Improved Debulking of Peritoneal Tumor Implants by Near-Infrared Fluorescent Nanobody Image Guidance in an Experimental Mouse Model

Debie, Pieterjan; Vanhoeij, Marian; Poortmans, Natalie; Puttemans, Janik; Gillis, Kris; Devoogdt, Nick; Lahoutte, Tony; Hernot, Sophie

doi:10.1007/s11307-017-1134-2

Cited by 45 publications

(34 citation statements)

References 44 publications

(46 reference statements)

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“…Some other fluorophores have been studied in humans, but none of them can currently be used outside experimental setting [29][30][31][32]. For the same reasons we decided not to consider studies on animal models and in vitro studies [20,[31][32][33]. Furthermore, we have not considered studies in which ICG is linked to molecules that bind directly to cancer cells [31,34,34].…”

Section: Discussionmentioning

confidence: 99%

Indocyanine Green Fluorescence-Guided Intraoperative Detection of Peritoneal Carcinomatosis: Systematic Review.

Baiocchi¹,

Gheza

Molfino

et al. 2020

Preprint

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BACKGROUND. To review the available clinical data about the value of Indocyanine Green (ICG) fluorescence imaging for intraoperative detection of peritoneal carcinomatosis. METHODS. We conducted a systematic review, according to the PRISMA guidelines, for clinical series investigating the possible role of ICG fluorescence imaging in detecting peritoneal carcinomatosis during surgical treatment of abdominal malignancies. Key words for search were “indocyanine green”, “carcinomatosis”, “peritoneum”, “fluorescence”. Papers including trials with fluorophores other than ICG were excluded. Papers including in vitro and experimental animals series were also excluded. We extracted data on patients and cancer features, timing, dose and modality of ICG administration, sensitivity, specificity and accuracy of fluorescence diagnosis of peritoneal nodules. RESULTS. Out of 192 screened papers, we finally retrieved 7 series reporting ICG-guided detection of peritoneal carcinomatosis. Two papers reported the same cases, thus only 6 series were analyzed, for a total of 71 patients. The investigated tumors were colorectal carcinomas in 28 cases, hepatocellular carcinoma in 16 cases, ovarian cancer in 26 cases and endometrial cancer in 1 case. In all but 4 cases, the clinical setting was an elective intervention in patients known as having peritoneal carcinomatosis. No series reported a laparoscopic procedure. Technical data of ICG management were consistent across the studies. Overall, 353 lesions were singularly analyzed and evaluated. Sensitivity varied from 72.4–100%, specificity from 54.2–100%. Two series reported that planned intervention changed in 25% and 29% of patients, respectively. CONCLUSION. Indocyanine Green based fluorescence of peritoneal carcinomatosis is a promising intraoperative tool for detection and characterization of peritoneal nodules in patients with colorectal, hepatocellular, ovarian carcinomas. Further prospective studies are needed, including stanging laparoscopy for pancreato-biliary, gastric cancer and other abdominal malignancies with frequent spread to peritoneum.

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Section: Discussionmentioning

confidence: 99%

Indocyanine Green Fluorescence-Guided Intraoperative Detection of Peritoneal Carcinomatosis: Systematic Review.

Baiocchi¹,

Gheza

Molfino

et al. 2020

Preprint

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“…In the present systematic review we decided to consider only papers describing the use of ICG to detect nodules of peritoneal carcinosis, with the aim of evaluating the practical effectiveness of this technique in terms of an immediate translation in the daily practice. Some other uorophores have been studied in humans, but none of them can currently be used outside experimental setting [31][32][33][34]. For the same reasons we decided not to consider studies on animal models and in vitro studies [33][34][35].…”

Section: Discussionmentioning

confidence: 99%

“…Some other uorophores have been studied in humans, but none of them can currently be used outside experimental setting [31][32][33][34]. For the same reasons we decided not to consider studies on animal models and in vitro studies [33][34][35]. Furthermore, we have not considered studies in which ICG is linked to molecules that bind directly to cancer cells.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, we have not considered studies in which ICG is linked to molecules that bind directly to cancer cells. This eld of research is very exciting from a theoretical point of view, and many papers have recently reported impressively favourable results; this strategy could make uorescence a truly oncological navigation [33,[36][37][38]; however, the need for an advanced molecular biology and biochemistry laboratory, ethical concern requiring IRB approval, high costs, make it still far from a practical application [39].…”

Section: Discussionmentioning

confidence: 99%

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Indocyanine Green Fluorescence-guided intraoperative detection of peritoneal carcinomatosis: systematic review.

Baiocchi¹,

Gheza

Molfino

et al. 2020

Preprint

View full text Add to dashboard Cite

Abstract BACKGROUND. To review the available clinical data about the value of Indocyanine Green (ICG) fluorescence imaging for intraoperative detection of peritoneal carcinomatosis. METHODS. We conducted a systematic review, according to the PRISMA guidelines, for clinical series investigating the possible role of ICG fluorescence imaging in detecting peritoneal carcinomatosis during surgical treatment of abdominal malignancies. With the aim to analyze actual application in the daily clinical practice, papers including trials with fluorophores other than ICG, in vitro and animals series were excluded. Data on patients and cancer features, timing, dose and modality of ICG administration, sensitivity, specificity and accuracy of fluorescence diagnosis of peritoneal nodules were extracted and analyzed. RESULTS. Out of 192 screened papers, we finally retrieved 7 series reporting ICG-guided detection of peritoneal carcinomatosis. Two papers reported the same cases, thus only 6 series were analyzed, for a total of 71 patients and 353 peritoneal nodules. The investigated tumors were colorectal carcinomas in 28 cases, hepatocellular carcinoma in 16 cases, ovarian cancer in 26 cases and endometrial cancer in 1 case. In all but 4 cases, the clinical setting was an elective intervention in patients known as having peritoneal carcinomatosis. No series reported a laparoscopic procedure. Technical data of ICG management were consistent across the studies. Overall, 353 lesions were harvested and singularly evaluated. Sensitivity varied from 72.4% to 100%, specificity from 54.2% to 100%. Two series reported that planned intervention changed in 25% and 29% of patients, respectively. CONCLUSION. Indocyanine Green based fluorescence of peritoneal carcinomatosis is a promising intraoperative tool for detection and characterization of peritoneal nodules in patients with colorectal, hepatocellular, ovarian carcinomas. Further prospective studies are needed to fix its actual diagnostic value on these and other abdominal malignancies with frequent spread to peritoneum.

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“…Smaller targeting agents -incorporating peptides, protein scaffolds, or antibody-fragments -with improved pharmacokinetic properties and specificity, have also been developed and are undergoing evaluation [25][26][27][28][29]. For example, fluorescent peptides have been clinically translated that were shown to improve the detection of polyps and neoplastic lesions in humans during an endoscopic examination at early time points [30][31].…”

Section: Fluorescence-guided Surgerymentioning

confidence: 99%

Emerging Intraoperative Imaging Modalities to Improve Surgical Precision

et al. 2018

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Intraoperative imaging (IOI) is performed to guide delineation and localization of regions of surgical interest. While oncological surgical planning predominantly utilizes x-ray computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound (US), intraoperative guidance mainly remains on surgeon interpretation and pathology for confirmation. Over the past decades however, intraoperative guidance has evolved significantly with the emergence of several novel imaging technologies, including fluorescence-, Raman, photoacoustic-, and radio-guided approaches. These modalities have demonstrated the potential to further optimize precision in surgical resection and improve clinical outcomes for patients. Not only can these technologies enhance our understanding of the disease, they can also yield large imaging datasets intraoperatively that can be analyzed by deep learning approaches for more rapid and accurate pathological diagnosis. Unfortunately, many of these novel technologies are still under preclinical or early clinical evaluation. Organizations like the Intra-Operative Imaging Study Group of the European Society for Molecular Imaging (ESMI) support interdisciplinary interactions with the aim to improve technical capabilities in the field, an approach that can succeed only if scientists, engineers, and physicians work closely together with industry and regulatory bodies to resolve roadblocks to clinical translation. In this review, we provide an overview of a variety of novel IOI technologies, discuss their challenges, and present future perspectives on the enormous potential of IOI for oncological surgical navigation.

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Improved Debulking of Peritoneal Tumor Implants by Near-Infrared Fluorescent Nanobody Image Guidance in an Experimental Mouse Model

Abstract: This study demonstrates the advantage of intraoperative fluorescence imaging using nanobody-based tracers on the efficiency of debulking surgery.

Cited by 45 publications

References 44 publications

Indocyanine Green Fluorescence-Guided Intraoperative Detection of Peritoneal Carcinomatosis: Systematic Review.

Indocyanine Green Fluorescence-Guided Intraoperative Detection of Peritoneal Carcinomatosis: Systematic Review.

Indocyanine Green Fluorescence-guided intraoperative detection of peritoneal carcinomatosis: systematic review.

Emerging Intraoperative Imaging Modalities to Improve Surgical Precision

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