Dynamic Changes in Microvascular Density Can Predict Viable and Non-Viable Areas in High-Risk Neuroblastoma.
Dynamic Changes in Microvascular Density Can Predict Viable and Non-Viable Areas in High-Risk Neuroblastoma.
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神经母细胞瘤是儿童最常见的颅外肿瘤。尽管有新的治疗选择，高危患者的长期生存率仍然很差。在手术过程中，区分存活的恶性组织与坏死区域和周围的健康组织是关键。肿瘤血管结构的变化可以指导外科医生只切除有活力的肿瘤区域，实现更安全，更有效的切除。在本文中，使用组织病理学扫描的载玻片，我们首先检查了不同肿瘤区域的血管密度的变化，表明存活和坏死区域与不同的血管特征相关。然后，我们使用基于光声成像的定制的高清晰度临床前成像设备扫描切除的人类NB标本，该设备非常适合血管成像，显示所获取的图像可以区分肿瘤内的宏观区域。尽管积极的治疗，高风险NB的预后仍然很差。外科肿瘤学需要创新的术中设备来帮助外科医生区分恶性组织和坏死组织以及周围的健康组织。肿瘤血管内的变化可在术中用作指导手术切除的诊断工具。在这里，我们回顾性分析了平均血管密度（MVD）的不同NB亚型在诊断和诱导化疗后使用扫描的组织学样本。前瞻性入组了1例患者，并对两个代表性切片进行了离体光声成像（派）扫描，以评估其区分不同肿瘤区域的能力。我们发现，化疗后，分化型NB和神经节神经母细胞瘤的存活区域与低分化NB相比，MVD更高。早期坏死区的MVD高于晚期坏死区和存活区。最后，钙化区域的MVD显著低于其他组织学成分。所获得的派图像显示出NB边缘的良好的高分辨率离体3D描绘。总的来说，这些结果表明，高清晰度临床前成像设备（如派）可能通过识别不同的血管特征来指导手术切除。
Neuroblastoma (NB) is the most common extracranial tumor in children. Despite the development of new therapeutic options, high-risk patients still have poor long-term survival. Distinguishing viable malignant tissue from necrotic areas and surrounding healthy tissue is pivotal during surgery. Variations in the tumor vascular architecture could guide surgeons to remove only viable tumor regions, achieving a safer and more efficient resection. In this paper, using histopathology scanned slides, we first examined variations in the vasculature density of different tumor regions, showing that viable and necrotic areas are associated with a distinct vascular signature. Then, we scanned an excised human NB specimen using a custom-made high-definition preclinical imaging device based on photoacoustic imaging, which is ideal for imaging vasculature, showing that the acquired images can differentiate macroscopic regions within the tumor. Despite aggressive treatments, the prognosis of high-risk NB remains poor. Surgical oncology needs innovative intraoperative devices to help surgeons discriminate malignant tissue from necrotic and surrounding healthy tissues. Changes within the tumor vasculature could be used intraoperatively as a diagnostic tool to guide surgical resection. Here, we retrospectively analyzed the mean vascular density (MVD) of different NB subtypes at diagnosis and after induction chemotherapy using scanned histological samples. One patient was prospectively enrolled, and an ex vivo photoacoustic imaging (PAI) scan was performed on two representative sections to assess its capacity to discriminate different tumor regions. We found that post-chemotherapy, viable areas of differentiating NBs and ganglioneuroblastomas are associated with higher MVD compared to poorly differentiated NBs. Early necrotic regions showed higher MVD than late necrotic and viable regions. Finally, calcified areas showed significantly lower MVD than any other histological component. The acquired PAI images showed a good high-resolution ex vivo 3D delineation of NB margins. Overall, these results suggest that a high-definition preclinical imaging device such as PAI could potentially be exploited to guide surgical resection by identifying different vasculature signatures.
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影响因子：
4.6
作者：
Bankhead P;Loughrey MB;Fernández JA;Dombrowski Y;McArt DG;Dunne PD;McQuaid S;Gray RT;Murray LJ;Coleman HG;James JA;Salto-Tellez M;Hamilton PW
通讯作者：
Hamilton PW
DOI：
10.3390/children8060482
发表时间：
2021-06-07
期刊：
Children (Basel, Switzerland)
影响因子：
--
作者：
Paraboschi I;Privitera L;Kramer-Marek G;Anderson J;Giuliani S
通讯作者：
Giuliani S
影响因子：
3.8
作者：
Manohar, Srirang;Vaartjes, Susanne E.;van Leeuwen, Ton G.
通讯作者：
van Leeuwen, Ton G.
DOI：
10.1002/ssu.2980090606
发表时间：
1993-11-01
期刊：
SEMINARS IN SURGICAL ONCOLOGY
影响因子：
--
作者：
KIELY, EM
通讯作者：
KIELY, EM
影响因子：
3.5
作者：
Guggenheim, James A.;Allen, Thomas J.;Beard, Paul C.
通讯作者：
Beard, Paul C.