Fluorescent-Guided Surgical Resection of Glioma with Targeted Molecular Imaging Agents: A Literature Review.
Fluorescent-Guided Surgical Resection of Glioma with Targeted Molecular Imaging Agents: A Literature Review.
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DOI：
10.1016/j.wneu.2016.02.060
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发表时间：
2016-06
影响因子：
2
通讯作者：
Brady-Kalnay SM
中科院分区：
文献类型：
--
作者：
Craig SEL;Wright J;Sloan AE;Brady-Kalnay SM
诊断为胶质母细胞瘤(GBM)后的平均预期寿命为15个月。虽然化疗有朝一日可能会通过杀死高度分散的恶性细胞来治愈GBM，但目前临床医生为提高存活率所能做出的最重要贡献是通过最大限度地扩大切除范围并提供同步放化疗，这已成为标准。随着改进的术中肿瘤可视化方法的出现和实施，这一领域已经取得了长足的进步。其中一种技术是使用靶向分子成像剂的光学荧光成像，它允许外科医生在手术过程中使用特殊显微镜查看荧光标记的肿瘤组织，从而突出哪里需要切除，并指示何时获得了无肿瘤的边缘。这一优势在难以观察到肿瘤细胞渗入正常组织的边缘时尤为重要。靶向荧光剂在识别肿瘤和非肿瘤组织方面也可能很有价值。在这篇综述中，我们首先对非靶向荧光肿瘤显像剂进行了简要的概述，然后讨论了在荧光引导手术或实时分子导航的背景下正在开发的用于脑胶质瘤成像的几种新型靶向荧光显像剂。其中许多药物目前正在进行临床前试验。然而，随着代理变得可用，有必要了解每个代理的优缺点。
The median life expectancy following a diagnosis of glioblastoma (GBM) is 15 months. While chemotherapeutics may someday cure GBM by killing the highly dispersive malignant cells, the most important contribution that clinicians can currently offer to improve survival is by maximizing the extent of resection and providing concurrent chemo-radiation, which has become standard. Strides have been made in this area with the advent and implementation of methods of improved intraoperative tumor visualization. One of these techniques, optical fluorescent imaging with targeted molecular imaging agents, allows the surgeon to view fluorescently labeled tumor tissue during surgery with the use of special microscopy – thereby highlighting where to resect, and indicating when tumor-free margins have been obtained. This advantage is especially important at the difficult to observe margins where tumor cells infiltrate normal tissue. Targeted fluorescent agents also may be valuable for identifying tumor versus non-tumor tissue. In this review, we briefly summarize non-targeted fluorescent tumor imaging agents before discussing several novel targeted fluorescent agents being developed for glioma imaging in the context of fluorescent guided surgery or live molecular navigation. Many of these agents are currently undergoing preclinical testing. As the agents become available, however, it is necessary to understand the strengths and weaknesses of each.