Dyes Highlight Tumors
And glow when exposed to near-infrared light. John B. Carnett

What: Fluorescence-Assisted Resection and Exploration, a new technique that makes cancerous tissue glow during surgery, one cell at a time
Where: Boston
Why: Of the 1.5 million cases of cancer diagnosed annually, nearly all of them require surgery.
Wow: Pinpoints the spread of cancer in seconds

The best way to stop a tumor from spreading is to simply cut it all out. The tricky part is to do that without damaging healthy tissue. Now oncologist John Frangioni at Beth Israel Deaconess Medical Center in Boston has invented a technique that lights up tumorous tissue like a neon sign and sets it off from non-cancerous tissue. It’s called FLARE, for Fluorescence-Assisted Resection and Exploration, and it works a bit like a multicolored highlighter for surgeons.

Step 1: Inject Dye
To map lymph nodes in a pig, doctors start by injecting a contrasting agent into its hind leg.

Step 2: Add Light
The dye flows through the pig’s lymphatic system and glows bright green on a monitor when exposed to near-infrared light.

Dyes Highlight Tumors

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And glow when exposed to near-infrared light

Step 3: Remove Tissue
Using the monitor as a guide, the surgeon cuts out the target lymph node, sparing the unlit healthy tissue around it.

In the operating room, the physician injects a patient’s tumor with dyes that tag lymph fluid and glow when exposed to near-infrared light. The $150,000 FLARE device has three infrared cameras, each calibrated to pick up different frequencies of light. On a video screen, the nerves to be avoided appear fuchsia, while a bright green shines from the tumor and outlines its drainage path to the sentinel lymph nodes — those most likely to collect cancer cells.

Frangioni and a colleague at Beth Israel Deaconess, surgeon Susan Troyan, are currently enrolling about 50 breast-cancer patients in the largest clinical trial of FLARE yet.