Bartholf DeWitt Suzanne, Eward William C, Eward Cindy A, Lazarides Alexander L, Whitley Melodi Javid, Ferrer Jorge M, Brigman Brian E, Kirsch David G, Berg John
Duke University Medical Center, Durham, North Carolina.
Veterinary Specialty Hospital of the Carolinas, Cary, North Carolina.
Vet Surg. 2016 Aug;45(6):715-22. doi: 10.1111/vsu.12487. Epub 2016 Jun 9.
To assess the ability of a novel imaging system designed for intraoperative detection of residual cancer in tumor beds to distinguish neoplastic from normal tissue in dogs undergoing resection of soft tissue sarcoma (STS) and mast cell tumor (MCT).
Non-randomized prospective clinical trial.
12 dogs with STS and 7 dogs with MCT.
A fluorescent imaging agent that is activated by proteases in vivo was administered to the dogs 4-6 or 24-26 hours before tumor resection. During surgery, a handheld imaging device was used to measure fluorescence intensity within the cancerous portion of the resected specimen and determine an intensity threshold for subsequent identification of cancer. Selected areas within the resected specimen and tumor bed were then imaged, and biopsies (n=101) were obtained from areas that did or did not have a fluorescence intensity exceeding the threshold. Results of intraoperative fluorescence and histology were compared.
The imaging system correctly distinguished cancer from normal tissue in 93/101 biopsies (92%). Using histology as the reference, the sensitivity and specificity of the imaging system for identification of cancer in biopsies were 92% and 92%, respectively. There were 10/19 (53%) dogs which exhibited transient facial erythema soon after injection of the imaging agent which responded to but was not consistently prevented by intravenous diphenhydramine.
A fluorescence-based imaging system designed for intraoperative use can distinguish canine soft tissue sarcoma (STS) and mast cell tumor (MCT) tissue from normal tissue with a high degree of accuracy. The system has potential to assist surgeons in assessing the adequacy of tumor resections during surgery, potentially reducing the risk of local tumor recurrence. Although responsive to antihistamines, the risk of hypersensitivity needs to be considered in light of the potential benefits of this imaging system in dogs.
评估一种专为术中检测肿瘤床残留癌而设计的新型成像系统，在接受软组织肉瘤（STS）和肥大细胞瘤（MCT）切除术的犬类中区分肿瘤组织与正常组织的能力。
非随机前瞻性临床试验。
12只患有STS的犬和7只患有MCT的犬。
在肿瘤切除术前4 - 6小时或24 - 26小时给犬注射一种可在体内被蛋白酶激活的荧光成像剂。手术过程中，使用手持式成像设备测量切除标本癌性部分的荧光强度，并确定后续识别癌症的强度阈值。然后对切除标本和肿瘤床内的选定区域进行成像，并从荧光强度超过或未超过阈值的区域获取活检样本（n = 101）。比较术中荧光结果和组织学结果。
成像系统在101份活检样本中的93份（92%）中正确区分了癌组织与正常组织。以组织学为参考，成像系统在活检样本中识别癌症的敏感性和特异性分别为92%和92%。有10/19（53%）只犬在注射成像剂后不久出现短暂的面部红斑，静脉注射苯海拉明对此有反应，但不能始终预防。
一种专为术中使用设计的基于荧光的成像系统能够高度准确地区分犬类软组织肉瘤（STS）和肥大细胞瘤（MCT）组织与正常组织。该系统有潜力协助外科医生在手术中评估肿瘤切除的充分性，可能降低局部肿瘤复发的风险。尽管对抗组胺药有反应，但鉴于这种成像系统对犬类的潜在益处，仍需考虑过敏风险。
