Detection Limits of Intraoperative Near Infrared Imaging for Tumor Resection
Detection Limits of Intraoperative Near Infrared Imaging for Tumor Resection
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DOI：
10.1002/jso.21735
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发表时间：
2010-12-01
影响因子：
2.5
通讯作者：
Weissleder, Ralph
中科院分区：
文献类型：
--
作者：
Thurber, Greg M.;Figueiredo, Jose-Luiz;Weissleder, Ralph
背景和目的：荧光分子成像在外科肿瘤学中的应用是一个发展中的领域，具有降低发病率和死亡率的潜力。然而，成功干预的检测阈值和其他要求仍然知之甚少。在这里，我们模拟和实验验证了肿瘤沉积的探测深度和大小，感兴趣区域的覆盖和分辨率，以及根据肿瘤靶点呈现的不同水平所需的探针的药代动力学。方法：利用宽视野外荧光和共聚焦显微镜对三个原位肿瘤模型进行成像，并将实验结果与药代动力学模型和光散射模拟结果进行比较，以确定检测阈值。结果：宽视野荧光成像在低客观放大下可以提供足够的对比度来显示肿瘤边缘，并基于标记的单抗检测3-5 mm深的肿瘤沉积。在更高的放大倍数下，细胞分辨率的表面肿瘤沉积可以在高表达抗原的TBR比率下被检测到。结论：具有宏观测量和显微成像能力的宽视野照明系统为不同的手术目标提供了最大的实用价值。这些结果对系统和制剂设计有影响，最终将有助于大多数外科床位的完全切除，并提供实时反馈以获得干净的切缘。J·奥科尔外科医生。2010；102：758-764。(C)2010年Wiley-Liss公司
Background and Objectives: The application of fluorescent molecular imaging to surgical oncology is a developing field with the potential to reduce morbidity and mortality. However, the detection thresholds and other requirements for successful intervention remain poorly understood. Here we modeled and experimentally validated depth and size of detection of tumor deposits, trade-offs in coverage and resolution of areas of interest, and required pharmacokinetics of probes based on differing levels of tumor target presentation.Methods: Three orthotopic tumor models were imaged by widefield epifluorescence and confocal microscopes, and the experimental results were compared with pharmacokinetic models and light scattering simulations to determine detection thresholds.Results: Widefield epifluorescence imaging can provide sufficient contrast to visualize tumor margins and detect tumor deposits 3-5 mm deep based on labeled monoclonal antibodies at low objective magnification. At higher magnification, surface tumor deposits at cellular resolution are detectable at TBR ratios achieved with highly expressed antigens.Conclusions: A widefield illumination system with the capability for macroscopic surveying and microscopic imaging provides the greatest utility for varying surgical goals. These results have implications for system and agent designs, which ultimately should aid complete resection in most surgical beds and provide real-time feedback to obtain clean margins. J. Surg. Oncol. 2010;102:758-764. (C) 2010 Wiley-Liss, Inc.