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First-in-human results of targeted intraoperative molecular imaging for visualization of ground glass opacities during robotic pulmonary resection
BACKGROUND: Identifying ground glass opacities (GGOs) is challenging during robot-assisted thoracic surgery (RATS). Intraoperative molecular imaging (IMI) using tumor-targeted fluorescent tracers may address this clinical problem, but has never been evaluated in RATS. In a pilot study, we sought to...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
AME Publishing Company
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9459620/ https://www.ncbi.nlm.nih.gov/pubmed/36090642 http://dx.doi.org/10.21037/tlcr-21-1004 |
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author | Kennedy, Gregory T. Azari, Feredun S. Bernstein, Elizabeth Marfatia, Isvita Din, Azra Deshpande, Charuhas Galvis, Nikki Sorger, Jonathan Kucharczuk, John C. Singhal, Sunil |
author_facet | Kennedy, Gregory T. Azari, Feredun S. Bernstein, Elizabeth Marfatia, Isvita Din, Azra Deshpande, Charuhas Galvis, Nikki Sorger, Jonathan Kucharczuk, John C. Singhal, Sunil |
author_sort | Kennedy, Gregory T. |
collection | PubMed |
description | BACKGROUND: Identifying ground glass opacities (GGOs) is challenging during robot-assisted thoracic surgery (RATS). Intraoperative molecular imaging (IMI) using tumor-targeted fluorescent tracers may address this clinical problem, but has never been evaluated in RATS. In a pilot study, we sought to determine whether IMI during RATS (RIMI) can localize GGOs. METHODS: Ten patients with a cT1 GGO were enrolled. Prior to resection, participants received a folate-receptor targeted fluorescent tracer (OTL38). During RATS, a white-light robotic scope was utilized to identify tumors. RIMI was then conducted using a RATS thoracoscope with a wavelength-specific camera. Finally, a video-assisted thoracic surgery (VATS) thoracoscope designed to detect OTL38 was used as a control to compare to RIMI. The lesions were then resected under RIMI guidance. RESULTS: By white-light robotic scope, 7/10 (70%) GGOs were visually identifiable by pleuroparenchymal distortions. RIMI identified tumor-specific fluorescence in all (100%) subjects. RIMI clearly located the three nodules that could not be seen by robotic white-light imaging. The mean fluorescence intensity (MFI) of tumors was 99.48 arbitrary units (A.U.) (IQR, 75.72–130.49 A.U.), which was significantly higher than background tissue with mean MFI 20.61 A.U. (IQR, 13.49–29.93 A.U., P<0.0001). Mean signal-to-background ratio was 5.71 (range, 2.28–10.13). When compared to VATS-IMI as a control, there were no significant differences in MFI of tumors, background tissue, or signal-to-background ratios. In summary, RIMI compared favorably to VATS-IMI by all measured imaging characteristics. CONCLUSIONS: RIMI is feasible for identification of GGOs during robotic resection as compared to white light thoracoscopy and compares favorably to VATS-IMI. |
format | Online Article Text |
id | pubmed-9459620 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | AME Publishing Company |
record_format | MEDLINE/PubMed |
spelling | pubmed-94596202022-09-10 First-in-human results of targeted intraoperative molecular imaging for visualization of ground glass opacities during robotic pulmonary resection Kennedy, Gregory T. Azari, Feredun S. Bernstein, Elizabeth Marfatia, Isvita Din, Azra Deshpande, Charuhas Galvis, Nikki Sorger, Jonathan Kucharczuk, John C. Singhal, Sunil Transl Lung Cancer Res Original Article BACKGROUND: Identifying ground glass opacities (GGOs) is challenging during robot-assisted thoracic surgery (RATS). Intraoperative molecular imaging (IMI) using tumor-targeted fluorescent tracers may address this clinical problem, but has never been evaluated in RATS. In a pilot study, we sought to determine whether IMI during RATS (RIMI) can localize GGOs. METHODS: Ten patients with a cT1 GGO were enrolled. Prior to resection, participants received a folate-receptor targeted fluorescent tracer (OTL38). During RATS, a white-light robotic scope was utilized to identify tumors. RIMI was then conducted using a RATS thoracoscope with a wavelength-specific camera. Finally, a video-assisted thoracic surgery (VATS) thoracoscope designed to detect OTL38 was used as a control to compare to RIMI. The lesions were then resected under RIMI guidance. RESULTS: By white-light robotic scope, 7/10 (70%) GGOs were visually identifiable by pleuroparenchymal distortions. RIMI identified tumor-specific fluorescence in all (100%) subjects. RIMI clearly located the three nodules that could not be seen by robotic white-light imaging. The mean fluorescence intensity (MFI) of tumors was 99.48 arbitrary units (A.U.) (IQR, 75.72–130.49 A.U.), which was significantly higher than background tissue with mean MFI 20.61 A.U. (IQR, 13.49–29.93 A.U., P<0.0001). Mean signal-to-background ratio was 5.71 (range, 2.28–10.13). When compared to VATS-IMI as a control, there were no significant differences in MFI of tumors, background tissue, or signal-to-background ratios. In summary, RIMI compared favorably to VATS-IMI by all measured imaging characteristics. CONCLUSIONS: RIMI is feasible for identification of GGOs during robotic resection as compared to white light thoracoscopy and compares favorably to VATS-IMI. AME Publishing Company 2022-08 /pmc/articles/PMC9459620/ /pubmed/36090642 http://dx.doi.org/10.21037/tlcr-21-1004 Text en 2022 Translational Lung Cancer Research. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) . |
spellingShingle | Original Article Kennedy, Gregory T. Azari, Feredun S. Bernstein, Elizabeth Marfatia, Isvita Din, Azra Deshpande, Charuhas Galvis, Nikki Sorger, Jonathan Kucharczuk, John C. Singhal, Sunil First-in-human results of targeted intraoperative molecular imaging for visualization of ground glass opacities during robotic pulmonary resection |
title | First-in-human results of targeted intraoperative molecular imaging for visualization of ground glass opacities during robotic pulmonary resection |
title_full | First-in-human results of targeted intraoperative molecular imaging for visualization of ground glass opacities during robotic pulmonary resection |
title_fullStr | First-in-human results of targeted intraoperative molecular imaging for visualization of ground glass opacities during robotic pulmonary resection |
title_full_unstemmed | First-in-human results of targeted intraoperative molecular imaging for visualization of ground glass opacities during robotic pulmonary resection |
title_short | First-in-human results of targeted intraoperative molecular imaging for visualization of ground glass opacities during robotic pulmonary resection |
title_sort | first-in-human results of targeted intraoperative molecular imaging for visualization of ground glass opacities during robotic pulmonary resection |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9459620/ https://www.ncbi.nlm.nih.gov/pubmed/36090642 http://dx.doi.org/10.21037/tlcr-21-1004 |
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