Purpose The aim of this review is to give an overview of the current status of targeted optical fluorescence imaging in the field of oncology, cardiovascular, infectious and inflammatory diseases to further promote clinical translation. Methods A meta-narrative approach was taken to systematically describe the relevant literature. Consecutively, each field was assigned a developmental stage regarding the clinical implementation of optical fluorescence imaging. Results Optical fluorescence imaging is leaning towards clinical implementation in gastrointestinal and head and neck cancers, closely followed by pulmonary, neuro, breast and gynaecological oncology. In cardiovascular and infectious disease, optical imaging is in a less advanced/proof of concept stage. Conclusion Targeted optical fluorescence imaging is rapidly evolving and expanding into the clinic, especially in the field of oncology. However, the imaging modality still has to overcome some major challenges before it can be part of the standard of care in the clinic, such as the provision of pivotal trial data. Intensive multidisciplinary (pre-)clinical joined forces are essential to overcome the delivery of such compelling phase III registration trial data and subsequent regulatory approval and reimbursement hurdles to advance clinical implementation of targeted optical fluorescence imaging as part of standard practice.
validation of final SPACE scores included clinical validity (against Harvey-Bradshaw score), concurrent validity (against Treatment Satisfaction Questionnaire for Medication -TSQM-), internal consistency reliability, test-retest reliability and responsiveness. RESULTS: The main population included 279 patients (mean ageϭ36, 56% female). Quality of completion was good (55-67% of patients with no missing items). Four items were little informative and thus removed from the final questionnaire. Eleven scores were defined: disease control, three transition scales (non-anal symptoms, anal symptoms, quality of life), side-effects, treatment convenience, three expectation disconfirmation scales (efficacy, side-effects, convenience), satisfaction with treatment, and motivation. Psychometric scores matched standards for clinical validity (better perception for patients with less severe disease), concurrent validity (e.g. correlation between SPACE satisfaction with treatment and TSQM satisfaction scoresϭ0.59), internal consistency reliability (Cronbach's alphasϭ0.67-0.93), test-retest reliability (intraclass correla-tionsϭ0.62-0.91), and responsiveness (better perception improvement for improved patients). CONCLUSIONS: The SPACE questionnaire is a valid, reliable and responsive instrument to measure patients' satisfaction with anti-TNF treatment in severe Crohn's disease.
Vascular endothelial growth factor-A (VEGF-A) is assumed to play a crucial role in the development and rupture of vulnerable plaques in the atherosclerotic process. We used a VEGF-A targeted fluorescent antibody (bevacizumab-IRDye800CW [bevacizumab-800CW]) to image and visualize the distribution of VEGF-A in (non-)culprit carotid plaques ex vivo. Freshly endarterectomized human plaques (n = 15) were incubated in bevacizumab-800CW ex vivo. Subsequent NIRF imaging showed a more intense fluorescent signal in the culprit plaques (n = 11) than in the non-culprit plaques (n = 3). A plaque received from an asymptomatic patient showed pathologic features similar to the culprit plaques. Cross-correlation with VEGF-A immunohistochemistry showed co-localization of VEGF-A over-expression in 91% of the fluorescent culprit plaques, while no VEGF-A expression was found in the non-culprit plaques (p < 0.0001). VEGF-A expression was co-localized with CD34, a marker for angiogenesis (p < 0.001). Ex vivo near-infrared fluorescence (NIRF) imaging by incubation with bevacizumab-800CW shows promise for visualizing VEGF-A overexpression in culprit atherosclerotic plaques in vivo.
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