Sheffield Cancer Research Centre Newsletter
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1 Sheffield Cancer Research Centre Newsletter Issue 13 November 2014 Novel intra-operative technology in development gets recognised as a finalist in annual Medipex NHS Innovation Award An innovation under development in the Department of Oncology was selected as one of five finalists in Medical Devices & Diagnostics Category in this year s Medipex NHS Innovation Awards competition. Accurate identification of parathyroid glands during thyroid and parathyroid surgery is important in preserving normal glands and excision of abnormally enlarged glands. Current practice relies on surgical judgement and experience and is often inaccurate. This may result in inadvertent damage to normal parathyroid glands resulting in hypocalcaemia. The fourth national audit of the British Association of Endocrine and Thyroid Surgeons (BAETS) demonstrates that this occurs in more than a quarter of patients undergoing total thyroidectomy. Postoperative hypocalcaemia is associated with significant short and long term morbidity. The innovation is to use an intra-operative device to enable the surgeon to accurately identify and preserve parathyroid glands. The technology that is being tested is near infrared (NIR) fluorescent imaging using intravenous Methylene Blue (MB). MB is a dye occasionally used in parathyroid surgery and helps in the naked-eye identification of enlarged parathyroid glands. At currently used doses, it is associated with significant side effects. However, low dose MB emits fluorescence that can potentially be detected intra-operatively. Fluobeam700 is a CE marked, hand held device for use in the intra-operative environment that is able to detect fluorescence at around 700nm from low dose Methylene Blue. The team in Oncology (Dr Saba Balasubramanian Senior Clinical Lecturer and Endocrine Surgeon, Mr Barney Harrison Consultant Endocrine Surgeon, Professor Nicola Brown, Professor of Oncology and Ramez Antakia, MPhil Research Student) have collaborated with Fluoptics, a SME in Grenoble, France (the manufacturers of the device). They have done animal and early Phase I human studies that have clearly demonstrated differential uptake of Methylene Blue in the soft tissues of the neck and the ability of the technology to detect MB emitted fluorescence. Currently, a phase Ib clinical study is underway to develop a clinical protocol that can be used routinely by surgeons undertaking this type of surgery. The clinical protocol will then be tested in phase II/III studies to evaluate the efficacy of the technology in the improvement of clinical outcomes. 1
2 Fluorescence intensity (grey levels/ms) Near infrared fluorescent imaging of soft tissues in the central compartment of the rabbit neck approximately seconds following intravenous administration of Methylene Blue. Left external parathyroid Right external parathyroid Graph showing the evolution of the fluorescence signal in the left and right lobes of the thyroid gland, left and right external parathyroid glands and muscle following the IV injection of 0.1 mg/ kg of MB in a rabbit Left parathyroid Right parathyroid Left Thyroid Right Thyroid Muscle Time (s) 2
3 Future doctors inspired by medical summer school. Cancer researchers secure cover of Clinical Cancer Research. This month s Clinical Cancer Research features a Sheffield Cancer Research Centre report profiling long non-coding RNA in bladder cancer. The authors from the Catto-lab (Professor James Catto) were delighted to be told they had been selected as the leading priority article in this high ranking translational research journal and that their image was the front cover story. 3
4 Jackie Pickering is a patient on a clinical trial at Weston Park Hospital. Yorkshire Post printed article about her experience. 4
5 Diary Dates Seminar Series for information, please see: Autumn series now available. 12 th November 2014 Internal Seminar University of Sheffield LT3, F Floor, Medical School Uveal Melanoma/Sarcoma Azeez Salawu, Department of Oncology Biomarkers/mechanistic proteins of breast cancer bone metastasis Jules Westbrook, Department of Oncology 10 th December 2014 Internal Seminar University of Sheffield LT3, F Floor, Medical School Leukaemia control/proficiency testing in flow cytometry David Barnett, Consultant Clinical Scientist, Director UK NEQAS for Leucocyte Immunophenotyping Nutritional status, oral HPV infection and oropharyngeal cancers Vanessa Hearnden, Human Nutrition, Department of Oncology, Call for Centre News Stories What exciting developments are taking place in your research and training? We need to show what great work is going on in Sheffield, not least so that we demonstrate our strengths to potential funders. We need to shout about: * New research findings, particularly published papers * Recently funded studies at start up * Prizes or awards received * Innovations in equipment/treatment * Your involvement in public events * Anything else you feel you would like to publicise or Please send anything of interest to Deborah Reid (deborah.reid@sheffield.ac.uk). 5
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