A Novel Imaging System Permits Real-time in Vivo Tumor Bed Assessment After Resection of Naturally Occurring Sarcomas in Dogs
Name
11999_2012_Article_2560.pdf
Size
534.41 KB
Format
Adobe PDF
Checksum (MD5)
316c0d4be40da0763f48d1587b4bdb00
Author(s)
Eward, William C.
Mito, Jeffrey K.
Eward, Cindy A.
Carter, Jessica E.
Kirsch, David G.
Brigman, Brian E.
Ferrer, Jorge M
Date Issued
September 2012
Journal
Clinical Orthopaedics and Related Research®
Publisher
Springer-Verlag
Citation
Eward, William C., Jeffrey K. Mito, Cindy A. Eward, Jessica E. Carter, Jorge M. Ferrer, David G. Kirsch, and Brian E. Brigman. “A Novel Imaging System Permits Real-Time in Vivo Tumor Bed Assessment After Resection of Naturally Occurring Sarcomas in Dogs.” Clinical Orthopaedics and Related Research® 471, no. 3 (September 13, 2012): 834–842.
Version
Author's final manuscript
Abstract
Background
Treatment of soft tissue sarcoma (STS) includes complete tumor excision. However, in some patients, residual sarcoma cells remain in the tumor bed. We previously described a novel hand-held imaging device prototype that uses molecular imaging to detect microscopic residual cancer in mice during surgery.
Questions/purposes
To test this device in a clinical trial of dogs with naturally occurring sarcomas, we asked: (1) Are any adverse clinical or laboratory effects observed after intravenous administration of the fluorescent probes? (2) Do canine sarcomas exhibit fluorescence after administration of the cathepsin-activated probe? (3) Is the tumor-to-background ratio sufficient to distinguish tumor from tumor bed? And (4) can residual fluorescence be detected in the tumor bed during surgery and does this correlate with a positive margin?
Methods
We studied nine dogs undergoing treatment for 10 STS or mast cell tumors. Dogs received an intravenous injection of VM249, a fluorescent probe that becomes optically active in the presence of cathepsin proteases. After injection, tumors were removed by wide resection. The tumor bed was imaged using the novel imaging device to search for residual fluorescence. We determined correlations between tissue fluorescence and histopathology, cathepsin protease expression, and development of recurrent disease. Minimum followup was 9 months (mean, 12 months; range, 9–15 months).
Results
Fluorescence was apparent from all 10 tumors and ranged from 3 × 107 to 1 × 109 counts/millisecond/cm2. During intraoperative imaging, normal skeletal muscle showed no residual fluorescence. Histopathologic assessment of surgical margins correlated with intraoperative imaging in nine of 10 cases; in the other case, there was no residual fluorescence, but tumor was found at the margin on histologic examination. No animals had recurrent disease at 9 to 15 months.
Conclusions
These initial findings suggest this imaging system might be useful to intraoperatively detect residual tumor after wide resections.
Clinical Relevance
The ability to assess the tumor bed intraoperatively for residual disease has the potential to improve local control.
MIT Department
Massachusetts Institute of Technology. Department of Chemistry
Terms of Use
Article is made available in accordance with the publisher's policy and may be subject to US copyright law. Please refer to the publisher's site for terms of use.
Persistent DSpace Link
DOI of Published Version
https://doi.org/10.1007/s11999-012-2560-8
