During operations to remove cancerous tumors, surgeons face difficulties in properly visualizing the entire tumor portion to be extracted. Start-up Beams is developing a tool capable of accurately detecting and locating the tumor residues to be removed in real time. Meeting with the general manager of the company.
Faced with cancer, one of the treatments used is the removal of the tumor. During the operation, surgeons try to visually identify the tumor tissue to be extracted and may also use preoperative images obtained with an X-ray scanner, an MRI (Magnetic Resonance Imaging) or PET (Positron Emission Tomography) imager. During the surgical procedure, certain techniques can also be used to clearly locate the entire tumor part, in particular the fluorescence one, but it is not effective in all types of cancer. On the other hand, intraoperative CT (Computed Tomography) and MRI images have the disadvantage of considerably prolonging the operative time. To date, there is no universal tool to accurately identify tumor residues in real time. The therapeutic challenge is capital, as leaving tumor residues is a factor that increases the risk of local recurrences. Since the mid-2000s, the IJCLab (Laboratoire de Physique des 2 Infinis Irène Joliot-Curie) has started a research program to design a tool capable of detecting tumors in real time during surgery. Last year, a start-up was born with the objective of commercializing this new instrument. Interview with Estelle Villedieu de Torcy, CEO of Beams.
Engineering Techniques: How does your tool work to locate tumors?
Estelle Villedieu de Torcy: We are developing a probe capable of detecting in real time tumor residues to be removed during ablation operations. For it to work, it is first necessary to inject, intravenously, a radiopharmaceutical emitting beta particles that accumulate in tumor tissues. This technique is not new and is already practiced in nuclear medicine, for PET imaging. It consists of the use of a radioactive nucleus surrounded by a matrix and which has the particularity of being specific for each tumor. For example, fluorine-18 is the most commonly used nucleus and can be associated with glucose, as tumor cells are particularly sugar consumers. The beta particles will then more specifically bind to the tumor cells. For brain tumors, it is not advisable to use this type of radiotracer, as neurons consume a lot of sugar. Instead, fluorine 18 is used in combination with dopamine or choline.
How do you manage to detect these beta particles using your probe?
We have developed a detection head made of a set of plastic fibers, shimmer fibers and clear fibers, which are fused together. When a beta particle comes into contact with a scintillating fiber, it transforms it into scintillating photons, that is, into light, and they are guided and conducted by the transparent fiber to a photodetector. This will then transform this light signal into an electrical signal. We then analyzed this spectrum to measure the concentration of beta particles. If the concentration is high, it means it is tumor tissue.
What are the benefits of your process?
Our technology is very sensitive. We were able to locate very small tumor clusters with an accuracy of the order of one millimeter, which corresponds to the precision of the surgeon’s gesture. On the other hand, beta particles have a short path through tissues and the probe must be in contact with the tissues to detect them. The objective, therefore, is not to search the tumor tissue in depth. The surgeon will first proceed with the complete removal of the visible part of the tumor, as he performs this act today. Then he can check with the probe that there is no tumor tissue to extract.
Our tool also has the advantage of being efficient in all tumors, as long as there is a specific radiotracer to locate the tumor part.
Our technology is also distinguished by the fact that the probe is integrated into an instrument already used by surgeons, namely a surgical aspirator used to remove blood and cells from the operated area. Instead of adding a new tool, we are enhancing an existing tool with dual functionality. We wanted to preserve his gesture and maintain his current practice, improving it.
Finally, our tool will allow you to form a coherent path of patient care. Beta radiopharmaceuticals are already used for preoperative diagnosis performed by PET and also in the postoperative period to verify the quality of the work. As we use the same radiotracers, it will be easier to interpret the results and anticipate how these radiotracers will accumulate in the tissues.
What stage is your project in?
We performed a proof of concept of our technology in a primate with a laboratory prototype. Today, we are adapting to make an industrial version. We are still in an R&D phase and a lot of work needs to be done on the probe assembly process and its ergonomics. We work with surgeons to design the most suitable tool in terms of design and compactness, and which maintains sufficient performance in terms of sensitivity. It is necessary to use assembly methods compatible with industrialization, which respect the quality standards and the entire regulatory part of the medical sector. We want to redo a proof-of-concept of the industrial version of our probe on large animals, then start manufacturing the first pre-series, carry out regulatory testing and then human trials. We plan to commercialize our tool by 2026-2027.