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Improved precision for certain brain tumor removal surgeries

​Atomic force microscopy was used to identify new markers, independent of conventional imaging, that can help delineate pituitary adenomas for more accurate removal.

Published on 2 June 2022

​Pituitary adenomas—a kind of brain tumor—are notoriously hard to detect using conventional imaging techniques like MRI. These tumors can be small, sometimes measuring less than 1 mm in diameter, and low-contrast. Endocsopic surgery is usually used to remove these tumors. And, due to the lack of imaging, removal is by trial and error. Researchers at CEA-Leti set out to find a solution in the form of new markers, independent of conventional imaging, to help make surgical excision more accurate.

They looked at healthy tissue and tumors using atomic force microscopy (AFM). Their observations revealed a substantial (a factor of 100) difference in elasticity between the two types of tissue. They then correlated the AFM data with histological data to determine that a breakdown of the collagenous framework in the tumor tissue was likely responsible for the difference.

This new information will be used to develop a system that leverages elastographic measurements (like high frequency ultrasound or shear wave) to help the surgeon locate the tumor and discern its edges with greater precision during the procedure. Ideally, the technology developed would be integrated into a new transsphenoidal endonasal probe and would have to offer high enough resolution to effectively detect microlesions.

Once this first probe has been developed, it could be modified for any infiltrating tumor, increasing the chances of complete removal and lowering the risk of recurrence and additional surgeries.

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