New high-powered camera to detect cancer being used at California Pacific Medical Center

California Pacific CURRENTS: The online journal of CPMC Research Institute

March 28, 2016 (San Francisco)

A key step in assessing a cancer patient’s stage and prognosis is checking their lymph nodes—small round organs that comprise the body’s lymphatic system—for signs of cancerous spread to other nearby nodes, organs and tissues. The sentinel lymph node (SLN) is the first lymph node to which cancer cells are most likely to spread from a primary tumor, and is often removed and examined in patients (especially those with breast cancer or melanoma) to determine whether cancer cells are present.

For the first time in the U.S., a new technique being studied at California Pacific Medical Center (CPMC) will non-invasively image SLNs in upwards of 100 cancer patients receiving treatment at the hospital. The Sentinella camera is the first intraoperative device of its kind being used to identify SLNs that may be overlooked by traditional imaging techniques or in other cases where visual guidance to see SLNs was impossible.

Correctly identifying SLNs has typically been limited by low resolution imaging during surgery. Undetected SLNs or false-negative biopsy results can lead to cancer recurrence, metastases (i.e., cancer spread) to neighboring tissues and organs, and potentially incorrect or inadequate treatment decisions.

“The Sentinella camera, when used with current standard procedures, offers superior resolution and portability compared with older methods,” said Stanley Leong, MD, a cancer surgeon and oncologist leading the prospective, open-label, single-arm study at CPMC. “This is the first study nationally to document utility of the camera. We anticipate that Sentinella may significantly improve the detection and removal of sentinel lymph nodes, making the sentinel lymph node biopsy more reliable and accurate than previous methods.”

During a standard SLN biopsy, the radiologist injects the patient with a radioactive dye near the tumor. Once the SLN is located, a small incision is made in the overlying skin and the node is removed by the surgeon using a gamma probe that detects radioactivity to find the SLN. The SLN is checked for the presence of cancer cells by a pathologist. If cancer is found, the surgeon may remove additional lymph nodes, either during the same biopsy procedure or during a follow-up surgical procedure.  The Sentinella camera is integrated with gamma probes, pointers and software, and used to precisely survey the excised area for any remaining SLNs. If found, the tissue is examined again with the gamma probe and any potentially cancerous areas are surgically removed. 

“This new technique gives surgeons real-time vision, potentially making a major clinical difference in especially challenging cases of breast cancer and melanoma,” said Dr. Leong. “Our study adds an important component to CPMC’s already broad portfolio of cancer clinical trials and the latest technologies to advance treatment for our patients.”

CPMC’s Center for Melanoma Research and Treatment is one of the largest programs of its kind in the U.S., with research and patient care initiatives that are helping make important strides in the diagnosis and treatment of melanoma. Moving away from a ‘one size fits all’ approach, Drs. Leong, Mohammed Kashani Sabet, MD, David Minor, MD, Kevin Kim, MD and their colleagues are focusing on targeted, personalized strategies to improve patient outcomes.

This year alone, more than 76,000 people will be diagnosed with melanoma in the U.S.

Read more about CPMC’s Center for Melanoma Research and Treatment.

Find melanoma clinical trials at CPMC.