Intraoperative Imaging of Pulmonary Adenocarcinoma

肺腺癌的术中影像学

• 批准号: 8918074
• 负责人: COLLEEN Gaughan
• 金额: --
• 依托单位: PHILADELPHIA VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-04-01 至 2020-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8918074
• 关键词: Address; Adenocarcinoma; Arts; Biological Preservation; Breast Carcinoma; Cancer Detection; Cancer Etiology; Cessation of life; Chest; Clinical; Clinical Trials; Contrast Media; Correlative Study; Deposition; Detection; Development; Disease; Enrollment; Excision; Eye; FOLR1 gene; Fluorescein-5-isothiocyanate; Fluorescent Probes; Folic Acid; Goals; Hand; Human; Image; Image-Guided Surgery; Immunotherapeutic agent; Incidence; Institutional Review Boards; Label; Left; Lung; Lung Adenocarcinoma; Lung Neoplasms; Malignant - descriptor; Malignant Neoplasms; Malignant neoplasm of lung; Medical; Medical center; Methods; Military Personnel; Morbidity - disease rate; Neoplasm Metastasis; Non-Small-Cell Lung Carcinoma; Normal tissue morphology; Operative Surgical Procedures; Optics; Ovarian; Parathyroid Adenoma; Patients; Perfusion; Philadelphia; Poison; Primary Neoplasm; Procedures; Recurrence; Resectable; Residual Tumors; Risk; Safety; Smoke; Staging; Surgeon; Surgical margins; Techniques; Technology; Testing; Therapeutic; Time; Tissues; Translations; United States; Unnecessary Surgery; Veterans; Work; aerosolized; cancer cell; cancer imaging; cancer surgery; chemotherapy; design; fluorescence imaging; fluorophore; folate-binding protein; improved; innovation; intraoperative imaging; kidney cell; lymph nodes; neoplastic cell; operation; optical imaging; overexpression; prevent; public health relevance; standard of care; success; tool; tumor

 DESCRIPTION (provided by applicant): Project Summary Surgery remains the best therapeutic option for lung cancer, and approximately 7,400 Veterans and 63,500 non-Veterans undergo lung cancer surgery in the United States each year. However, 17-20% of patients develop local recurrences after lung cancer surgery. Once they recur, their 2 year survival is less than 15%. Patients typically develop local recurrences in two places: positive surgical margins and regional metastases. Our goal is to improve the intraoperative identification of tumor cells at positive margins and regiona metastases that may be missed by a surgeon during a pulmonary resection. Improved identification of tumor cells will result in superior disease clearance and more accurate clinical staging. We hypothesize that targeted fluorescent imaging during surgery will improve identification of positive margins and metastases. Since folate receptor alpha (FRa) is expressed on 55% of resectable lung cancer, we will utilize a fluorescent probe (folate- FITC) that targets these tumors. In order to test our hypothesis, we will investigate the following objectives: 1) Evaluate the safety, feasibility and applicability of performing intraoperative imaging during a pulmonary resection. 2) To assess the intraoperative benefits of image-guided surgery using a folate receptor-targeted fluorescent probe. 3) To conduct ex vivo correlative studies on the lung tumors following intraoperative imaging. This technology has the potential to fundamentally transform cancer surgery in the United States. As real-time imaging provides more information to the surgeon, more personalized and directed operations can be conducted. This work will allow for more preservation of normal tissue, decreased morbidity, decreased surgical time, increased surgical confidence, improved cancer detection, decreased unnecessary surgery and ultimately improved tumor free survival. This technology should transform clinical surgery from an art that depends fully on the human factor to a procedure that has precision and fail safes.

 描述（由申请人提供）： 手术仍然是肺癌的最佳治疗选择，美国每年约有7，400名退伍军人和63，500名非退伍军人接受肺癌手术。然而，17-20%的患者在肺癌手术后出现局部复发。一旦复发，2年生存率不到15%。患者通常在两个地方出现局部复发：手术切缘阳性和区域转移。我们的目标是提高术中识别肿瘤细胞在阳性边缘和区域转移，可能会错过外科医生在肺切除术。改进肿瘤细胞的识别将导致更好的上级疾病清除和更准确的临床分期。我们假设，在手术中靶向荧光成像将提高阳性边缘和转移的识别。由于叶酸受体α（FRa）在55%的可切除肺癌上表达，我们将利用靶向这些肿瘤的荧光探针（叶酸- FITC）。为了验证我们的假设，我们将研究以下目标：1）评价肺切除术期间进行术中成像的安全性，可行性和适用性。2)评估使用叶酸受体靶向荧光探针进行图像引导手术的术中获益。3)目的：对肺肿瘤术中影像学进行离体相关研究。这项技术有可能从根本上改变美国的癌症手术。由于实时成像为外科医生提供了更多信息，因此可以进行更个性化和更有针对性的手术。这项工作将允许更多地保护正常组织，降低发病率，减少手术时间，增加手术信心，改善癌症检测，减少不必要的手术，并最终提高无肿瘤生存率。这项技术应该将临床手术从完全依赖人为因素的艺术转变为具有精确度和故障安全性的手术。