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Fluorescent guided surgery

Alessandro Della Puppa, Giuseppe Lombardi, Marta Rossetto, Oriela Rustemi, Franco Berti, Diego Cecchin, Marina Paola Gardiman, Giuseppe Rolma, Luca Persano, Vittorina Zagonel, Renato Scienza
The purpose of the study was to evaluate the clinical outcome of the association of BCNU wafers implantation and 5-aminolevulinic acid (5-ALA) fluorescence in the treatment of patients with newly diagnosed glioblastoma (ndGBM). Clinical and surgical data from patients who underwent 5-ALA surgery followed by BCNU wafers implantation were retrospectively evaluated (20 patients, Group I) and compared with data of patients undergoing surgery with BCNU wafers alone (42 patients, Group II) and 5-ALA alone (59 patients, Group III)...
October 18, 2016: Journal of Neuro-oncology
Jintao Liu, Wenbin Guo, Meng Tong
BACKGROUND: Different techniques have been used for the guidance of nonpalpable breast cancer (NBC), but none of them has yet achieved perfect results. The aim of this study was to evaluate the feasibility of indocyanine green (ICG) fluorescence-guided nonpalpable breast cancer lesion excision (IFNLE), to introduce an alternative technique. METHODS: The data about 56 patients with preoperatively diagnosed NBCs operated with the help of intraoperative IFNLE between November of 2010 and September of 2014 were retrospectively analyzed...
October 18, 2016: World Journal of Surgical Oncology
Nayan Patel, Paula Pera, Penny Joshi, Mykhaylo Dukh, Walter A Tabaczynski, Kevin E Siters, Mark Kryman, Ravindra R Cheruku, Farukh Durrani, Joseph R Missert, Ramona Watson, Tymish Y Ohulchanskyy, Erin Tracy, Heinz Baumann, Ravindra K Pandey
We report herein, the synthesis and biological efficacy of near-infrared (NIR), bacteriochlorin analogs: 3-(1'-butyloxy)ethyl-3-deacetyl-bacteriopurpurin-18-N-butylimide methyl ester (3) and the corresponding carboxylic acid 10. In in vitro assays, compared to its methyl ester analog 3, the corresponding carboxylic acid derivative 10 showed higher photosensitizing efficacy. However, due to drastically different pharmacokinetics in vivo, the PS 3 (HPLC purity > 99%) showed higher tumor uptake and long-term tumor cure than 10 (HPLC purity > 96...
October 17, 2016: Journal of Medicinal Chemistry
Eric Leblanc, Fabrice Narducci, Lucie Bresson, Delphine Hudry
OBJECTIVE: To explore the feasibility of an oncologically acceptable management for an intermediate-risk endometrial cancer (EC) in an elderly, using the combination of transvaginal single-port laparoscopy and sentinel node policy. METHODS: For this 85-years old patient, BMI 32kg/m(2), with IB grade 2 endometrioid EC, a single vaginal approach was attempted [1] to perform a total hysterectomy, bilateral salpinago-oophorectomy and pelvic node assessment guided by SND [2]...
October 13, 2016: Gynecologic Oncology
Kara M Harmatys, Anthony J Musso, Kasey J Clear, Bradley D Smith
Administration of exogenous 5-aminolevulinic acid (5-ALA) to cancerous tissue leads to intracellular production of photoactive protoporphyrin IX, a biosynthetic process that enables photodynamic therapy and fluorescence-guided surgery of cancer. Cell uptake of 5-ALA is limited by its polar structure and there is a need for non-toxic chemical additives that can enhance its cell permeation. Two zinc-bis(dipicolylamine) (ZnBDPA) compounds were evaluated for their ability to promote uptake of 5-ALA into Chinese Hamster Ovary (CHO-K1) cells and produce protoporphyrin IX...
October 7, 2016: Photochemical & Photobiological Sciences
Justin A Neira, Timothy H Ung, Jennifer S Sims, Hani R Malone, Daniel S Chow, Jorge L Samanamud, George J Zanazzi, Xiaotao Guo, Stephen G Bowden, Binsheng Zhao, Sameer A Sheth, Guy M McKhann, Michael B Sisti, Peter Canoll, Randy S D'Amico, Jeffrey N Bruce
OBJECTIVE Extent of resection is an important prognostic factor in patients undergoing surgery for glioblastoma (GBM). Recent evidence suggests that intravenously administered fluorescein sodium associates with tumor tissue, facilitating safe maximal resection of GBM. In this study, the authors evaluate the safety and utility of intraoperative fluorescein guidance for the prediction of histopathological alteration both in the contrast-enhancing (CE) regions, where this relationship has been established, and into the non-CE (NCE), diffusely infiltrated margins...
October 7, 2016: Journal of Neurosurgery
Jonathan T Elliott, Alisha V Dsouza, Kayla Marra, Brian W Pogue, David W Roberts, Keith D Paulsen
Fluorescence guided surgery has the potential to positively impact surgical oncology; current operating microscopes and stand-alone imaging systems are too insensitive or too cumbersome to maximally take advantage of new tumor-specific agents developed through the microdose pathway. To this end, a custom-built illumination and imaging module enabling picomolar-sensitive near-infrared fluorescence imaging on a commercial operating microscope is described. The limits of detection and system specifications are characterized, and in vivo efficacy of the system in detecting ABY-029 is evaluated in a rat orthotopic glioma model following microdose injections, showing the suitability of the device for microdose phase 0 clinical trials...
September 1, 2016: Biomedical Optics Express
Z Li, Q Zhou, J Zhou, X Duan, J Zhu, T D Wang
Minimally-invasive surgery of hepatocellular carcinoma (HCC) can be limited by poor tumor visualization with white light. We demonstrate systemic administration of a Cy5.5-labeled peptide specific for epidermal growth factor receptor (EGFR) to target HCC in vivo in a mouse xenograft model. We attached a compact imaging module to the proximal end of a medical laparoscope to collect near-infrared fluorescence and reflectance images concurrently at 15 frames/sec. We measured a mean target-to-background ratio of 2...
September 1, 2016: Biomedical Optics Express
Yukihiko Hiroshima, Thinzar M Lwin, Takashi Murakami, Ali A Mawy, Tanaka Kuniya, Takashi Chishima, Itaru Endo, Bryan M Clary, Robert M Hoffman, Michael Bouvet
BACKGROUND AND OBJECTIVES: Delineation of adequate tumor margins is critical in oncologic surgery, particularly in resection of metastatic lesions. Surgeons are limited in visualization with bright-light surgery, but fluorescence-guided surgery (FGS) has been efficacious in helping the surgeon achieve negative margins. METHODS: The present study uses FGS in a mouse model that has undergone surgical orthotopic implantation (SOI) of colorectal liver metastasis tagged with green fluorescent protein (GFP)...
October 3, 2016: Journal of Surgical Oncology
Shuya Yano, Kiyoto Takehara, Shinji Miwa, Hiroyuki Kishimoto, Hiroshi Tazawa, Yasuo Urata, Shunsuke Kagawa, Michael Bouvet, Toshiyoshi Fujiwara, Robert M Hoffman
We have previously developed a genetically-engineered GFP-expressing telomerase-dependent adenovirus, OBP-401, which can selectively illuminate cancer cells. In the present report, we demonstrate that targeting a triple-negative high-invasive human breast cancer, orthotopically-growing in nude mice, with OBP-401 enables curative fluorescence-guided surgery (FGS). OBP-401 enabled complete resection and prevented local recurrence and greatly inhibited lymph-node metastasis due to the ability of the virus to selectively label and subsequently kill cancer cells...
September 28, 2016: Oncotarget
Jean-Yves Winum
The present patent discloses the identification of small-molecule fluorescent probes constituted by pteroic acid moiety connected to near-infrared (NIR) dye via amino acids. These folate receptor (FR) targeted conjugates were shown to have high affinity for tumors that overexpress FRs. A selected compound from this new class, pteroyl-L-tyrosine-S0456 (OTL-0038), displays high affinity and specificity for FRs and was shown (i) to accumulate in vivo in tumor cells expressing FRs, and (ii) to be non-toxic in mice at clinical dose x 1000...
October 4, 2016: Expert Opinion on Therapeutic Patents
Sameer H Halani, D Cory Adamson
Surgical resection is typically the first line of treatment for gliomas. However, the neurosurgeon faces a major challenge in achieving maximal resection in high-grade gliomas as these infiltrative tumors make it difficult to discern tumor margins from normal brain with conventional white-light microscopy alone. To aid in resection of these infiltrative tumors, fluorescence-guided surgery has gained much popularity in intraoperative visualization of malignant gliomas, with 5-aminolevulinic acid (5-ALA) leading the way...
2016: OncoTargets and Therapy
Agnieszka Rychlik, Silvia Marin, Javier De Santiago, Ignacio Zapardiel
OBJECTIVE: Multiple tracers have been used to improve lymphatic mapping and to reduce the false-negative rate of the sentinel node detection in gynecologic cancers. Nowadays, 99mTc colloids combined with blue-dye technique is the most extended technique. New alternatives such as the fluorescent indocyanine green and near-infrared fluorescent imaging detection have been introduced in lymphatic mapping staging procedures because of its easier visualization compared with the previous tracers...
September 2016: International Journal of Gynecological Cancer
Takuro Matsumoto, Atsushi Suetsugu, Kosuke Hasegawa, Miki Nakamura, Yuhei Shibata, Hitomi Aoki, Takahiro Kunisada, Hisashi Tsurumi, Masahito Shimizu, Michael Bouvet, Robert M Hoffman
BACKGROUND: Fluorescence-guided surgery (FGS) of tumors is an area of intense development. Peritoneally-disseminated cancer, however, represents a difficult surgical challenge. MATERIALS AND METHODS: To help meet this challenge, EL4 mouse T-cell lymphoma cells expressing red fluorescent protein (RFP) were injected intraperitoneally in nude mice. RESULTS: Two weeks after injection of EL4-RFP cells, established peritoneally-disseminated tumors were observed...
September 2016: Anticancer Research
Kosuke Hasegawa, Atsushi Suetsugu, Miki Nakamura, Takuro Matsumoto, Takahiro Kunisada, Masahito Shimizu, Shigetoyo Saji, Hisataka Moriwaki, Michael Bouvet, Robert M Hoffman
BACKGROUND/AIM: Fluorescence-guided surgery (FGS) of cancer is an emerging technology. We have previously shown the importance of resecting both the tumor and the tumor microenvironment (TME) for curative FGS. We also previously developed a syngeneic model using the mouse lymphoma cell line EL-4, expressing red fluorescent protein (EL-4-RFP), growing in green fluorescent protein (GFP) transgenic mice, which we have used in the present report to develop FGS of the tumor microenvironment...
September 2016: Anticancer Research
Hideo Takahashi, Nisar Zaidi, Eren Berber
BACKGROUND: There has been a recent interest in the use of Indocyanine green (ICG) imaging. The aim of this study is to review our initial experience in liver surgery. METHODS: ICG fluorescent imaging was used in 15 patients undergoing surgical treatment of their liver tumors between 2015 and 2016. ICG imaging was initially performed, followed by intraoperative ultrasound (IOUS). Findings on fluorescence were compared with preoperative cross-sectional imaging and IOUS...
October 2016: Journal of Surgical Oncology
Simon C Y Chow, Calvin S H Ng
In the modern era when screening and early surveillance of pulmonary nodules is increasing in importance, the management of the pulmonary nodule represents a different challenge to thoracic surgeons. The difficulty lies in the merging of sound surgical and oncological principles with more minimally invasive and appropriate lung sparing surgery. Furthermore, the intra-operative identification and surgical management of small and sometimes multi-focal pulmonary lesions remain challenging. There have been many developments and innovations in the field of video-assisted thoracoscopic surgery (VATS) to cater for the demands from increasing incidence of pulmonary nodules with associated paradigm shift in their surgical management...
July 2016: Journal of Thoracic Disease
Lindsay Scott Moore, Eben L Rosenthal, Thomas K Chung, Esther de Boer, Neel Patel, Andrew C Prince, Melissa L Korb, Erika M Walsh, Erik Scott Young, Todd M Stevens, Kirk P Withrow, Anthony B Morlandt, Joshua Richman, William R Carroll, Kurt R Zinn, Jason M Warram
RATIONALE: To assess the potential of US Food and Drug Administration cleared devices designed for indocyanine green-based perfusion imaging to identify cancer-specific bioconjugates with overlapping excitation and emission wavelengths. BACKGROUND: Recent clinical trials have demonstrated potential for fluorescence-guided surgery, but the time and cost of the approval process may impede clinical translation. To expedite this translation, we explored the feasibility of repurposing existing optical imaging devices for fluorescence-guided surgery...
September 1, 2016: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
Priya Patel, Tatsuya Kato, Hideki Ujiie, Hironobu Wada, Daiyoon Lee, Hsin-Pei Hu, Kentaro Hirohashi, Jin Young Ahn, Jinzi Zheng, Kazuhiro Yasufuku
BACKGROUND: Investigation of CF800, a novel PEGylated nano-liposomal imaging agent containing indocyanine green (ICG) and iohexol, for real-time near infrared (NIR) fluorescence and computed tomography (CT) image-guided surgery in an orthotopic lung cancer model in nude mice. METHODS: CF800 was intravenously administered into 13 mice bearing the H460 orthotopic human lung cancer. At 48 h post-injection (peak imaging agent accumulation time point), ex vivo NIR and CT imaging was performed...
2016: PloS One
Andrei Nemes, Thomas Fortmann, Stephan Poeschke, Burkhard Greve, Daniel Prevedello, Antonio Santacroce, Walter Stummer, Volker Senner, Christian Ewelt
OBJECTIVE: Pituitary adenomas (PA), especially invasive ones, are often not completely resectable. Usage of 5-aminolevulinic acid (5-ALA) for fluorescence guided surgery could improve the rate of total resection and, additionally, open the doors for photodynamic therapy (PDT) in case of unresectable or partially resected PAs. The aim of this study was to investigate the uptake of 5-ALA and the effect of 5-ALA based PDT in cell lines. METHODS: GH3 and AtT-20 cell lines were incubated with different concentrations of 5-ALA, protoporphyrin IX (PPIX) fluorescence was measured by flow cytometry and fluorescencespectrometry...
2016: PloS One
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