Fluorescence-guided surgery using methylene blue to improve identification of metastatic small intestinal neuroendocrine tumours

Galema, Hidde A.; Ginhoven, Tessa M. van; Franssen, Gaston J H; Hofland, Johannes; Bouman, Claire G O T; Verhoef, Cornelis; Vahrmeijer, Alexander L.; Hutteman, Merlijn; Hilling, Denise E.; Keereweer, Stijn

doi:10.1093/bjs/znad043

Cited by 4 publications

(5 citation statements)

References 11 publications

(11 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…56 For example, methylene blue helps to improve identification of metastatic small intestinal neuroendocrine tumors when injected intravenously, although the mechanism involved is not known. 57 Consequently, the NIR fluorescence of methylene blue can be utilized to identify pancreatic neuroendocrine tumors. 58 Intraoperative imaging of cancer lesions and sentinel lymph node in breast cancer surgery using methylene blue has also been reported.…”

Section: Clinically Used Imaging Fluorophores and Probesmentioning

confidence: 99%

“…In the medical field, methylene blue has often been used as an always-on fluorescent marker in various surgical techniques, including intraoperative fluorescence imaging . For example, methylene blue helps to improve identification of metastatic small intestinal neuroendocrine tumors when injected intravenously, although the mechanism involved is not known . Consequently, the NIR fluorescence of methylene blue can be utilized to identify pancreatic neuroendocrine tumors .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Activity-Based Fluorescence Diagnostics for Cancer

Fujita,

Urano

2024

Chem. Rev.

View full text Add to dashboard Cite

Fluorescence imaging is one of the most promising approaches to achieve intraoperative assessment of the tumor/normal tissue margins during cancer surgery. This is critical to improve the patients' prognosis, and therefore various molecular fluorescence imaging probes have been developed for the identification of cancer lesions during surgery. Among them, "activatable" fluorescence probes that react with cancer-specific biomarker enzymes to generate fluorescence signals have great potential for high-contrast cancer imaging due to their low background fluorescence and high signal amplification by enzymatic turnover. Over the past two decades, activatable fluorescence probes employing various fluorescence control mechanisms have been developed worldwide for this purpose. Furthermore, new biomarker enzymatic activities for specific types of cancers have been identified, enabling visualization of various types of cancers with high sensitivity and specificity. This Review focuses on recent advances in the design, function and characteristics of activatable fluorescence probes that target cancer-specific enzymatic activities for cancer imaging and also discusses future prospects in the field of activity-based diagnostics for cancer. CONTENTS

show abstract

Section: Clinically Used Imaging Fluorophores and Probesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Activity-Based Fluorescence Diagnostics for Cancer

Fujita,

Urano

2024

Chem. Rev.

View full text Add to dashboard Cite

show abstract

“…When intravenously injected, MB can accumulate in neuroendocrine tumors; a clinical study to investigate the detection of small intestinal neuroendocrine tumors (SI-NETs) with MB found that 93% of lesions had a positive fluorescence signal and MB fluorescence enabled the identification of additional metastases in 3 out of 16 patients (ICTRP NL9305). 6 5-ALA is a porphyrin precursor that, when supplied exogenously, is consumed by certain cancers to form the fluorescent PpIX, resulting in tumor-specific fluorescence. 7 The fluorescence of PpIX allowed for the detection of focal intratumoral areas of malignant transformation in 22 patients with suspected diffusely infiltrating gliomas (NCT01116661).…”

Section: Chemical Development Of Molecular Probes For Imaging In Humansmentioning

confidence: 99%

“…On the other hand, MB is a clinically available tracer that absorbs around 665 nm and emits around 685 nm. When intravenously injected, MB can accumulate in neuroendocrine tumors; a clinical study to investigate the detection of small intestinal neuroendocrine tumors (SI-NETs) with MB found that 93% of lesions had a positive fluorescence signal and MB fluorescence enabled the identification of additional metastases in 3 out of 16 patients (ICTRP NL9305) . 5-ALA is a porphyrin precursor that, when supplied exogenously, is consumed by certain cancers to form the fluorescent PpIX, resulting in tumor-specific fluorescence .…”

Section: Chemical Development Of Molecular Probes For Imaging In Humansmentioning

confidence: 99%

Fluorescent Probes for Imaging in Humans: Where Are We Now?

Seah,

Cheng,

Vendrell

2023

ACS Nano

View full text Add to dashboard Cite

Optical imaging has become an indispensable technology in the clinic. The molecular design of cell-targeted and highly sensitive materials, the validation of specific disease biomarkers, and the rapid growth of clinically compatible instrumentation have altogether revolutionized the way we use optical imaging in clinical settings. One prime example is the application of cancer-targeted molecular imaging agents in both trials and routine clinical use to define the margins of tumors and to detect lesions that are “invisible” to the surgeons, leading to improved resection of malignant tissues without compromising viable structures. In this Perspective, we summarize some of the key research advances in chemistry, biology, and engineering that have accelerated the translation of optical imaging technologies for use in human patients. Finally, our paper comments on several research areas where further work will likely render the next generation of technologies for translational optical imaging.

show abstract

“…Methylene blue 28 and fluorescein are also FDA approved agents. Pafolacianine, which is linked to an NIR dye with a peak excitation and emission at 776 and 796 nm, respectively, and contains ligands to folate receptor-alpha that are over-expressed in multiple types of cancer (e.g., ovarian and lung cancer), was cleared by the FDA in 2021 29 .…”

Section: Overview Of Open-field Fgs Contrasts Components and Parametersmentioning

confidence: 99%

Assessment of open-field fluorescence guided surgery systems: implementing a standardized method for characterization and comparison

Ochoa,

Ruiz,

LaRochelle

et al. 2023

J. Biomed. Opt.

View full text Add to dashboard Cite

Fluorescence guided surgery (FGS) has demonstrated improvements in decision making and patient outcomes for a wide range of surgical procedures. Not only can FGS systems provide a higher level of structural perfusion accuracy in tissue reconstruction cases but they can also serve for real-time functional characterization. Multiple FGS devices have been Food and Drug administration (FDA) cleared for use in open and laparoscopic surgery. Despite the rapid growth of the field, there has been a lack standardization methods.Aim: This work overviews commonalities inherent to optical imaging methods that can be exploited to produce such a standardization procedure. Furthermore, a system evaluation pipeline is proposed and executed through the use of photostable indocyanine green fluorescence phantoms. Five different FDA-approved open-field FGS systems are used and evaluated with the proposed method.Approach: The proposed pipeline encompasses the following characterization:(1) imaging spatial resolution and sharpness, (2) sensitivity and linearity, (3) imaging depth into tissue, (4) imaging system DOF, (5) uniformity of illumination, (6) spatial distortion, (7) signal to background ratio, (8) excitation bands, and (9) illumination wavelength and power. Results:The results highlight how such a standardization approach can be successfully implemented for inter-system comparisons as well as how to better understand essential features within each FGS setup.Conclusions: Despite clinical use being the end goal, a robust yet simple standardization pipeline before clinical trials, such as the one presented herein, should benefit regulatory agencies, manufacturers, and end-users to better assess basic performance and improvements to be made in next generation FGS systems.

show abstract

Fluorescence-guided surgery using methylene blue to improve identification of metastatic small intestinal neuroendocrine tumours

Cited by 4 publications

References 11 publications

Activity-Based Fluorescence Diagnostics for Cancer

Activity-Based Fluorescence Diagnostics for Cancer

Fluorescent Probes for Imaging in Humans: Where Are We Now?

Assessment of open-field fluorescence guided surgery systems: implementing a standardized method for characterization and comparison

Contact Info

Product

Resources

About