研究目的
To investigate the use of optical specimen mapping with near-infrared fluorescence imaging for rapid, non-invasive assessment of surgical margins in oral squamous cell carcinoma to improve intraoperative feedback and reduce positive margin rates.
研究成果
Optical specimen mapping is a highly sensitive and specific method for detecting cancer within 5 mm of surgical margins in head and neck squamous cell carcinoma specimens. It provides immediate intraoperative feedback, potentially reducing positive margin rates and improving patient outcomes. Future work should focus on larger clinical trials and broader applications in other cancers.
研究不足
The study is limited by its small sample size (n=8 patients, with only 6 eligible for analysis). The penetration depth of fluorescence is limited to approximately 6.3 mm in human tissue, which may not be sufficient for all cancer types requiring wider margins. Autofluorescence and tissue composition variations can affect signal accuracy. The technique relies on the availability and approval of specific fluorescent imaging agents like panitumumab-IRDye800.
1:Experimental Design and Method Selection:
A first-in-human pilot study was conducted using optical specimen mapping (OSM) with a closed-field fluorescence imaging device. The study involved infusing patients with panitumumab-IRDye800, a fluorescently labeled antibody, to target tumor tissue. The OSM device was used to image resected specimens, and results were correlated with pathological findings.
2:Sample Selection and Data Sources:
Eight patients with head and neck squamous cell carcinoma (HNSCC) were enrolled. Specimens were obtained from surgical resections, and data points (n=160) were extracted from histological sections.
3:List of Experimental Equipment and Materials:
OSM device (IGP-ELVIS, LI-COR), panitumumab-IRDye800, tissue-mimicking phantoms made with agarose, bovine blood, intralipid emulsion, formalin for fixation, hematoxylin and eosin (H&E) staining materials, ImageJ software, Image Studio software (LI-COR Biosciences), LabVIEW control program.
4:Experimental Procedures and Operational Workflow:
Patients were infused with panitumumab-IRDye800 1-4 days before surgery. After resection, specimens were imaged with the OSM device in the operating room. Specimens were then formalin-fixed, sectioned into 5 mm slices, processed, and H&E stained. Fluorescence signals were analyzed using thresholding, and margin distances were measured from digitized H&E slides.
5:Data Analysis Methods:
Quantitative analysis of fluorescence intensity was performed using Image Studio. Sensitivity and specificity were calculated using receiver operating characteristic (ROC) curves. Statistical analysis included unpaired t-tests for comparing margin distances, with results reported as means with standard deviations and 95% confidence intervals.
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OSM device
IGP-ELVIS
LI-COR
Provides an enclosed ambient light-free space for consistent and reliable closed-field fluorescence imaging of surgical specimens, allowing for optical specimen mapping with motion and rotational stages.
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panitumumab-IRDye800
Fluorescently labeled antibody used for targeting tumor tissue in near-infrared fluorescence imaging to detect cancer margins.
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Image Studio
LI-COR Biosciences
Software for imaging collection, storage, and analysis, used to quantify fluorescence intensity and perform region of interest (ROI) analysis.
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LabVIEW
National Instrument
Control program for running the imaging process of the OSM device.
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ImageJ
version 1.50i
National Institute of Health
Software used to measure margin distances from digitized H&E slides.
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agarose
Life Technologies
Used in creating tissue-mimicking phantoms for validation studies.
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bovine blood
Sigma-Aldrich
Component in tissue-mimicking phantoms to simulate physiological conditions.
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intralipid emulsion
Sigma-Aldrich
Component in tissue-mimicking phantoms to simulate scattering properties of tissue.
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IRDye800CW-carboxylate
Fluorescent dye used in phantoms to test penetration depth and imaging parameters.
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