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Consensus Statement on the Use of Near-Infrared Fluorescence Imaging during Pancreatic Cancer Surgery Based on a Delphi Study: Surgeons’ Perspectives on Current Use and Future Recommendations

SIMPLE SUMMARY: Despite the potential of fluorescence imaging during pancreatic cancer surgery, more research is needed to facilitate the approval of tumor-targeted probes, standardize imaging techniques, and most importantly, gain trust from surgeons. Despite advancements in the development of nove...

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Autores principales: de Muynck, Lysanne D. A. N., White, Kevin P., Alseidi, Adnan, Bannone, Elisa, Boni, Luigi, Bouvet, Michael, Falconi, Massimo, Fuchs, Hans F., Ghadimi, Michael, Gockel, Ines, Hackert, Thilo, Ishizawa, Takeaki, Kang, Chang Moo, Kokudo, Norihiro, Nickel, Felix, Partelli, Stefano, Rangelova, Elena, Swijnenburg, Rutger Jan, Dip, Fernando, Rosenthal, Raul J., Vahrmeijer, Alexander L., Mieog, J. Sven D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9913161/
https://www.ncbi.nlm.nih.gov/pubmed/36765609
http://dx.doi.org/10.3390/cancers15030652
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author de Muynck, Lysanne D. A. N.
White, Kevin P.
Alseidi, Adnan
Bannone, Elisa
Boni, Luigi
Bouvet, Michael
Falconi, Massimo
Fuchs, Hans F.
Ghadimi, Michael
Gockel, Ines
Hackert, Thilo
Ishizawa, Takeaki
Kang, Chang Moo
Kokudo, Norihiro
Nickel, Felix
Partelli, Stefano
Rangelova, Elena
Swijnenburg, Rutger Jan
Dip, Fernando
Rosenthal, Raul J.
Vahrmeijer, Alexander L.
Mieog, J. Sven D.
author_facet de Muynck, Lysanne D. A. N.
White, Kevin P.
Alseidi, Adnan
Bannone, Elisa
Boni, Luigi
Bouvet, Michael
Falconi, Massimo
Fuchs, Hans F.
Ghadimi, Michael
Gockel, Ines
Hackert, Thilo
Ishizawa, Takeaki
Kang, Chang Moo
Kokudo, Norihiro
Nickel, Felix
Partelli, Stefano
Rangelova, Elena
Swijnenburg, Rutger Jan
Dip, Fernando
Rosenthal, Raul J.
Vahrmeijer, Alexander L.
Mieog, J. Sven D.
author_sort de Muynck, Lysanne D. A. N.
collection PubMed
description SIMPLE SUMMARY: Despite the potential of fluorescence imaging during pancreatic cancer surgery, more research is needed to facilitate the approval of tumor-targeted probes, standardize imaging techniques, and most importantly, gain trust from surgeons. Despite advancements in the development of novel probes, preclinical research settings do not always accurately represent the surgical setting. This first-of-its-kind Delphi consensus survey highlights current experiences and attitudes towards fluorescence imaging during pancreatic cancer surgery, specifically from surgeon’s perspectives. The results from this consensus survey highlight potential new directions for future research, which could facilitate the standardized use of fluorescence imaging during pancreatic surgery. ABSTRACT: Indocyanine green (ICG) is one of the only clinically approved near-infrared (NIR) fluorophores used during fluorescence-guided surgery (FGS), but it lacks tumor specificity for pancreatic ductal adenocarcinoma (PDAC). Several tumor-targeted fluorescent probes have been evaluated in PDAC patients, yet no uniformity or consensus exists among the surgical community on the current and future needs of FGS during PDAC surgery. In this first-published consensus report on FGS for PDAC, expert opinions were gathered on current use and future recommendations from surgeons’ perspectives. A Delphi survey was conducted among international FGS experts via Google Forms. Experts were asked to anonymously vote on 76 statements, with ≥70% agreement considered consensus and ≥80% participation/statement considered vote robustness. Consensus was reached for 61/76 statements. All statements were considered robust. All experts agreed that FGS is safe with few drawbacks during PDAC surgery, but that it should not yet be implemented routinely for tumor identification due to a lack of PDAC-specific NIR tracers and insufficient evidence proving FGS’s benefit over standard methods. However, aside from tumor imaging, surgeons suggest they would benefit from visualizing vasculature and surrounding anatomy with ICG during PDAC surgery. Future research could also benefit from identifying neuroendocrine tumors. More research focusing on standardization and combining tumor identification and vital-structure imaging would greatly improve FGS’s use during PDAC surgery.
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spelling pubmed-99131612023-02-11 Consensus Statement on the Use of Near-Infrared Fluorescence Imaging during Pancreatic Cancer Surgery Based on a Delphi Study: Surgeons’ Perspectives on Current Use and Future Recommendations de Muynck, Lysanne D. A. N. White, Kevin P. Alseidi, Adnan Bannone, Elisa Boni, Luigi Bouvet, Michael Falconi, Massimo Fuchs, Hans F. Ghadimi, Michael Gockel, Ines Hackert, Thilo Ishizawa, Takeaki Kang, Chang Moo Kokudo, Norihiro Nickel, Felix Partelli, Stefano Rangelova, Elena Swijnenburg, Rutger Jan Dip, Fernando Rosenthal, Raul J. Vahrmeijer, Alexander L. Mieog, J. Sven D. Cancers (Basel) Article SIMPLE SUMMARY: Despite the potential of fluorescence imaging during pancreatic cancer surgery, more research is needed to facilitate the approval of tumor-targeted probes, standardize imaging techniques, and most importantly, gain trust from surgeons. Despite advancements in the development of novel probes, preclinical research settings do not always accurately represent the surgical setting. This first-of-its-kind Delphi consensus survey highlights current experiences and attitudes towards fluorescence imaging during pancreatic cancer surgery, specifically from surgeon’s perspectives. The results from this consensus survey highlight potential new directions for future research, which could facilitate the standardized use of fluorescence imaging during pancreatic surgery. ABSTRACT: Indocyanine green (ICG) is one of the only clinically approved near-infrared (NIR) fluorophores used during fluorescence-guided surgery (FGS), but it lacks tumor specificity for pancreatic ductal adenocarcinoma (PDAC). Several tumor-targeted fluorescent probes have been evaluated in PDAC patients, yet no uniformity or consensus exists among the surgical community on the current and future needs of FGS during PDAC surgery. In this first-published consensus report on FGS for PDAC, expert opinions were gathered on current use and future recommendations from surgeons’ perspectives. A Delphi survey was conducted among international FGS experts via Google Forms. Experts were asked to anonymously vote on 76 statements, with ≥70% agreement considered consensus and ≥80% participation/statement considered vote robustness. Consensus was reached for 61/76 statements. All statements were considered robust. All experts agreed that FGS is safe with few drawbacks during PDAC surgery, but that it should not yet be implemented routinely for tumor identification due to a lack of PDAC-specific NIR tracers and insufficient evidence proving FGS’s benefit over standard methods. However, aside from tumor imaging, surgeons suggest they would benefit from visualizing vasculature and surrounding anatomy with ICG during PDAC surgery. Future research could also benefit from identifying neuroendocrine tumors. More research focusing on standardization and combining tumor identification and vital-structure imaging would greatly improve FGS’s use during PDAC surgery. MDPI 2023-01-20 /pmc/articles/PMC9913161/ /pubmed/36765609 http://dx.doi.org/10.3390/cancers15030652 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
de Muynck, Lysanne D. A. N.
White, Kevin P.
Alseidi, Adnan
Bannone, Elisa
Boni, Luigi
Bouvet, Michael
Falconi, Massimo
Fuchs, Hans F.
Ghadimi, Michael
Gockel, Ines
Hackert, Thilo
Ishizawa, Takeaki
Kang, Chang Moo
Kokudo, Norihiro
Nickel, Felix
Partelli, Stefano
Rangelova, Elena
Swijnenburg, Rutger Jan
Dip, Fernando
Rosenthal, Raul J.
Vahrmeijer, Alexander L.
Mieog, J. Sven D.
Consensus Statement on the Use of Near-Infrared Fluorescence Imaging during Pancreatic Cancer Surgery Based on a Delphi Study: Surgeons’ Perspectives on Current Use and Future Recommendations
title Consensus Statement on the Use of Near-Infrared Fluorescence Imaging during Pancreatic Cancer Surgery Based on a Delphi Study: Surgeons’ Perspectives on Current Use and Future Recommendations
title_full Consensus Statement on the Use of Near-Infrared Fluorescence Imaging during Pancreatic Cancer Surgery Based on a Delphi Study: Surgeons’ Perspectives on Current Use and Future Recommendations
title_fullStr Consensus Statement on the Use of Near-Infrared Fluorescence Imaging during Pancreatic Cancer Surgery Based on a Delphi Study: Surgeons’ Perspectives on Current Use and Future Recommendations
title_full_unstemmed Consensus Statement on the Use of Near-Infrared Fluorescence Imaging during Pancreatic Cancer Surgery Based on a Delphi Study: Surgeons’ Perspectives on Current Use and Future Recommendations
title_short Consensus Statement on the Use of Near-Infrared Fluorescence Imaging during Pancreatic Cancer Surgery Based on a Delphi Study: Surgeons’ Perspectives on Current Use and Future Recommendations
title_sort consensus statement on the use of near-infrared fluorescence imaging during pancreatic cancer surgery based on a delphi study: surgeons’ perspectives on current use and future recommendations
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9913161/
https://www.ncbi.nlm.nih.gov/pubmed/36765609
http://dx.doi.org/10.3390/cancers15030652
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