Title |
First-in-human evaluation of a hybrid modality that allows combined radio- and (near-infrared) fluorescence tracing during surgery
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Published in |
European Journal of Nuclear Medicine and Molecular Imaging, June 2015
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DOI | 10.1007/s00259-015-3109-3 |
Pubmed ID | |
Authors |
Nynke S. van den Berg, Hervé Simon, Gijs H. Kleinjan, Thijs Engelen, Anton Bunschoten, Mick M. Welling, Bernard M. Tijink, Simon Horenblas, Jacques Chambron, Fijs W. B. van Leeuwen |
Abstract |
The clinical introduction of the hybrid tracer indocyanine green (ICG)-(99m)Tc-nanocolloid, composed of a radioactive and a near-infrared (NIR) fluorescence component, has created the need for surgical (imaging) modalities that allow for simultaneous detection of both signals. This study describes the first-in-human use of a prototype opto-nuclear probe during sentinel node (SN) biopsy using ICG-(99m)Tc-nanocolloid. To allow for fluorescence tracing, a derivative of the conventional gamma probe technology was generated in which two optical fibers were integrated to allow for excitation (785 nm) and emission signal collection (> 810 nm). The ability of this opto-nuclear probe to detect the fluorescence signal of the hybrid tracer ICG-(99m)Tc-nanocolloid was firstly determined ex vivo in (non)SNs samples obtained from 41 patients who underwent hybrid tracer-based SN biopsy in the head and neck or urogenital area. In an in vivo proof-of-concept study in nine of these 41 patients, SNs were localized using combined gamma and fluorescence tracing with the opto-nuclear probe. Fluorescence tracing was performed in a similar manner as gamma tracing and under ambient light conditions. Ex vivo, the gamma tracing option of the opto-nuclear probe correctly identified the SN in all 150 evaluated (non)SN samples. Ex vivo fluorescence tracing in the low-sensitivity mode correctly identified 71.7 % of the samples. This increased to 98.9 % when fluorescence tracing was performed in the high-sensitivity mode. In vivo fluorescence tracing (high-sensitivity mode) accurately identified the SNs in all nine patients (20 SNs evaluated; 100 %). This study demonstrates the first-in-human evaluation of a hybrid modality capable of detecting both gamma and fluorescence signals during a surgical procedure. Fluorescence tracing could be performed in ambient light. |
X Demographics
Geographical breakdown
Country | Count | As % |
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Unknown | 2 | 100% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Practitioners (doctors, other healthcare professionals) | 2 | 100% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
United Kingdom | 2 | 5% |
Netherlands | 1 | 2% |
Unknown | 41 | 93% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Master | 10 | 23% |
Researcher | 7 | 16% |
Student > Ph. D. Student | 7 | 16% |
Other | 3 | 7% |
Student > Bachelor | 3 | 7% |
Other | 3 | 7% |
Unknown | 11 | 25% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 13 | 30% |
Chemistry | 4 | 9% |
Biochemistry, Genetics and Molecular Biology | 3 | 7% |
Agricultural and Biological Sciences | 2 | 5% |
Nursing and Health Professions | 2 | 5% |
Other | 6 | 14% |
Unknown | 14 | 32% |