Department of Head and Neck Surgery, David Geffen School of Medicine, University of California, Los Angeles, 10833 Le Conte Ave. 62-132 CHS, Los Angeles, CA, 90095-1624, USA.
Department of Electrical and Computer Engineering, University of California, Los Angeles, Los Angeles, USA.
Sci Rep. 2022 Jul 27;12(1):12871. doi: 10.1038/s41598-022-16975-w.
Surgical management of head and neck cancer requires a careful balance between complete resection of malignancy and preservation of function. Surgeons must also determine whether to resect important cranial nerves that harbor perineural invasion (PNI), as sacrificing nerves can result in significant morbidity including facial paralysis. Our group has previously reported that Dynamic Optical Contrast Imaging (DOCI), a novel non-invasive imaging system, can determine margins between malignant and healthy tissues. Herein, we use an in vivo murine model to demonstrate that DOCI can accurately identify cancer margins and perineural invasion, concordant with companion histology. Eight C3H/HeJ male mice were injected subcutaneously into the bilateral flanks with SCCVIISF, a murine head and neck cancer cell line. DOCI imaging was performed prior to resection to determine margins. Both tumor and margins were sent for histologic sectioning. After validating that DOCI can delineate HNSCC margins, we investigated whether DOCI can identify PNI. In six C3H/HeJ male mice, the left sciatic nerve was injected with PBS and the right with SCCVIISF. After DOCI imaging, the sciatic nerves were harvested for histologic analysis. All DOCI images were acquired intraoperatively and in real-time (10 s per channel), with an operatively relevant wide field of view. DOCI values distinguishing cancer from adjacent healthy tissue types were statistically significant (P < 0.05). DOCI imaging was also able to detect perineural invasion with 100% accuracy compared to control (P < 0.05). DOCI allows for intraoperative, real-time visualization of malignant and healthy tissue margins and perineural invasion to help guide tumor resection.
头颈部癌症的外科治疗需要在恶性肿瘤的完全切除和功能保留之间取得精细的平衡。外科医生还必须确定是否切除含有神经周围侵犯（PNI）的重要颅神经，因为牺牲神经会导致严重的发病率，包括面瘫。我们的研究小组之前曾报道过，一种新型的非侵入性成像系统——动态光学对比成像（DOCI）可以确定恶性组织和健康组织之间的边界。在此，我们使用体内小鼠模型证明，DOCI 可以准确识别肿瘤边界和神经周围侵犯，与伴行的组织学结果一致。将 SCCVIISF，一种鼠头颈部癌细胞系，注射到 8 只 C3H/HeJ 雄性小鼠的双侧肋腹皮下。在切除前进行 DOCI 成像以确定边界。肿瘤和边界均被送进行组织学切片。在验证了 DOCI 可以描绘头颈部鳞状细胞癌的边界后，我们研究了 DOCI 是否可以识别神经周围侵犯。在 6 只 C3H/HeJ 雄性小鼠中，左侧坐骨神经注射 PBS，右侧坐骨神经注射 SCCVIISF。在 DOCI 成像后，收获坐骨神经进行组织学分析。所有的 DOCI 图像均在术中实时采集（每个通道 10 秒），具有手术相关的宽视野。DOCI 值区分癌症与相邻健康组织类型具有统计学意义（P<0.05）。与对照相比，DOCI 成像也能够以 100%的准确率检测神经周围侵犯（P<0.05）。DOCI 允许术中实时可视化恶性和健康组织边界以及神经周围侵犯，以帮助指导肿瘤切除。
