Division of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada.
TECHNA Institute, University Health Network, Toronto, Ontario, Canada.
PLoS One. 2019 Jan 17;14(1):e0209501. doi: 10.1371/journal.pone.0209501. eCollection 2019.
To evaluate CF800, a novel lipid-based liposomal nanoparticle that co-encapsulates indocyanine green (ICG) and iohexol, for CT imaging of pulmonary vasculature in minimally-invasive thoracic surgery planning.
CF800 was intravenously administered to 7 healthy rabbits. In vivo CT imaging was performed 15 min post-injection, with a subset of animals imaged at 24h, 48h, and 72h post injection. Signal-to-background ratios (SBR) were calculated at the inferior vena cava and compared across time-points. A similar protocol was applied to 2 healthy pigs to evaluate the feasibility and efficacy in a large animal model. To evaluate the feasibility of clinical application, a survey was completed by 7 surgical trainees to assess pre- and post-injection CT images of rabbits and pigs. Responses on the discernibility of pulmonary vasculature sub-branches and comfort level to use the images for pre-operative planning were collected and analyzed.
CF800 injection improved visualization of pulmonary vessels in both rabbit and pig models. The SBR of rabbit pulmonary vasculature was significantly higher after CF800 injection (range 3.7-4.4) compared to pre-injection (range 3.3-3.8, n = 7; p<0.05). SBR remained significantly different up to 24 hours after injection (range 3.7-4.3, n = 4; p<0.05). Trainees' evaluation found the post-injection CT images had significantly higher discernibility at the second vessel branch generation in both rabbit and pig models. Trainees identified smaller vasculature branch generations in the post-injection images compared to the pre-treatment images in both rabbit (mean 6.7±1.8 vs 5.4±2.1; p<0.05) and pig (mean 6.7±1.8 vs 5.4±2.1; p<0.05). Trainees were significantly more comfortable using post-injection images for surgical planning compared to the pre-injection images (rabbit: 8.1±1.1 vs. 4.7±2.1; pig: 7.6±2.1 vs. 4.9±2.2; p<0.05).
CF800 provides SBR and contrast enhancement of pulmonary vasculature which may assist in pre-surgical CT planning of minimally invasive thoracic surgery.
评估 CF800，一种新型脂质体脂质纳米颗粒，可共包封吲哚菁绿（ICG）和碘海醇，用于微创胸外科手术规划中的肺血管 CT 成像。
将 CF800 静脉内给予 7 只健康兔。在注射后 15 分钟进行体内 CT 成像，部分动物在注射后 24h、48h 和 72h 进行成像。在腔静脉计算信号与背景比（SBR），并在不同时间点进行比较。对 2 只健康猪应用类似方案，以评估在大型动物模型中的可行性和功效。为了评估临床应用的可行性，对 7 名外科受训者进行了一项调查，以评估兔和猪的注射前后 CT 图像。收集并分析了对肺血管亚分支的可识别性以及使用图像进行术前规划的舒适度的应答。
CF800 注射可改善兔和猪模型中肺血管的可视化。与注射前（范围 3.3-3.8，n = 7；p<0.05）相比，CF800 注射后兔肺血管的 SBR 明显升高（范围 3.7-4.4，n = 7；p<0.05）。在注射后 24 小时内，SBR 仍明显不同（范围 3.7-4.3，n = 4；p<0.05）。受训者的评估发现，在兔和猪模型中，第二次血管分支生成时，注射后的 CT 图像具有更高的可识别性。与治疗前图像相比，受训者在兔（平均 6.7±1.8 比 5.4±2.1；p<0.05）和猪（平均 6.7±1.8 比 5.4±2.1；p<0.05）中在注射后图像中识别出更小的血管分支生成。与注射前图像相比，受训者在手术规划中使用注射后图像明显更舒适（兔：8.1±1.1 比 4.7±2.1；猪：7.6±2.1 比 4.9±2.2；p<0.05）。
CF800 提供了肺血管的 SBR 和对比增强，这可能有助于微创胸外科手术的术前 CT 规划。
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