Intraoperative near‐infrared II window fluorescence imaging‐assisted nephron‐sparing surgery for complete resection of cystic renal masses

Cao, Chuanxiang; Deng, Shaohui; Wang, Binshuai; Shi, Xiaojing; Ge, Liyuan; Qiu, Min; Zhang, Fan; Lu, Min; Ma, Lulin; Chi, Chongwei; Hu, Zhenhua; Tian, Jie; Zhang, Shudong

doi:10.1002/ctm2.604

Cited by 19 publications

(5 citation statements)

References 10 publications

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“…Here, SWIRFI has shown both image and patient outcome improvements over NIRFI for liver tumor surgery, glioma resection, cystic renal mass removal, and brain metastasis (19)(20)(21)(22). However, there is an unmet need for a workhorse cancer-targeting agent for SWIRFI like that of 18 F-FDG for PET (23).…”

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confidence: 99%

Ambient Light Resistant Shortwave Infrared Fluorescence Imaging for Preclinical Tumor Delineation via the pH Low-Insertion Peptide Conjugated to Indocyanine Green

Mc Larney,

Kim,

Roberts

et al. 2023

J Nucl Med

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Shortwave infrared (900-1,700 nm) fluorescence imaging (SWIRFI) has shown significant advantages over visible (400-650 nm) and nearinfrared (700-900 nm) fluorescence imaging (reduced autofluorescence, improved contrast, tissue resolution, and depth sensitivity). However, there is a major lag in the clinical translation of preclinical SWIRFI systems and targeted SWIRFI probes. Methods: We preclinically show that the pH low-insertion peptide conjugated to indocyanine green (pHLIP ICG), currently in clinical trials, is an excellent candidate for cancer-targeted SWIRFI. Results: pHLIP ICG SWIRFI achieved picomolar sensitivity (0.4 nM) with binary and unambiguous tumor screening and resection up to 96 h after injection in an orthotopic breast cancer mouse model. SWIRFI tumor screening and resection had ambient light resistance (possible without gating or filtering) with outstanding signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) values at exposures from 10 to 0.1 ms. These SNR and CNR values were also found for the extended emission of pHLIP ICG in vivo (.1,100 nm, 300 ms). Conclusion: SWIRFI sensitivity and ambient light resistance enabled continued tracer clearance tracking with unparalleled SNR and CNR values at video rates for tumor delineation (achieving a tumor-to-muscle ratio above 20). In total, we provide a direct precedent for the democratic translation of an ambient light resistant SWIRFI and pHLIP ICG ecosystem, which can instantly improve tumor resection.

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confidence: 99%

Ambient Light Resistant Shortwave Infrared Fluorescence Imaging for Preclinical Tumor Delineation via the pH Low-Insertion Peptide Conjugated to Indocyanine Green

Mc Larney,

Kim,

Roberts

et al. 2023

J Nucl Med

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“…The article highlights that conventional fluorescence-guided surgery primarily utilizes the first window (NIR-I, 700–900 nm), characterized by a limited tissue penetration depth ranging from 1 to 6 mm [ [87] , [88] , [89] ]. Conversely, the second near-infrared window (NIR-II, 1000–1700 nm) significantly surpasses the constraints imposed by tissue absorption, autofluorescence, and photon scattering, enabling profound tissue penetration (up to 20 mm), micron-scale spatial resolution, intelligent decision-making with U-Net Segmentation, and a high tumor-to-normal tissue (T/NT) ratio exceeding 190 [ [90] , [91] , [92] , [93] , [94] , [95] , [96] , [97] ]. These features hold promise for enhancing T/NT ratio and delineating tumor margins more precisely, thereby facilitating more accurate tumor resection.…”

Section: New Fluorescent Agents Of Molecular Actionmentioning

confidence: 99%

Fluorescence visualization for cancer DETECTION: EXPERIENCE and perspectives

Kravchenko,

Sikora,

Wireko

et al. 2024

Heliyon

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“…ICG NIR-II imaging has been employed as well in nephron-sparing surgery [ 63 ]. Determining the margin of renal carcinoma is a challenging problem.…”

Section: Cancer Imaging In Nir-ii Spectrummentioning

confidence: 99%

Intraoperative fluorescence molecular imaging accelerates the coming of precision surgery in China

Zhang

Chi

et al. 2022

Eur J Nucl Med Mol Imaging

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Purpose China has the largest cancer population globally. Surgery is the main choice for most solid cancer patients. Intraoperative fluorescence molecular imaging (FMI) has shown its great potential in assisting surgeons in achieving precise resection. We summarized the typical applications of intraoperative FMI and several new trends to promote the development of precision surgery. Methods The academic database and NIH clinical trial platform were systematically evaluated. We focused on the clinical application of intraoperative FMI in China. Special emphasis was placed on a series of typical studies with new technologies or high-level evidence. The emerging strategy of combining FMI with other modalities was also discussed. Results The clinical applications of clinically approved indocyanine green (ICG), methylene blue (MB), or fluorescein are on the rise in different surgical departments. Intraoperative FMI has achieved precise lesion detection, sentinel lymph node mapping, and lymphangiography for many cancers. Nerve imaging is also exploring to reduce iatrogenic injuries. Through different administration routes, these fluorescent imaging agents provided encouraging results in surgical navigation. Meanwhile, designing new cancer-specific fluorescent tracers is expected to be a promising trend to further improve the surgical outcome. Conclusions Intraoperative FMI is in a rapid development in China. In-depth understanding of cancer-related molecular mechanisms is necessary to achieve precision surgery. Molecular-targeted fluorescent agents and multi-modal imaging techniques might play crucial roles in the era of precision surgery.

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Intraoperative near‐infrared II window fluorescence imaging‐assisted nephron‐sparing surgery for complete resection of cystic renal masses

Abstract: Age/year, M (range) 46 (35-65)

Cited by 19 publications

References 10 publications

Ambient Light Resistant Shortwave Infrared Fluorescence Imaging for Preclinical Tumor Delineation via the pH Low-Insertion Peptide Conjugated to Indocyanine Green

Ambient Light Resistant Shortwave Infrared Fluorescence Imaging for Preclinical Tumor Delineation via the pH Low-Insertion Peptide Conjugated to Indocyanine Green

Fluorescence visualization for cancer DETECTION: EXPERIENCE and perspectives

Intraoperative fluorescence molecular imaging accelerates the coming of precision surgery in China

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