Use of in vivo near-infrared laser confocal endomicroscopy with indocyanine green to detect the boundary of infiltrative tumor Laboratory investigation
Use of in vivo near-infrared laser confocal endomicroscopy with indocyanine green to detect the boundary of infiltrative tumor Laboratory investigation
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DOI：
10.3171/2011.8.jns11559
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发表时间：
2011-12-01
影响因子：
4.1
通讯作者：
Preul, Mark C.
中科院分区：
文献类型：
--
作者：
Martirosyan, Nikolay L.;Cavalcanti, Daniel D.;Preul, Mark C.
物体。浸润性肿瘤切除是基于对肿瘤组织的局部(宏观)成像识别，并试图在宏观上看起来正常的组织中勾画出浸润性肿瘤的边缘，同时保留正常的脑组织。以吲哚青绿(ICG)为活体工具，利用近红外(NIR)成像系统对微型化共聚焦光纤内窥镜进行检测，以识别浸润性胶质母细胞瘤细胞和肿瘤边缘。30只小鼠于移植GL261-Luc细胞14天后行开颅及活体成像。静脉注射ICG 0.4 mg/kg。使用手持共聚焦内窥镜探头采集正常脑、明显肿瘤和瘤周区域的近红外图像。组织学标本取自匹配的成像区域，用于组织图像的对比。在体内，近红外波长共聚焦显微镜与ICG检测肿瘤细胞的荧光。使用手术显微镜进行的NIR和ICG宏观成像一般与肿瘤和瘤周区域相关，但使用ICG进行的NW共聚焦内窥镜显示瘤周组织中单个肿瘤细胞和卫星；明确的肿瘤边界；以及与标准临床组织学特征和已知组织结构相关的不同肿瘤区域显著的微血管、细胞和亚细胞结构(例如，有丝分裂和细胞核)。宏观荧光对肉眼肿瘤的检测是有效的，但使用ICG进行的近红外共聚焦内窥镜检查提高了肿瘤检测的敏感性，提供了与成像位置精确相关的实时真实微观组织学信息。首次使用这种近红外技术来检测癌症表明，结合宏观和微观的活体ICG成像可以交互地识别微观的肿瘤细胞向大脑的渗透，从而大大改善手术中的决策。(DOI：10.317112011.8.JNS11559)
Object. Infiltrative tumor resection is based on regional (macroscopic) imaging identification of tumorous tissue and the attempt to delineate invasive tumor margins in macroscopically normal-appearing tissue, while preserving normal brain tissue. The authors tested miniaturized confocal fiberoptic endomicroscopy by using a near-infrared (NIR) imaging system with indocyanine green (ICG) as an in vivo tool to identify infiltrating glioblastoma cells and tumor margins.Methods. Thirty mice underwent craniectomy and imaging in vivo 14 days after implantation with GL261-luc cells. A 0.4 mg/kg injection of ICG was administered intravenously. The NIR images of normal brain, obvious tumor, and peritumoral zones were collected using the handheld confocal endomicroscope probe. Histological samples were acquired from matching imaged areas for correlation of tissue images.Results. In vivo NIR wavelength confocal endomicroscopy with ICG detects fluorescence of tumor cells. The NIR and ICG macroscopic imaging performed using a surgical microscope correlated generally to tumor and peritumor regions, but NW confocal endomicroscopy performed using ICG revealed individual tumor cells and satellites within peritumoral tissue; a definitive tumor border; and striking fluorescent microvascular, cellular, and subcellular structures (for example, mitoses, nuclei) in various tumor regions correlating with standard clinical histological features and known tissue architecture.Conclusions. Macroscopic fluorescence was effective for gross tumor detection, but NIR confocal endomicroscopy performed using ICG enhanced sensitivity of tumor detection, providing real-time true microscopic histological information precisely related to the site of imaging. This first-time use of such NIR technology to detect cancer suggests that combined macroscopic and microscopic in vivo ICG imaging could allow interactive identification of microscopic tumor cell infiltration into the brain, substantially improving intraoperative decisions. (DOI: 10.317112011.8.JNS11559)