A groundbreaking experimental genetic test is transforming brain cancer surgery by enabling surgeons to identify cancer cells in real-time during operations. The Ultra-Rapid droplet digital PCR test can detect cancer cells in tissue samples within just 15 minutes, providing critical feedback while patients remain in the operating room.
Developed by researchers at NYU Langone Health, the test demonstrates remarkable sensitivity, capable of detecting as few as five cancer cells per square millimeter of tissue. This level of precision makes it the first practical tool of its kind for real-time cancer cell detection during brain surgery.
Revolutionary Speed and Accuracy
"For many cancers, such as tumors in the brain, the success of cancer surgery and preventing the cancer's return is predicated on removing as much of the tumor and surrounding cancer cells as is safely possible," explained Dr. Daniel Orringer, associate professor of neurosurgery and pathology at NYU Grossman School of Medicine and co-senior investigator of the study.
The Ultra-Rapid test represents a significant advancement over the standard droplet digital PCR test, which typically requires several hours to produce results. In a validation study published February 25 in the journal Cell, the Ultra-Rapid test produced identical results to standard testing in more than 75 tissue samples from 22 patients undergoing surgery for glioma tumors.
"With Ultra-Rapid droplet digital PCR, surgeons may now be able to determine what cells are cancerous and how many of these cancer cells are present in any particular tissue region at a level of accuracy that has never before been possible," Orringer said.
Addressing a Critical Surgical Challenge
Complete tumor removal remains one of the greatest challenges in brain cancer surgery. Residual tumor cells left behind after surgery significantly increase the risk of cancer recurrence and often necessitate additional operations.
Current methods for detecting residual tumor during surgery, including MRI scans and fluorescent dyes, have significant limitations. Studies show that human doctors relying on these methods miss high-risk residual tumor approximately 25% of the time.
Dr. Gilad Evrony, geneticist at the Center for Human Genetics and Genomics at NYU Grossman School of Medicine and co-senior investigator, noted: "Our study shows that Ultra-Rapid droplet digital PCR could be a fast and efficient tool for making a molecular diagnosis during surgery for brain cancer, and it has potential to also be used for cancers outside the brain."
Technical Innovation
The research team achieved the test's unprecedented speed by optimizing each step of the standard PCR process. They reduced DNA extraction time from 30 minutes to less than five minutes and shortened sample treatment time from two hours to under three minutes.
The resulting test delivers results in approximately 10 seconds, making it practical for intraoperative use. In validation testing, the Ultra-Rapid test accurately assessed samples with known cancer and samples without any cancer.
Future Applications and Development
The technology shows promise beyond brain cancer applications. Researchers are already planning to adapt the Ultra-Rapid test for other cancer types, potentially revolutionizing surgical approaches across multiple oncology fields.
Next steps include automating the Ultra-Rapid test to make it faster and simpler to use in operating rooms. However, researchers caution that widespread clinical availability will require further refinement and clinical trials.
This innovation comes amid growing interest in technology-assisted cancer surgery. Recent advances in artificial intelligence have also shown promise in detecting brain tumor tissue that surgeons might otherwise miss. An AI system called FastGlioma, developed at the University of Michigan Health, has demonstrated 92% accuracy in calculating residual brain cancer following surgery, with results available within seconds.
These complementary technologies represent a significant advancement in precision cancer surgery, potentially improving outcomes for thousands of brain cancer patients annually by maximizing tumor removal while preserving healthy brain tissue.
