Here at the University of Michigan we are testing a new microscope that will radically change brain tumor surgery—making it safer and more efficient. So far, we have used the microscope on tissues from 89 patients with great success.
Timing and location are important
One of the most difficult things for a brain surgeon is figuring out exactly where a brain tumor starts and stops because brain tumor tissue can be hard to distinguish from the rest of the brain. The new stimulated Raman scattering (SRS) microscope allows us to see the edges of a tumor in a few seconds instead of waiting the 30-45 minutes it usually takes for a frozen tumor section to be developed.
Right now, we are using the microscope on an experimental basis through grants from the National Institutes of Health and the University of Michigan Translational Research and Commercialization for Life Sciences Program. We are using the microscope almost exclusively on neurosurgical cases. I’m also collaborating with Matt Spector, who is a head and neck surgeon, to look at squamous cell carcinoma.
Our work suggests that surgeons will be able to use the SRS microscope in breast cancer surgery and for other cancerous tumors.
What the SRS microscope means for patients
We’re trying to deliver the best possible surgical results to our brain tumor patients and tumor patients in general. With the SRS, we’re using more of a data-driven, objective approach to determine the exact location of the tumor instead of relying exclusively on the surgeon’s intuition. For our patients, this means a better surgical outcome.
How speed is possible
The standard pathology lab workflow used for 150 years requires removing the tumor tissue, then fixing, embedding, staining with dyes and mounting the tissue on slides.
With the SRS technology, you simply load the tissue into the SRS microscope’s cassette and take an image of it. There are no other steps. The images we get are comparable to the images we get with traditional microscopes. The SRS microscopecan tell you on the spot, in the operating room, whether tissue contains tumor or not.
The SRS technology we are using was originally developed in the laboratory of my collaborator at Harvard, Professor Sunney Xie, and built by a company called Invenio Imaging, Inc.
What comes next
We are also working on a second-generation SRS microscope that will sit close to the operating table. The entire medical team will be able to use and understand the device easily, and the images will help determine immediately whether the surgeon needs to remove more tissue.
We hope to have the machine approved by the FDA within 18 to 24 months.
Our work on the SRS microscope is one more step in our goal to provide the best, most accurate care and treatment for patients here at University of Michigan and elsewhere. This is the kind of technology that makes working in medicine so exciting and so worthwhile.
Daniel A. Orringer, M.D., is Assistant Professor of Neurological Surgery, University of Michigan Health System. He received his degree from the Ohio State University College of Medicine & Public Health and completed his residency in neurosurgery at the University of Michigan Health System. Dr. Orringer is committed to providing the best possible care and treatment for patients with brain tumors.
The University of Michigan’s multidisciplinary neuroscience team is made up of more than 70 nationally recognized neurologists and neurosurgeons. Leading the way in brain, spine and nervous system care for close to 100 years, patients have access to services that can be found at only a handful of places as well as cutting-edge treatments with the latest research. Neurology and Neurosurgery at the University of Michigan Health System have been recognized by U.S. News & World Report numerous times for excellence in patient care.