New tool for brain surgery in development for neurosurgeons

Antti-Pekka Elomaa, Adjunct Professor and neurosurgeon at Kuopio University Hospital, and his colleagues, have developed a new fluorescence-based method to help neurosurgeons delineate the surgical site more precisely in brain cancer operations.
 
The idea for the invention arose when Elomaa, while performing glioma operations, began to consider how to improve the surgical prognosis for diffusely growing cancers.

“Despite advanced surgical techniques, cytostatic and radiotherapy treatments, the treatment outcomes for high-grade gliomas are quite inconsolable”, says Elomaa.

The problem is that the brain tumour is susceptible to recur in the already operated area. Undetected cancer cells may have been left behind. On the other hand, surgeons aim to resect tissues carefully as removing healthy brain tissue can have major drawbacks.
 
There was an identified clinical problem for which a solution was found through research.  
 
The method, developed in Eastern Finland, enables cancer cells to be identified by small fluorescent tissue pieces removed by the surgeon during the operation. This helps to delineate the surgical area. The first patient trials are scheduled to begin later this year. 

AUDIBLE SIGNAL OF CANCEROUS TISSUE

Fluorescent dyes are commonly used in brain cancer surgery to aid in the identification of an active cancer cell. However, visual inspection of the lustre with a surgical microscope is not always easy.

“Studies show that about half of the fluorescent areas go unnoticed. Using an imaging device during the surgery can be clumsy and the fluorescence too dim for the eyes. In addition, the surgeon’s field of view can be disrupted by many things, such as constant bleeding or dead angles at the operating site“, adds Elomaa.

With the researchers’ method, the surgeon does not have to evaluate the fluorescence with their own eyes. A smart tissue monitor is utilised to continuously measure fluorescence from the cell mass that enters the suction tube. Almost all of the tissue removed by the surgeon passes through the suction tube into the waste container during surgery.
 
The device provides the surgeon feedback, an audible signal, informing that the material is fluorescent, i.e. containing cancerous tissue. When the surgeon removes the tumour one piece at a time during the surgery, audible signals assist the surgeon in performing the operation. “The device proves real-time information to help the surgeon decide where more resection is needed and where enough has already been removed”.

ENTERING INTERNATIONAL MARKETS

The researchers founded a start-up company Marginum Ltd to commercialise the method for which patents have been applied for.
 
“The goal is for us to get the method approved and implemented to glioma treatment within three years”, says Elomaa. 
 
According to Elomaa, the intention is to start exporting the method to international markets immediately. Although the device is currently intended for the surgical treatment of gliomas, in the future it could be applied in other areas of oncological surgery as well.

“In cancer surgery, there is a general trend towards more radical yet more conserving method of surgery”, adds Elomaa.

This means that the aim is to remove the cancer tissue as accurately and completely as possible while simultaneously sparing healthy tissue.
 
“The method could potentially be used in surgical treatment of liver, ovarian, intestinal and bladder cancers”.
 
Antti-Pekka Elomaa states that Marginum is a good indication of how spinoff companies can emerge from basic clinical research. The idea for a new tool for brain cancer surgery came from a combination of working as a neurosurgeon and a researcher.
 
“There was a problem in the medical work for which a solution was found through research”.
 
As a researcher, Elomaa has long been interested in optical methods — partly due to his own photography hobby. He has a research team that is investigating, among other things, the use of a hyperspectral camera to identify tumour cells and study the optical features of cancerous tissue.

ANGEL INVESTOR CAME ALONG

According to Elomaa, it was important that Samu Lehtonen, a medical student and Bachelor of Science in Technology, who was starting his research for a doctoral dissertation in the research group, was enthusiastic about the idea. Lehtonen set out to develop the idea and find out if the method would have potential for business and be economically viable. 
 
Around the idea, Lehtonen and Elomaa formed a suitable team which also has expertise in the commercial field and photonics. The company was founded in November 2020.
 
“I myself will continue to work as a researcher and neurosurgeon but will be involved in the company as a Chairman of the Board and as a medical advisor”, explains Elomaa.
 
The company has acquired an angel investor. It also received a private equity investment in December 2021 from Nostetta Ventures.
 
“We now have good conditions to move forward”, says Elomaa.

The original full article in Finnish can be read at Mediuutiset journal after accessing paywall.