Image-Guided Brain Tumor Surgery Using Invisible Near-Infrared Fluorescent Light

Lay Summary

Development of a new imaging technique may guide more precise surgical removal of brain tumors

Investigators from Harvard, collaborating with scientists at Dana-Farber Cancer Institute, will develop new contrast agents for image-guided brain tumor surgery in an animal model of induction glioma. If successful, this research will be immediately translated into patient trials.

The prognosis for a patient with a malignant brain tumor, called glioma, remains less than two years, despite decades of research into improved chemotherapeutic, surgical and radiological interventions. Annually, about one-half of the 1.5 million people with malignant brain tumors undergo surgical removal of the cancer. But neurosurgeons lack the technology to enable them to precisely identify the tumor’s margins prior to surgery and, during surgery, to differentiate tumor tissue while sparing healthy brain tissue—and cognitive functions. As a result, there is about a 30 percent cancer recurrence rate with subsequent metastasis of residual malignant cells, leading to further complications and death.

Following years of research to develop improved methods to guide cancer surgeons, researchers at Harvard’s Beth Israel Deaconess Medical Center have developed a promising new optical imaging system called FLARE (Fluorescence-Assisted Resection and Exploration).  FLARE uses near-infrared (NIR) fluorescent light that is invisible to the human eye but can penetrate several millimeters into tissue to guide cancer surgeons. Currently, FLARE is undergoing clinical trials for use in colon and breast cancer surgery.  The researchers hypothesize that NIR fluorescent light, used in conjunction with two contrast agents—one that binds to tumor tissue and another that binds to brain tissue—will provide sensitive, specific and real-time image guidance to neurosurgeons in precisely removing brain tumors and improving patients’ prognoses. The Harvard researchers will collaborate with Dana-Farber Cancer Institute investigators who have developed an animal model of induction glioma. They will develop and test a family of NIR fluorescent agents that will be specifically designed for brain surgery in this animal model of deadly glioma.

Significance: Successful demonstration that NIR image-guided surgery facilitates more precise brain tumor removal in an animal model of induction glioma would be immediately translated into human clinical trials, potentially increasing life expectancy and improved quality of life for patients.