For the past few years Columbia neurosurgeons have been working on a way to make glioblastoma brain tumors light up. Using a fluorescent dye and special light filter during surgery, the surgeons can more accurately remove the tumor.
Their work so far has shown them that when fluorescein dye is injected into the patient’s bloodstream it’s absorbed by the tumor but not by normal brain tissue.
During surgery using this dye and a special filter on the operating microscope makes the glioblastoma tumor glow a bright yellow-green.
Glioblastoma tumors are the most common form of brain cancer and the most aggressive. The cells of this kind of tumor extend deep into normal brain tissue—sometimes far from the center of the tumor—making it difficult for a surgeon to tell tumor cells from normal brain tissue. If the surgeon cannot remove all of the tumor, it can regrow.
Recently a Columbia research team conducted another clinical trial to see just how well fluorescein dye can help with this problem by allowing the surgeon to see the edges of the tumor that extend deep into normal brain tissue.
They already knew that fluorescein dye makes the tumor glow under a special operating microscope. But how good is fluorescein at highlighting only the tumor and nothing else? And how good is it at highlighting the tricky edges of the tumor?
To find out, the researchers took samples of glioblastoma tumors from patients undergoing tumor removal who had been injected with the dye. Some of the samples were from the core of the tumor, and some were from the edges.
These samples were analyzed to find out how much of each sample was tumor, how much was normal brain tissue and how much the dye was fluorescing (glowing). Did the glowing areas match up well with the actual tumors? And were the edges of the tumors glowing?
They found that the fluorescein dye did indeed do a good job of highlighting the tumor, and it successfully lit up even the hard-to-see edges. The results were encouraging, and second-year resident Dr. Justin Neira, neurosurgeons Dr. Bruce, Dr. Michael Sisti, Dr. Guy McKhann and Dr. Sameer Sheth, and neuropathologist Dr. Peter Canoll, published their findings in the Journal of Neurosurgery.
The next step for these researchers is to investigate the potential of using fluorescein in other types of brain tumors, and even in spine tumors, lighting them up to help even more patients get relief from cancer.
*Full list of authors: Justin A. Neira, MD; Timothy H. Ung, MD; Jennifer S. Sims, PhD; Hani R. Malone, MD; Daniel S. Chow, MD; Jorge L. Samanamud; George J. Zanazzi, MD, PhD; Xiaotao Guo, PhD; Stephen G. Bowden, BM; Binsheng Zhao, DSc; Dr. Sameer A. Sheth, MD, PhD; Guy M. McKhann II, MD; Michael B. Sisti, MD; Peter Canoll, MD, PhD; Randy S. D’Amico, MD; Jeffrey N. Bruce, MD
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