Multispectral Fluorescence Imaging During Robot-assisted Laparoscopic Sentinel Node Biopsy: A First Step Towards a Fluorescence-based Anatomic Roadmap

Berg, Nynke S. van den; KleinJan, G.H.; Buckle, Tessa; Poel, Henk G. van der; Leeuwen, Fijs W. B. van

doi:10.1016/j.eururo.2016.06.012

Cited by 51 publications

(34 citation statements)

References 24 publications

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“…Besides radioguided navigation, intraoperative near-infrared imaging has made promising advances to improve the care of prostate cancer patients (5,6). The nontargeting agents methylene blue and indocyanine green represent the first Food and Drug Administration-approved compounds with near-infrared fluorescence properties for clinical use.…”

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confidence: 99%

PSMA-11–Derived Dual-Labeled PSMA Inhibitors for Preoperative PET Imaging and Precise Fluorescence-Guided Surgery of Prostate Cancer

et al. 2017

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Resection of tumors using targeted dual-modality probes combining preoperative imaging with intraoperative guidance is of high clinical relevance and might considerably affect the outcome of prostate cancer therapy. This work aimed at the development of dual-labeled prostate-specific membrane antigen (PSMA) inhibitors derived from the established -bis[2-hydroxy-5-(carboxyethyl)benzyl]ethylenediamine--diacetic acid (HBED-CC)-based PET tracer Ga-Glu-urea-Lys(Ahx)-HBED-CC (Ga-PSMA-11) to allow accurate intraoperative detection of PSMA-positive tumors. A series of novel PSMA-targeting fluorescent dye conjugates of Glu-urea-Lys-HBED-CC was synthesized, and their biologic properties were determined in cell-based assays and confocal microscopy. As a preclinical proof of concept, specific tumor uptake, pharmacokinetics, and feasibility for intraoperative fluorescence guidance were investigated in tumor-bearing mice and healthy pigs. The designed dual-labeled PSMA inhibitors exhibited high binding affinity and PSMA-specific effective internalization. Conjugation of fluorescein isothiocyanate (10.86 ± 0.94 percentage injected dose [%ID]/g), IRDye800CW (13.66 ± 3.73 %ID/g), and DyLight800 (15.62 ± 5.52 %ID/g) resulted in a significantly increased specific tumor uptake, whereas Ga-Glu-urea-Lys-HBED-CC-AlexaFluor488 (9.12 ± 5.47 %ID/g) revealed a tumor uptake similar to that ofGa-PSMA-11 (4.89 ± 1.34 %ID/g). The first proof-of-concept studies with the clinically relevant candidate Ga-Glu-urea-Lys-HBED-CC-IRDye800CW reinforced a fast, specific enrichment in PSMA-positive tumors, with rapid background clearance. With regard to intraoperative navigation, a specific fluorescence signal was detected in PSMA-expressing tissue. This study demonstrated that PSMA-11-derived dual-labeled dye conjugates are feasible for providing PSMA-specific pre-, intra-, and postoperative detection of prostate cancer lesions and have high potential for future clinical translation.

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confidence: 99%

PSMA-11–Derived Dual-Labeled PSMA Inhibitors for Preoperative PET Imaging and Precise Fluorescence-Guided Surgery of Prostate Cancer

et al. 2017

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“…[55,56] The combination of two methods with a radionuclide and a dye has been the gold standard for SLN detection. [67] However, such conventional fluorescent probes as ICG have been facing clinical translation hurdles, including the high molar amounts of dye needed and narrow operation range of clinical instruments. [57] The SLN biopsy with the gold standard method is not much in clinical settings due to the use of radiotracer, and novel radioisotope-free methods are expected.…”

Section: Mapping Sentinel Lymph Nodes (Slns) For Surgerymentioning

confidence: 99%

“…c) Intraoperative Raman imaging-guided tumor resection with ability to detect microscopic tumor foci confirmed by histological analysis. [63,65,67,228] Moreover, ICG-99m Tc-nanocolloids can facilitate the intraoperative SLN biopsy of patients with melanoma in the head and neck region [225] and cervical cancer. [111] Copyright 2012, Springer Nature.…”

Section: Pet/spect/ct-based Multimodal Imagingmentioning

confidence: 99%

Advanced Nanotechnology Leading the Way to Multimodal Imaging‐Guided Precision Surgical Therapy

et al. 2019

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Surgical resection is the primary and most effective treatment for most patients with solid tumors. However, patients suffer from postoperative recurrence and metastasis. In the past years, emerging nanotechnology has led the way to minimally invasive, precision and intelligent oncological surgery after the rapid development of minimally invasive surgical technology. Advanced nanotechnology in the construction of nanomaterials (NMs) for precision imaging-guided surgery (IGS) as well as surgery-assisted synergistic therapy is summarized, thereby unlocking the advantages of nanotechnology in multimodal IGS-assisted precision synergistic cancer therapy. First, mechanisms and principles of NMs to surgical targets are briefly introduced. Multimodal imaging based on molecular imaging technologies provides a practical method to achieve intraoperative visualization with high resolution and deep tissue penetration. Moreover, multifunctional NMs synergize surgery with adjuvant therapy (e.g., chemotherapy, immunotherapy, phototherapy) to eliminate residual lesions. Finally, key issues in the development of ideal theranostic NMs associated with surgical applications and challenges of clinical transformation are discussed to push forward further development of NMs for multimodal IGS-assisted precision synergistic cancer therapy.

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“…Although most fluorescence-based PSMA-targeting concepts are still confined to the preclinical stage, there is an ongoing clinical trial in the United Kingdom using a fluorophore-conjugated reagent (45). Preliminary data suggest that the fluorescence approach is feasible and highly likely to impact future care, with the increasing compatibility of multicolor fluorescence imaging with state-of-the-art laparoscopic and robotic surgical platforms (46,47). To combine the benefits of the radioguided and fluorescence-guided surgery concept, bimodal or, rather, hybrid tracers have been introduced into the clinic-for example, for sentinel node imaging in PC patients (48).…”

Section: Noteworthymentioning

confidence: 99%

“…With the development of drop-in g-probes for robot-assisted minimally invasive surgery, patient discomfort and morbidity are likely to decrease, fueling further demand for such molecularly targeted approaches to achieve effective precision surgery with improved outcomes (41,42). Modifications and further developments of PSMA-directed tracers, especially in combination with fluorescence, will enable visual or even bimodal tracking by fluorescence cameras and g-probes (46,47,49,50). Tools for advanced intraoperative navigation via augmented-reality and virtual reality displays may further help to increase the surgical targeting accuracy while reducing morbidity (74).…”

Section: Future Perspectivesmentioning

confidence: 99%

Prostate-Specific Membrane Antigen–Guided Surgery

et al. 2019

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Since its introduction to the diagnostic pathway for prostate cancer management, prostate-specific membrane antigen (PSMA)-ligand PET has demonstrated great potential. PSMA-ligand imaging is increasingly influencing therapeutic decision making, although its impact on patient outcomes still needs to be defined. One relatively new application, enabled through chemical and engineering efforts, is PSMA-guided surgery. This review highlights the potential of PSMA-guided surgery and discusses its implications in lymph node dissection in primary and recurrent prostate cancer.

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Multispectral Fluorescence Imaging During Robot-assisted Laparoscopic Sentinel Node Biopsy: A First Step Towards a Fluorescence-based Anatomic Roadmap

Cited by 51 publications

References 24 publications

PSMA-11–Derived Dual-Labeled PSMA Inhibitors for Preoperative PET Imaging and Precise Fluorescence-Guided Surgery of Prostate Cancer

PSMA-11–Derived Dual-Labeled PSMA Inhibitors for Preoperative PET Imaging and Precise Fluorescence-Guided Surgery of Prostate Cancer

Advanced Nanotechnology Leading the Way to Multimodal Imaging‐Guided Precision Surgical Therapy

Prostate-Specific Membrane Antigen–Guided Surgery

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