Evaluation of intraoperative fluorescence imaging-guided surgery in cancer-bearing dogs: a prospective proof-of-concept phase II study in 9 cases
Evaluation of intraoperative fluorescence imaging-guided surgery in cancer-bearing dogs: a prospective proof-of-concept phase II study in 9 cases
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DOI：
10.1016/j.trsl.2015.12.001
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发表时间：
2016-04-01
影响因子：
7.8
通讯作者：
Carozzo, Claude
中科院分区：
文献类型：
--
作者：
Gabon, Quentin;Sayag, David;Carozzo, Claude
目的是前瞻性评价术中荧光成像（IOFI）在使用新型脂质纳米颗粒造影剂的犬恶性肿块手术切除中的应用。前瞻性入组表现为自发性软组织肉瘤或皮下肿瘤的犬。进行临床分期和全身计算机断层扫描（CT）。所有的狗接受静脉注射的染料负载的脂质纳米颗粒，LipImage 815。CT检查后行广泛或根治性切除。在皮肤切开前和肿瘤切除后进行实时IOFI。在根治性切除的情况下，淋巴结（LN）成像。测量切缘/正常组织荧光比值或LN/正常组织荧光比值，并与组织学切缘或LN状态进行比较。包括9只狗。截肢3例，广泛切除6例。未观察到不良反应。在所有9个肿瘤中观察到荧光。6只犬中有5只犬在广泛手术切除后切缘干净，所有这些犬的切缘/健康组织荧光比值均接近1.0。在1例病例中观察到浸润边缘，边缘/健康组织荧光比为3.2。3例淋巴结中有2例证实转移，与淋巴结/健康组织荧光比值为2.1和4.2相关，而非转移性淋巴结与比值为1.0相关。在IOFI期间用作造影剂的LipImage 815似乎可以很好地区分肿瘤和健康组织。未来的研究计划使用LipImage 815作为示踪剂来评估IOFI的灵敏度和特异性。
The objective was to prospectively evaluate the application of intraoperative fluorescence imaging (IOFI) in the surgical excision of malignant masses in dogs, using a novel lipid nanoparticle contrast agent. Dogs presenting with spontaneous soft-tissue sarcoma or subcutaneous tumors were prospectively enrolled. Clinical staging and whole-body computed tomography (CT) were performed. All the dogs received an intravenous injection of dye-loaded lipid nanoparticles, LipImage 815. Wide or radical resection was realized after CT examination. Real-time IOFI was performed before skin incision and after tumor excision. In cases of radical resection, the lymph nodes (LNs) were imaged. The margin/healthy tissues fluorescence ratio or LN/healthy tissues fluorescence ratio was measured and compared with the histologic margins or LN status. Nine dogs were included. Limb amputation was performed in 3 dogs, and wide resection in 6. No adverse effect was noted. Fluorescence was observed in all 9 of the tumors. The margins were clean in 5 of 6 dogs after wide surgical resection, and the margin/healthy tissues fluorescence ratio was close to 1.0 in all these dogs. Infiltrated margins were observed in 1 case, with a margin/healthy tissues fluorescence ratio of 3.2. Metastasis was confirmed in 2 of 3 LNs, associated with LN/healthy tissues fluorescence ratios of 2.1 and 4.2, whereas nonmetastatic LN was associated with a ratio of 1.0. LipImage 815 used as a contrast agent during IOFI seemed to allow for good discrimination between tumoral and healthy tissues. Future studies are scheduled to evaluate the sensitivity and specificity of IOFI using LipImage 815 as a tracer.