Researchers at the OU Health Stephenson Cancer Center at the University of Oklahoma Health Sciences have launched a revolutionary new research study that could improve detection of a deadly disease -; Pancreatic cancer -; and give patients the chance to live longer, healthier lives.
The research focused on an innovative combination of imaging techniques: a newly developed contrast agent that recognizes pancreatic cancer cells, combined with multispectral optoacoustic tomography, or MSOT. Together, the method can detect pancreatic cancer cells the width of an eyelid -; About 10 times higher levels than what is currently possible. The research is led by Lacey McNally, PhD, and Ajay Jain, MD, who are professors of surgery in the OU College of Medicine. They received a $3 million grant from the National Cancer Institute of the National Institutes of Health for the project, which is believed to be one of the first of its kind in the world.
Pancreatic cancer is one of the most difficult cancers to cure because it is difficult to detect cancer cells at the microscopic level. Because pancreatic cancer has no early symptoms, it is usually not diagnosed until it has spread and the outcome is very poor -; The overall chance of survival is about 9%. Surgery and chemotherapy give patients the best chance, but for surgery to work, we have to remove all the cancer, and that’s hard to do.”
Ajay Jain, MD, is a professor of surgery at the OU College of Medicine
The new imaging method aims to improve the detection of pancreatic cancer cells at the microscopic level, or about 200 microns, as thin as an eyelid. Current imaging options such as CT scans detect cancer when it is large, about one centimeter in size.
The promise of the new imaging method lies in the combined power of its two components. In the laboratory, McNally developed a contrast agent unique to pancreatic cancer cells. When the agent is delivered through an IV, it can differentiate pancreatic cancer cells from other cells because the pancreatic cancer environment is acidic. When the contrast agent encounters that acidity, its dye essentially “turns on.”
Another component, the MSOT device, works in conjunction with the contrast agent. MSOT delivers infrared light to the body, which stimulates the dye in the contrast agent. This stimulus creates sound waves, which the MSOT device picks up and converts into color. The result is an image so detailed that it captures cancer cells that might otherwise escape detection.
“It’s a hybrid approach that accomplishes what a city can’t,” McNally said. “Pancreatic cancer often forms tentacles that spread beyond the primary. Currently, the surgeon has no way of knowing where they are. But if the surgical team can use this MSOT method in the operating room, the tumor can actually tell them the time where the cancer has metastasized. So they can remove it.”
This capability will be a game-changer for pancreatic cancer surgeons. Pancreatic cancer disproportionately affects people 60 years of age and older, who face greater risks from a major operation than younger patients and usually cannot tolerate a second surgery.
“One of the first questions patients ask me is, ‘Will the surgery be worth it? What are your chances of getting it all?’ This method, at a very microscopic level, seems to be able to tell us whether we’re getting all the cancer,” Jain said.
The new imaging technique may also help surgeons plan their surgical procedures. If the MSOT device revealed, for example, that the cancer had invaded two critical blood vessels that hug the head of the pancreas, surgeons would conduct the procedure differently than if they didn’t know. If chemotherapy is given before surgery, imaging can tell whether cancerous cells in blood vessels have died or whether microscopic cancer is still present.
Ultimately, the new imaging method could be used as a screening tool for patients who are at high risk of pancreatic cancer, such as those with a family history or genetic predisposition. “Early detection of pancreatic cancer offers the best chance of a cure,” Jain said. “If we can detect cancer at an early, microscopic stage, it may be curable.”
Grant funding will allow McNally and Jain to continue testing the imaging technique. McNally is an international leader for his research expertise in using the MSOT device with contrast agents developed for various cancers. He is testing imaging methods in other clinical trials at OU Health Sciences, including a recently completed study in breast cancer. Although MSOT technology is not new, it is novel in the field of medicine, and funding agencies such as the NIH are increasingly supporting studies in this area. McNally and Jain’s grant scored in the top percentile of nearly 55,000 grants submitted to the National Cancer Institute last year, indicating the strength of the research.
“This type of research collaboration between a translational scientist and a surgeon is extremely unusual,” McNally said. “We have an opportunity to improve a surgical technique. The scientific and medical communities have made great progress in the treatment of some types of cancer, but the survival of pancreatic cancer patients is the poorest. The results of this research could fundamentally change people’s lives.”
The University of Oklahoma and Georgia State University jointly own pending patent applications using contrast agents and MSOT devices with contrast agents.