{"id":72762,"date":"2021-11-19T10:48:00","date_gmt":"2021-11-19T15:48:00","guid":{"rendered":"https:\/\/revealsurgical.com\/?p=72762"},"modified":"2021-11-25T11:01:54","modified_gmt":"2021-11-25T16:01:54","slug":"made-in-quebec-illuminating-hidden-brain-cancer-cells","status":"publish","type":"post","link":"https:\/\/revealsurgical.com\/fr\/made-in-quebec-illuminating-hidden-brain-cancer-cells\/","title":{"rendered":"Fabriqu\u00e9 au Qu\u00e9bec : \u00e9clairer les cellules canc\u00e9reuses cach\u00e9es du cerveau"},"content":{"rendered":"<p><\/p>\n\n\n\n<p class=\"has-text-align-center\"><strong>Montreal-based Reveal Surgical has developed a hand-held light probe that helps find the hidden cancer cells that most brain surgeries miss. <\/strong><\/p>\n\n\n\n<p><\/p>\n\n\n\n<p>It&#8217;s a scene that plays out daily in operating rooms around the world: a surgeon removes a malignant brain tumour. But rather than registering the satisfaction of having saved a patient\u2019s life, hanging in the air is an all-too-real statistic; in 99.5% of these operations, unseen cancer cells remain. That hidden cancer will eventually grow and spread, and the operation will have become only a short reprieve for the patient and their family.<img loading=\"lazy\" decoding=\"async\" height=\"640\" width=\"560\" alt=\"Kevin Petrecca, Chief of the Department of Neurosurgery, McGill University Health Centre\" src=\"https:\/\/www.mcgill.ca\/innovation\/files\/innovation\/kevin-petrecca.jpg\"><\/p>\n\n\n\n<p>Kevin Petrecca, Chief of Neurosurgery Department, McGill University Health CentreWhat\u2019s equally frustrating is that those remaining deadly cells, invisible going into or during surgery, are most often lying agonizingly close to where the removed tumour resided. The indetectable nature of these cells is one reason why survival after diagnosis averages only 15 months for these cancers.<\/p>\n\n\n\n<p>\u201cNinety percent of the time the failures are exactly where the surgery stopped,\u201d explains Kevin Petrecca, Chief of the Department of Neurosurgery at the McGill University Health Centre, about those elusive cancer cells.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Taking aim at glioblastomas<\/strong><\/h3>\n\n\n\n<figure class=\"wp-block-image\"><a href=\"https:\/\/www.mcgill.ca\/innovation\/files\/innovation\/mcg-ip_reveal-gr1_1104x736px_eng-linkedin.png\"><img decoding=\"async\" src=\"https:\/\/www.mcgill.ca\/innovation\/files\/innovation\/mcg-ip_reveal-gr1_1104x736px_eng-linkedin.png\" alt=\"Glioblastoma multiforme (GBM) is the most aggressive type of cancer\"\/><\/a><\/figure>\n\n\n\n<p>Now, the Montreal-based company that Petrecca helped found is poised to solve the problem of residual brain cancer. Reveal Surgical is taking aim at glioblastomas, the most common and fatal type of malignant brain tumour. The medical device start-up, formerly known as ODS Medical, has developed a probe that can locate normally undetectable cells during surgery, allowing the surgeon to remove both the primary tumour and its microscopic tentacles at the same time. It has also built an artificial-intelligence component into the device, which confirms malignancies with an inventory of catalogued cancer biopsies.<img loading=\"lazy\" decoding=\"async\" height=\"640\" width=\"560\" alt=\"Christopher Kent, CEO, Reveal Surgical\" src=\"https:\/\/www.mcgill.ca\/innovation\/files\/innovation\/christopher-kent.jpg\"><\/p>\n\n\n\n<p>Christopher Kent, CEO, Reveal Surgical<\/p>\n\n\n\n<p>Reveal Surgical\u2019s CEO Christopher Kent says his company\u2019s device increases the surgeon\u2019s visual landscape. Called the Sentry System, it captures telltale signs of cancerous cells. The probe shines a light onto brain tissue, and then notes wavelength shifts. Those shifts reflect the molecular makeup of cancerous tissues, distilling a fingerprint of sorts for different tissue types and molecular signatures of cancer cells. Reveal\u2019s technology classifies these fingerprints, enabling surgeons to know during surgery whether the tissue they are investigating contains invisible cancer or not.<\/p>\n\n\n\n<p>He puts in succinct but no less monumental terms the device\u2019s power to offer surgeons next-level access to tissue-derived data: \u201cWe\u2019re giving them the ability to see the unseen.\u201d<\/p>\n\n\n\n<p>The idea for this probe was born and developed in Quebec and, as it goes through various medical and regulatory tests, has put the province at the centre of an increasingly international network of hospitals that will test the device. Preliminary results have been positive, making this a story where an enterprising Quebec company, founded by local researchers working in established higher-education institutions with IP licensing partnerships, is set to provide numerous health care institutions with a tool that has the ability to save and prolong lives.<\/p>\n\n\n\n<p>\u201cThis should have an impact on tens of thousands of people each year around the world,\u201d says Kent, who lays out the company\u2019s initial vision: \u201cWe wanted to address a pretty pressing problem in neurosurgery, which is that the surgeon&#8217;s ability to visualize the tumour ahead of the procedure is really limited by a reliance on MRI, and there\u2019s a lot of cancer that just doesn\u2019t show up. Everybody knew that they were leaving cancer behind, but they had no way of reliably identifying which tissue was containing cancer.\u201d<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Combining engineering with medicine<\/strong><\/h3>\n\n\n\n<figure class=\"wp-block-image\"><a href=\"https:\/\/www.mcgill.ca\/innovation\/files\/innovation\/mcg-ip_reveal-gr2_1104x736px_eng-linkedin.png\"><img decoding=\"async\" src=\"https:\/\/www.mcgill.ca\/innovation\/files\/innovation\/mcg-ip_reveal-gr2_1104x736px_eng-linkedin.png\" alt=\"Profile of Reveal Surgical\"\/><\/a><\/figure>\n\n\n\n<p>In 2012, Petrecca, who works out of the McGill\u2019s&nbsp;<a href=\"https:\/\/www.mcgill.ca\/neuro\/\">The Neuro (Montreal Neurological Institute-Hospital)<\/a>, and Fr\u00e9d\u00e9ric Leblond, an Engineering Physics professor who heads the Optical Radiology Laboratory at Polytechnique Montreal, began to talk.<\/p>\n\n\n\n<p>Leblond had developed an expertise in the use of light and optics to uncover the molecular characteristics of tissue in clinical settings. Meanwhile, Petrecca, who spent years sitting down with patients and their families to discuss the dire survival rates of glioblastoma surgery, had found an opportunity to potentially bring those rates down, as well as offer Leblond his surgical perspective on a new operating room tool.<\/p>\n\n\n\n<p>\u201cFred is the engineer, the designer and the optics specialist, and I\u2019m the guy who knows about the nature of the cancer, acquiring samples and what will and won\u2019t work in the OR,\u201d says Petrecca.<\/p>\n\n\n\n<p>They were also both familiar with Raman spectrometry, which measures the vibrations of molecules to detect when normal cells have transformed into cancerous ones.<\/p>\n\n\n\n<p>That confluence of elements, from the pressing need to bring down that frustrating 99.5% recurrence figure to breakthroughs in light-sensitive detection techniques, led the two of them and their team to put together a prototype and start non-human testing.<\/p>\n\n\n\n<p>\u201cOnce the design was made, we would come into the OR,\u201d recalls Petrecca. \u201cIt was like, \u2018how much light can you shine?\u2019 \u2018No, that\u2019s too much light.\u2019 Everything was one step at a time with a certain amount of trial and error until we had a device that actually works.\u201d<\/p>\n\n\n\n<p>That testing is now taking place in real-world conditions, explains Kent. The company has received breakthrough designation from the FDA, which is helping them put together what\u2019s referred to as pivotal trials. It has also received authorization for investigational testing from Health Canada for their prototype.<\/p>\n\n\n\n<p>\u201cAt this stage, we\u2019re wrapping up our pilot clinical studies, so we\u2019re deployed in three hospitals in Montreal, New York City and Vienna, and once those are finished towards the end of this year, we\u2019re hoping to launch a multi-site pivotal trial next year, and that will be at 10 hospitals across North America and Europe.\u201d<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Real-time results provide key benefits<\/strong><\/h3>\n\n\n\n<p>Costas Hadjipanayis, a professor of Neurosurgery and Oncological Sciences at the Icahn School of Medicine at Mount Sinai in New York City, was involved in one of the three initial hospital studies. He counts the real-time results as the device\u2019s key benefit, adding that, while MRIs have helped surgeons see the three-dimensionality of cancer, they have their limitations. \u201cThat\u2019s just a snapshot in time,\u201d he says, noting that a surgeon would need to take a patient in and out of the operating room several times for MRIs in order to get the type of continuous live shots of the brain that the Sentry System provides.<\/p>\n\n\n\n<p>He appreciates Reveal Surgical\u2019s product for its ability to take measurements of the tumour and the surrounding brain, and how the pen-like device classifies&nbsp;corresponding tissue specimens.<\/p>\n\n\n\n<p>Key to Reveal Surgical\u2019s product is their AI component. Positive and negative diagnoses of tissues that surgeons interrogate with the probe and biopsy during an operation are used to train machine learning models. Once the company has a big enough database, surgeons can take measurements of a specific tissue and then the machine will tell them right away if it\u2019s a match with the ones they\u2019ve classified. In the three studies, data has been collected from over 120 patients. \u201cWe were generating an encyclopedia of data that AI is going to sort,\u201d says Hadjipanayis, who adds that this project will help set the stage for a more definitive multicentre study in the US and Canada.<\/p>\n\n\n\n<p>Glioblastomas, notes Hadjipanayis, don\u2019t stand out visually like other cancers, which are usually darker than healthy tissue. \u201cThat\u2019s been our limitation for decades\u2014the subtle colour difference of that tissue that could be a tumour.\u201d Having cancer cells light up and then be classified takes away that handicap.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Matching AI with the human element<\/strong><\/h3>\n\n\n\n<p>Reveal Surgical has made sure not to overreach with its AI component. \u201cThere is a strong human element to medicine, and as much as we may want to reduce it to an engineering problem, there are still people involved,\u201d says Kent. \u201cThe surgeons have to have a sense of what\u2019s actually happening. They\u2019re manipulating the probe and acquiring information from areas that are of high interest, and then they\u2019re the ones deciding what to do with that information. So just because it says it\u2019s cancer doesn\u2019t necessarily mean that they\u2019re going take it out. And just because it says it\u2019s normal doesn\u2019t necessarily mean that they\u2019re going to leave it alone.\u201d<\/p>\n\n\n\n<p>Hadjipanayis says the AI component helps define thresholds for the presence of cancer cells and tissue specimens. \u201cThis can show the strength of the technology not only in diagnosing intraoperative tumour tissue, but in helping us resect (cut out) the tumour in a second stage.\u201d He says the immediate results coming from the Sentry System make it a unique venture. \u201cI don\u2019t know of any other device doing this.\u201d<\/p>\n\n\n\n<p>This position that the growing Quebec-based company finds itself, with respect from international researchers and tests taking place in hospitals outside Canada, can be traced back to the Neuro\u2019s pioneer status as an early adopter of high-end imaging and the research it applied it to.<\/p>\n\n\n\n<p>\u201cAt the Neuro, we were the first centre in the world, along with Massachusetts General and the Mayo Clinic, to have an MRI scan. And people started doing MRIs on brain cancer,\u201d recounts Petrecca, who says those scans guided surgery but also mapped out how the disease would later spread. \u201cThey were looking at how much of the cancer remained after surgery and started doing studies.\u201d<\/p>\n\n\n\n<p>Researchers recognized that larger resections led to longer survival times. \u201cBased on that data, the reason people were dying was not because they didn\u2019t receive radiation or chemotherapy; it was simply because there was a distance of about five millimeters more of tumour that needed to be removed.\u201d<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Accolades and investors<\/strong><\/h3>\n\n\n\n<figure class=\"wp-block-image\"><a href=\"https:\/\/www.mcgill.ca\/innovation\/files\/innovation\/mcg-ip_reveal-gr3_1104x736px_eng-linkedin.png\"><img decoding=\"async\" src=\"https:\/\/www.mcgill.ca\/innovation\/files\/innovation\/mcg-ip_reveal-gr3_1104x736px_eng-linkedin.png\" alt=\"Quebec's Life Science and MedTech sector is poised for dramatic growth\"\/><\/a><\/figure>\n\n\n\n<p>The project has not just been given the blessings of the Neuro and regulators, but it also received accolades from the Quebec science community and the public. The system won the&nbsp;<a href=\"https:\/\/www.chumontreal.qc.ca\/en\/crchum\/news\/quebec-sciences-2017-discovery-year-peoples-choice-award\">2017 Quebec Science Discovery of the Year Award<\/a>, given by the magazine Qu\u00e9bec Science. Initially selected as one of the 10 most impressive discoveries in Quebec by a jury of researchers and journalists, it was then picked as the winner by one third of the public respondents.<\/p>\n\n\n\n<p>The company has also received much interest from investors, whose infusions of capital show the growing confidence in the technology. They\u2019ve already raised $8 million and are approaching a Series A round of financing in early 2022 to further drive their commercialization efforts.<\/p>\n\n\n\n<p>Kent believes the probe will become an indispensable surgical tool. \u201cThis is a new way of looking at tissue and exploring the surgical space.\u201d The team is ready to look beyond brain cancers and is exploring the possibility of adapting the system and its AI technology to other diseases like prostate, lung and breast cancers.<\/p>\n\n\n\n<p>Reveal Surgical\u2019s work to make what\u2019s hidden more visible could very well make Quebec more visible in the competitive world of Medical Technology. The province\u2019s agenda, to make Quebec one of the top five North American life sciences clusters by 2027, and to attract $4 billion in investments by 2022, is ambitious. Thanks to companies like Reveal, whose cancer-locating tech offers hope to so many people around the world, the province\u2019s far-reaching goals are coming into view.<\/p>\n\n\n\n<p><a href=\"https:\/\/www.mcgill.ca\/innovation\/articles-by-author\/Philip%20Fine\">Philip Fine<\/a>&nbsp;| 18 Nov 2021&nbsp;<a href=\"https:\/\/www.mcgill.ca\/innovation\/category\/article-categories\/made-quebec\">Made in Quebec<\/a><\/p>\n\n\n\n<p>Keywords:&nbsp;<a href=\"https:\/\/www.mcgill.ca\/innovation\/taxonomy\/term\/351\">Innovation<\/a><a href=\"https:\/\/www.mcgill.ca\/innovation\/taxonomy\/term\/407\">Montreal Neurological Institute and Hospital (The Neuro)<\/a><a href=\"https:\/\/www.mcgill.ca\/innovation\/category\/tags\/medicine\">medicine<\/a><a href=\"https:\/\/www.mcgill.ca\/innovation\/category\/tags\/technology\">technology<\/a><\/p>\n\n\n\n<p>You can find the original article <a href=\"https:\/\/www.mcgill.ca\/innovation\/article\/made-quebec\/made-quebec-illuminating-hidden-brain-cancer-cells\">here <\/a><\/p>\n\n\n\n<p><\/p>","protected":false},"excerpt":{"rendered":"Montreal-based Reveal Surgical has developed a hand-held light probe that helps find the hidden cancer cells that most brain surgeries miss. It&#8217;s a scene that plays out daily in operating rooms around the world: a surgeon removes a malignant brain tumour. But rather than registering the satisfaction of having saved a patient\u2019s life, hanging in&#8230; <a class=\"view-article\" href=\"https:\/\/revealsurgical.com\/fr\/made-in-quebec-illuminating-hidden-brain-cancer-cells\/\">View Article<\/a>","protected":false},"author":2,"featured_media":72768,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":"","_links_to":"","_links_to_target":""},"categories":[12],"tags":[],"class_list":["post-72762","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-in-the-press"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Made in Quebec: Illuminating hidden brain cancer cells | Reveal Surgical<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/revealsurgical.com\/fr\/made-in-quebec-illuminating-hidden-brain-cancer-cells\/\" \/>\n<meta property=\"og:locale\" content=\"fr_CA\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Made in Quebec: Illuminating hidden brain cancer cells | Reveal Surgical\" \/>\n<meta property=\"og:description\" content=\"Montreal-based Reveal Surgical has developed a hand-held light probe that helps find the hidden cancer cells that most brain surgeries miss. It&#8217;s a scene that plays out daily in operating rooms around the world: a surgeon removes a malignant brain tumour. But rather than registering the satisfaction of having saved a patient\u2019s life, hanging in... View Article\" \/>\n<meta property=\"og:url\" content=\"https:\/\/revealsurgical.com\/fr\/made-in-quebec-illuminating-hidden-brain-cancer-cells\/\" \/>\n<meta property=\"og:site_name\" content=\"Reveal Surgical\" \/>\n<meta property=\"article:published_time\" content=\"2021-11-19T15:48:00+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2021-11-25T16:01:54+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/media-reveal.operaticsites.com\/wp-content\/uploads\/2021\/11\/25105949\/MRI.png\" \/>\n\t<meta property=\"og:image:width\" content=\"397\" \/>\n\t<meta property=\"og:image:height\" content=\"168\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"author\" content=\"Sarah Garringer\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Sarah Garringer\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading 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