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NIR Infrared imaging after peritumoral injection of indocyanine green to guide lymph node dissection in head and neck squamous cell carcinoma: A pilot feasibility study
摘要： In head and neck squamous cell carcinoma (HNSCC), neck dissection is part of the surgical therapy. Beyond to the fact that radicality is a critical prognostic factor, this dissection could lead to significant morbidity, potentially avoidable when resected lymph nodes (LN) are proven to be non-invaded at pathology. Therefore, the definition of a method able to reliably identify the specific LN drainage area in HNSCC would represent a relevant progress, to better guide the neck dissection, potentially improving the radicality and reducing the morbidity. As near-infrared fluorescence imaging (NIR-FI) after indocyanine green (ICG) peritumoral injection has been validated as a sentinel procedure, we hypothesized that this approach could represent a new technique to identify the tumor-drainage area in HNSCC. We prospectively evaluated this technique in 14 patients with oral or oropharyngeal carcinoma scheduled for primary tumor resection and LN dissection. The trial was approved by the ethics committee of the Institut Jules Bordet (CE-2178) (EudraCT 2014-000298-37) and all patients signed informed consent before inclusion.
关键词： Head and neck squamous cell carcinoma,Indocyanine green,Near-infrared fluorescence imaging,Lymph node dissection,Surgical guidance
更新于2025-09-23 15:21:01
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Fluorescence imaging of invasive head and neck carcinoma cells with integrin αvβ6-targeting RGD-peptides: an approach to a fluorescence-assisted intraoperative cytological assessment of bony resection margins
摘要： We assessed the use of peptides containing arginylglycylaspartic acid (RGD) that target integrin (cid:2)v(cid:3)6 as a potential approach for a fluorescence-assisted intraoperative cytological assessment of bony resection margins (F-AICAB) in patients who had bone-infiltrating squamous cell carcinoma (SCC) of the head and neck. This was assessed to demarcate invasive carcinoma cells that stained for (cid:2)v(cid:3)6. Specimens from bony resection margins (n=362) were defined as either malignant or benign according to the results of cytological and histological examinations. Integrin (cid:2)v(cid:3)6-targeting fluorescence-labelled RGD peptides were added to the cytological samples and the accuracy of the resulting signal assessed by comparing it with the cytological findings. The value of F-AICAB was evaluated to find out if it could help to improve future diagnoses, tests, and treatments. Integrin (cid:2)v(cid:3)6 was strongly expressed in invasive SCC cells and qualified as a marker for bone-infiltrating carcinoma cells. It showed a high affinity to bind to invasive SCC cells and enabled swift and specific demarcation of (cid:2)v(cid:3)6-stained carcinoma cells. It was also diagnostic, with a sensitivity of 100% (95% CI 81.3% to 99.3%), specificity of 98.3% (95% CI 94.4% to 99.0%), positive predictive value of 92% (95% CI 70.2% to 94.3%), and negative predictive value of 100% (95% CI 96.9% to 99.9%), compared with the cytological findings. The targeting of specific integrin subtypes with selective, synthetic ligands, adapted for multimodal imaging, is a promising new approach to diagnosis. Further studies are necessary to provide more evidence for successful clinical translation and to establish the impact on clinical procedures.
关键词： Fluorescence imaging,Integrins,(cid:2)v(cid:3)6 integrin,Head and neck squamous cell carcinoma,RGD peptide,Cytology,Intraoperative margin control
更新于2025-09-04 15:30:14