About the Project

The European Commission has awarded a 1.3M Euro grant to an international consortium to evaluate a ground-breaking cancer imaging technology. The imaging technology, termed Cerenkov Luminescence Imaging, has the potential to detect cancer during surgery and help ensure that all of the cancerous tissue is removed.

Problem to be addressed

Cancer is the second largest cause of death and morbidity in Europe, with more than 3 million new cases diagnosed each year. The most effective treatment strategy for most forms of cancer is early detection followed by surgery. However, cancers frequently recur following surgery. For example, nearly 1 in 4 breast cancer patients will see theirtumour recur after surgery. The consequences of cancer recurrence include repeat operations, delayed adjuvant treatment, increased likelihood of distant recurrence, poorer cosmetic and functional outcomes, emotional distress, and financial cost. The financial costs are staggering. Europe spends €125 billion annually on cancer care, approximately 5% of which is managing post-surgicalrecurrence.

Tumours recur after surgery primarily due to incomplete excision of the tumour or inadequate clearance of surgical margins. Tumours fail to be completely excised because the surgeon only has the visual appearance of the tumour and palpation to differentiate malignant from benign tissue. Consequently, there is an urgent clinical and market need for improved tools to detect cancerous tissue during surgery.

How this project seeks to address the problem

Real-time imaging during surgery would enable the surgeon to more accurately resect tumours and thereby reduce the likelihood of post-surgical recurrence. However, all efforts to develop an intraoperative imaging modality capable of accurately detecting cancer during surgery have so far been unsuccessful.

Cerenkov luminescence imaging (CLI) is a ground-breaking imaging modality that can provide realtime molecular imaging during surgery. CLI is based on the recently-discovered phenomenon that beta-emitting radiopharmaceuticals also generate light in the visible range, albeit at ultra-weak levels. CLI enables optical imaging of PET (Positron Emission Tomography) radiopharmaceuticals, combining the advantages of optical imaging (i.e., low cost and small form factor) with those of PET imaging (i.e., high diagnostic sensitivity and specificity).

By combining efforts, the CLIO consortium plans to test the CLI prototypes pre-clinically and clinically; collect surgeon feedback; develop the next stage of the imaging devices for the market; and develop CLI imaging services.

This addresses a fundamental business need of Lightpoint Medical to test the device in vivo and for ABX CRO and CROmed to develop imaging services for CLI.

How the Project`s Results Enable Further Improvement in Guided Surgeries

Pre-clinical Trials in a highly relevant setting of spontaneously occurring cancer of pet animals have shown feasibility of image-guided surgery using in-vitro Cerenkov Imaging and the application of another new concept, direct imaging of in-vivo beta particle emissions.

The proof-of-concept clinical trial in gastric and upper intestinal cancer patients is to demonstrate feasibility of clinical application of the combination of in-vitro and in vivo detection of tumorous cell clusters at the excision margins and in specified patient locations during surgery.

The dosimetric risks of radioisotope application for image-guided surgeries are surveyed by ABX-CRO and CROmed with state-of-the art equipment.