FLARE imaging tool could aid in seeing tumors in new light.

A cancer surgeon's primary goal in the operating room is simple, at least in theory: cut out all of the diseased tissue while leaving the healthy tissue behind. But surgeons today can't see tumor cells clearly so they don't know until long after they've left the operating room if they've achieved that goal.

"Right now the major imaging system used by a surgeon is their eyes and brain, and we all know we can't see through blood and tissue," John Frangioni, MD, PhD, of Beth Israel Deaconess Medical Center (BIDMC; Boston), told Diagnostics & Imaging Week.

Frangioni and his colleagues have spent the last eight years developing an imaging system designed to highlight cancerous tissue using near-infrared (NIR) light that penetrates through blood and tissue to allow the surgeon to more easily see what needs to be removed and what should be left alone.

GE Healthcare (Waukesha, Wisconsin) has licensed the imaging system, he said.

"This technique is really the first time that cancer surgeons can see structures that are otherwise invisible, providing true image-guided surgery," said Frangioni, who is the co-director of BIDMC's Center for Imaging Technology and Molecular Diagnostics and also an associate professor at Harvard Medical School (Boston). "If we're able to see cancer, we have a chance of curing it."

According to the researchers, the technique shows particular promise for improving surgery for breast, prostate and lung cancer, whose tumor boundaries can be difficult to track at advanced stages, they say. The Fluorescence-Assisted Resection and Exploration (FLARE) device, described at the recent annual meeting of the American Chemical Society (Washington) in Philadelphia, also can help cancer surgeons avoid cutting critical structures such as blood vessels and nerves.

FLARE is a portable system consisting of an NIR imaging system, a video monitor, and a computer. "The system has no moving parts, uses LEDs instead of lasers for excitation, makes no contact with the patient, and is sterile," Frangioni says.