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Proceedings Paper

Near-infrared (NIR) fluorescence imaging of head and neck squamous cell carcinoma for fluorescence-guided surgery (Conference Presentation)
Author(s): Lindsay Moore; Jason M. Warram; Esther de Boer; William R. Carroll; Anthony Morlandt; Kirk P. Withrow; Eben L. Rosenthal
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Paper Abstract

During fluorescence-guided surgery, a cancer-specific optical probe is injected and visualized using a compatible device intraoperatively to provide visual contrast between diseased and normal tissues to maximize resection of cancer and minimize the resection of precious adjacent normal tissues. Six patients with squamous cell carcinomas of the head and neck region (oral cavity (n=4) or cutaneous (n=2)) were injected with an EGFR-targeting antibody (Cetuximab) conjugated to a near-infrared (NIR) fluorescent dye (IRDye800) 3, 4, or 7 days prior to surgical resection of the cancer. Each patient’s tumor was then imaged using a commercially available, open-field NIR fluorescence imaging device each day prior to surgery, intraoperatively, and post-operatively. The mean fluorescence intensity (MFI) of the tumor was calculated for each specimen at each imaging time point. Adjacent normal tissue served as an internal anatomic control for each patient to establish a patient-matched “background” fluorescence. Resected tissues were also imaged using a closed-field NIR imaging device. Tumor to background ratios (TBRs) were calculated for each patient using both devices. Fluorescence histology was correlated with traditional pathology assessment to verify the specificity of antibody-dye conjugate binding. Peak TBRs using the open-field device ranged from 2.2 to 11.3, with an average TBR of 4.9. Peak TBRs were achieved between days 1 and 4. This study demonstrated that a commercially available NIR imaging device suited for intraoperative and clinical use can successfully be used with a fluorescently-labeled dye to delineate between diseased and normal tissue in this single cohort human study, illuminated the potential for its use in fluoresence-guided surgery.

Paper Details

Date Published: 26 April 2016
PDF: 1 pages
Proc. SPIE 9696, Molecular-Guided Surgery: Molecules, Devices, and Applications II, 969610 (26 April 2016); doi: 10.1117/12.2214002
Show Author Affiliations
Lindsay Moore, The Univ. of Alabama School of Medicine (United States)
Jason M. Warram, The Univ. of Alabama School of Medicine (United States)
Esther de Boer, The Univ. of Alabama School of Medicine (United States)
William R. Carroll, The Univ. of Alabama School of Medicine (United States)
Anthony Morlandt, The Univ. of Alabama School of Medicine (United States)
Kirk P. Withrow, The Univ. of Alabama School of Medicine (United States)
Eben L. Rosenthal, Stanford Univ. (United States)

Published in SPIE Proceedings Vol. 9696:
Molecular-Guided Surgery: Molecules, Devices, and Applications II
Brian W. Pogue; Sylvain Gioux, Editor(s)

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