The precise excision of tumours is a key and formidable part of oncological surgery. For example, up to 35% of surgical operations for breast cancer result in positive margins, which show that there are cancerous cells in the area around the removed tissue. This increases the risk of cancer recurrence and often leads to repeated surgeries. Before surgery, imaging techniques like ultrasonography are helpful, but during the process, they frequently fail to clearly define the boundaries of the tumour. The necessity for real-time intraoperative imaging equipment that can better support surgeons during their surgeries has increased as a result of this discrepancy.

An innovative surgical imaging platform has been developed to meet this need by a collaborative research team led by Dr. Seung Beum Suh (Centre for Bionics) and Dr. Sehoon Kim (Centre for Chemical and Biological Convergence) at the Korea Institute of Science and Technology (KIST), in collaboration with Professor Hyo-Jin Lee from Chungnam National University Hospital. In order to properly illuminate cancerous tissue during surgery, the team has created a technology that uses genetically modified bacteria that release fluorescent light at tumour areas. This technique is similar to a “neon sign” for tumours.

The researchers have developed a bacterial system that induces fluorescence exclusively in tumour environs, allowing surgeons to pinpoint the tumor’s location and margins in real-time. The signal persists in the body for over 72 hours and delineates tumours, including those in deep or intricate internal organs. This method renders tumours discernible to the unaided eye under standard surgical illumination, thereby diminishing uncertainty and alleviating surgical stress.

This platform, in contrast to conventional contrast agents designed for specific cancer types, addresses two common traits of several solid tumours: hypoxia and immune evasion. This renders it widely effective against diverse tumour forms. Because it operates in the near-infrared region and emits a fluorescent signal that is around five times more powerful than that of conventional agents, it can be used with standard imaging equipment and surgical scopes. Additionally, it might be easily integrated with intraoperative imaging and robotic surgery, improving the accuracy and efficiency of surgery.

This invention shows great therapeutic and commercial promise and may be integrated with hospitals’ existing fluorescence-guided surgery systems.

The platform will eventually be developed into a whole cancer treatment system that includes therapy, surgery, and diagnostics, according to the study team. The modified bacteria may serve as delivery systems for anticancer pharmaceuticals or therapeutic proteins. Present initiatives concentrate on integrating this bacterial platform with sophisticated imaging technologies, precise drug delivery mechanisms, and comprehensive safety evaluations to facilitate clinical application.

Dr. Suh of KIST emphasized the innovation, stating, “This study demonstrates a novel approach in which bacteria autonomously locate tumors and emit fluorescent signals, allowing real-time identification of tumor location and boundaries during surgery. Its applicability across a range of solid tumors positions it as a potential new standard for precision surgical imaging.”

Established in 1966 as the first government-funded research institute in South Korea, KIST continues to use cutting-edge science and innovation to address important national and societal issues. Further details are available at https://www.kist.re.kr/eng/index.do.

This pioneering research received assistance from the Ministry of Science and ICT (Minister Sang Im Yoo) under KIST’s Major Program. The research was highlighted on the Front Cover of the international journal Advanced Materials (Impact Factor: 29.4, JCR ranking: 2.0%), emphasising the global importance of the findings.

Original Publication
Authors: Dohee Lee, Heung Jin Jeon, Dohyub Jang, Deukhee Lee, Solbi Kim, Minju Han, Sharon Jiyoon Jung, Jung‐Hyun Lee, Jia Choi, Dong Ha Kim, Dong June Ahn, Keri Kim, Sehoon Kim, Hyo‐Jin Lee and SeungBeum Suh.
Journal: Advanced Materials
DOI: 10.1002/adma.202504389
Article Title: Engineering Bacterial Secretion Systems for Enhanced Tumor Imaging and Surgical Guidance
Article Publication Date: 21-May-2025