Privitera Laura, Musleh Layla, Paraboschi Irene, Ogunlade Olumide, Ogunbiyi Olumide, Hutchinson J Ciaran, Sebire Neil, Beard Paul, Giuliani Stefano
Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London W1W 7TY, UK.
Cancer Section, Developmental Biology and Cancer Programme, UCL Great Ormond Street Institute of Child Health, London WC1N 1EH, UK.
Cancers (Basel). 2023 Feb 1;15(3):917. doi: 10.3390/cancers15030917.
Despite aggressive treatments, the prognosis of high-risk NB remains poor. Surgical oncology needs innovative intraoperative devices to help surgeons discriminate malignant tissue from necrotic and surrounding healthy tissues. Changes within the tumor vasculature could be used intraoperatively as a diagnostic tool to guide surgical resection. Here, we retrospectively analyzed the mean vascular density (MVD) of different NB subtypes at diagnosis and after induction chemotherapy using scanned histological samples. One patient was prospectively enrolled, and an ex vivo photoacoustic imaging (PAI) scan was performed on two representative sections to assess its capacity to discriminate different tumor regions. We found that post-chemotherapy, viable areas of differentiating NBs and ganglioneuroblastomas are associated with higher MVD compared to poorly differentiated NBs. Early necrotic regions showed higher MVD than late necrotic and viable regions. Finally, calcified areas showed significantly lower MVD than any other histological component. The acquired PAI images showed a good high-resolution ex vivo 3D delineation of NB margins. Overall, these results suggest that a high-definition preclinical imaging device such as PAI could potentially be exploited to guide surgical resection by identifying different vasculature signatures.
尽管采取了积极的治疗措施，但高危神经母细胞瘤（NB）的预后仍然很差。外科肿瘤学需要创新的术中设备，以帮助外科医生区分恶性组织与坏死组织及周围健康组织。肿瘤血管系统的变化可在术中用作诊断工具，以指导手术切除。在此，我们使用扫描的组织学样本，回顾性分析了不同NB亚型在诊断时和诱导化疗后的平均血管密度（MVD）。前瞻性纳入了一名患者，并对两个代表性切片进行了离体光声成像（PAI）扫描，以评估其区分不同肿瘤区域的能力。我们发现，化疗后，与低分化NB相比，分化型NB和神经节神经母细胞瘤的存活区域与更高的MVD相关。早期坏死区域的MVD高于晚期坏死和存活区域。最后，钙化区域的MVD明显低于任何其他组织学成分。获得的PAI图像显示出良好的离体高分辨率NB边缘三维描绘。总体而言，这些结果表明，诸如PAI之类的高清临床前成像设备有可能通过识别不同的血管特征来指导手术切除。
