Researchers at the University Medical Center Schleswig-Holstein (UKSH), Lübeck Campus, the University of Lübeck, the Medical Laser Center Lübeck and the University Medical Center Hamburg-Eppendorf (UKE) want to analyze intraoperatively obtained, fragmented tumour tissue using aspirate histology. The ASPIRAT project, led by the Department of Neurosurgery at the UKSH, Lübeck Campus, is being funded by the Federal Ministry of Education and Research with a total of 3.3 million euros over three years. The funding is part of the “Health Research Germany, Medical Technology” program. The aim of the project is to optimize the removal of tumour tissue and reach a diagnosis more quickly.
Scientific background: In about 40 percent of brain tumour surgeries, an ultrasonic aspirator is used to remove tumours from the central nervous system. While operating on the tumour site, this device uses ultrasonic vibrations to fragment the tissue. The debris is then irrigated with saline solution and continuously aspirated. Thus, the tumor tissue fragments are currently left unused as a “waste product” (aspirate). In the new project, this aspirate tumour tissue is to be examined during surgery using a microscopy technique developed at the University of Lübeck. The SLIDE microscopy technique offers ultra high-speed multiphoton microscopy, which can help to examine the aspirate tissue fragments at high throughput and deeper penetration depth than conventional microscopic histology. Thus, this approach is coined imaging flow histology. Due to the high speed, this approach has the potential to histologically evaluate the abundance of tissue fragments live during surgery. The image analysis is supported by the use of artificial intelligence. An aim of this research endeavour is to potentially show the neurosurgeon whether the site of tissue removal is approaching the border of the tumour and thus tissue removal leaves healthy tissue untouched. Further, it will be investigated whether the imaging procedure can also shed light on the tumour type.
Until now, it has not been possible to determine the type of tumour and where the boundaries between healthy and diseased brain tissue are located, either before or during the operation. An initial neuropathological frozen section diagnosis, the current standard for intraoperative tumour diagnostics, takes 20 to 40 minutes and provides only limited information on the type of tumour. The final exact diagnosis takes eight to twelve days. Both procedures are time-consuming and cost-intensive
“We are aiming for a treatment strategy that directly benefits patients. This is because faster intraoperative information about the extent of resection achieved and initial histological information about the type of tumour can allow personalized therapy to begin much earlier. The earlier start of therapy combined with an optimized extent of resection has a direct influence on the survival time and the quality of life of the patients,” says Dr. Matteo Bonsanto, project manager and senior physician at the Department of Neurosurgery, Lübeck Campus. The new approach could also be translated to other tumour diseases in which the ultrasound aspirator is used intraoperatively, for example on the liver, prostate and kidney.
All oncology facilities of the UKSH and the Universities of Lübeck and Kiel are part of the University Cancer Center Schleswig-Holstein (UCCSH). As a supra-regional cancer center, the UCCSH works together with cooperation partners on innovative research projects, among many other projects.
Contact:
Dr. Matteo Bonsanto
University of Lübeck and
University Medical Center Schleswig-Holstein, Campus Lübeck
Clinic for Neurosurgery
Email: matteo.bonsanto(at)uni-luebeck(dot)de
