Detecting the previously undetectable

New surgical cancer-detection device helps fuel research collaboration at Polytechnique Montréal

One of the biggest challenges in brain tumour surgery is making sure that all cancer cells are removed. “If you leave a few cancer cells behind, the cancer will come back,” says Frédéric Leblond, an engineer and full professor in the Department of Engineering Physics at Polytechnique Montréal. “It’s a universal problem, especially with neurosurgery.”

That’s why Dr. Leblond, in collaboration with Kevin Petrecca, director of the brain tumour research program and chief of neurosurgery at the Montreal Neurological Institute-Hospital, developed a hand-held probe using Raman spectroscopy to distinguish cancer from healthy tissue.

Currently, CT and MRI imaging are used to examine tumours, but they do not show tumours to their full extent. With the Raman probe, laser illumination of the tumour provides a rainbow spectrum that contains detailed information about a sample’s chemical structure. That information helps surgeons identify previously undetectable cancer cells.

This powerful cancer-cell detection method can be applied with minimal disruption to the surgical workflow. The Raman probe can be used in real time to help neurosurgeons differentiate cancer cells from healthy cells during tumour surgery, and has demonstrated an accuracy of more than 90 per cent after a year-long study.

“For us biomedical engineers, it’s not about pushing our tech onto patients,” says Dr. Leblond. “It’s about finding needs and adapting our tech to meet those needs – and working with clinicians to make it work. Funding from the Canada Foundation for Innovation helped me set up a lab that was fertile ground to develop the Raman probe and help improve patient outcomes. The infrastructure support also allowed us to refurbish and adapt ourselves to the new realities of research – the impact of that is huge.”

It’s not only about the clinicians and engineers; the patients are involved, and industry stakeholders can also see what we’re doing. It’s an ecosystem where we involve all the necessary actors to develop technologies for patients to fully benefit.— Dr. Frédéric Leblond, Professor, Department of Engineering Physics, Polytechnique Montréal

Another important lever was the Canada First Research Excellence Fund, which enabled the creation of the TransMedTech Institute. The TransMedTech Institute is a living laboratory dedicated to supporting engineers, health-care professionals, patients and companies to co-develop new medical technologies and interventions, and to train the next generation of medical technology professionals.

“Combining engineering and medicine is a more common paradigm in research now, but what distinguishes us is our living lab,” says Dr. Leblond. “It’s not only about the clinicians and engineers; the patients are involved, and industry stakeholders can also see what we’re doing. It’s an ecosystem where we involve all the necessary actors to develop technologies for patients to fully benefit.”

The TransMedTech Institute has also made new detection applications of the Raman probe technology possible – in particular, for other types of cancer such as prostate cancer. Prostate cancer is the most common cancer directly affecting men in Canada. The Canadian Cancer Society says some 23,000 men will be diagnosed with prostate cancer this year, and approximately 4,200 will die from the disease during this same period.

As with other cancers, prostate cancer comes in different forms, called subtypes, which advance at varying rates. Identifying each of these subtypes is a big challenge for pathologists. Occasionally, misdiagnosis occurs and patients do not access the optimal treatment for their type of cancer. The Raman spectroscopy technology could help with the identification of prostate biopsy samples, thereby aiding in effective treatment plans.

Similarly, Dr. Leblond and his team are using the new research infrastructure to create a saliva-based, reagent-free, rapid-screening test for COVID-19. This test uses Raman spectroscopy to analyze saliva in less than two minutes without the need for reagents such as enzymes, which all current chemical COVID-19 tests require. Reagents have become scarce because of the demand for COVID-19 testing and limited production capacity. The Raman test could facilitate self-sampling and greater accessibility.

The test-development methodology could also be adapted to other infectious diseases, such as seasonal influenza and measles, and offer improved capability to address mass testing for future waves of COVID-19.

Add to that, the Raman probe has given rise to a new company, Reveal Surgical, which will commercialize the probe to make it available at hospitals across North America. “Reveal Surgical ensures we get things right,” Dr. Leblond explains. “The road to commercialization means very carefully doing the testing and making sure we get the right patents, otherwise it will never happen.”

The development of the Raman probe offers a shining example of how critical research infrastructure is to scientific discovery and innovation. Laying this groundwork made vital collaborations possible, leading to lifesaving technologies, spinoff companies to make these technologies accessible and new synergetic research facilities to continue important work.

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