dr. Andreas Kappel, DE-Marburg

The status of tumor margins is important for long-term survival. If the margins are positive, the probability for recurrence of the cancer increases. Conventional tumor surgery is performed with a safe tissue-margin to ensure the complete removal of the tumor. For example, in breast interventions,
i.e. lumpectomy or open surgery, not only the tumor has to be removed but also a layer around the malignant lesion that does not contain any cancerous cells. This layer is called safety margin and consists of a few centimeter tissue material. During the intervention, the excised tissue is investigated by histological methods (immunohistochemistry, microscope) to see whether the margin of the excised tissue is free of tumor cells. If not, the surgery is continued and the procedure of probing the tissue is repeated.

The disadvantage of conventional surgery is that it is an invasive procedure with the risk of the removal of too much or little tissue. Furthermore, the current workflow is suboptimal.

Recently, MIT (Minimally Invasive Therapy) methods have been introduced. Today however, the routine application of minimally invasive surgery is limited to liver surgery. For other organs, minimally invasive therapy procedures are in a status of research. Among them are radio frequency ablation (RFA), thermo ablation by microwaves, magnetic thermo ablation, interstitial laser therapy, cryotherapy, local radiation therapy (brachytherapy) and highly focused ultrasound (HIFU) as examples. The problem of these MIT procedures is the precise determination of the tumor margin, as the cancerous tissue is destroyed locally by the application of energy.

The idea is to use sensors fixed to surgical instruments (e.g. needles, balloons used for brachytherapy) to measure the signal of tumor markers during the minimally invasive therapy procedure. The biosensor unit can be based on any transducer technology, which is suitable for point of care measurements and is able to be miniaturized and automated. Technologies that can be included are fluorescent-optical assays (measurement of auto-fluorescence, fluorescence of targeted contrast agents), measurement of cytoplasm/nucleus ratio, quartz microbalances, evanescent field detectors, impedance sensors, enzymatic assays, apoptosis markers, necrosis markers etc. A biosensor array might be used for multiparameter analysis.

Based on the measured signal, the tumor can be identified and/or localized. The idea is applied to determining the complete removal of the tumor (see Figure 1), or to...