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Cerenkov luminescence imaging (CLI) for image-guided cancer surgery

View Article: PubMed Central - PubMed

ABSTRACT

Cerenkov luminescence imaging (CLI) is a novel molecular optical imaging technique based on the detection of optical Cerenkov photons emitted by positron emission tomography (PET) imaging agents. The ability to use clinically approved tumour-targeted tracers in combination with small-sized imaging equipment makes CLI a particularly interesting technique for image-guided cancer surgery. The past few years have witnessed a rapid increase in proof-of-concept preclinical studies in this field, and several clinical trials are currently underway. This article provides an overview of the basic principles of Cerenkov radiation and outlines the challenges of CLI-guided surgery for clinical use. The preclinical and clinical trial literature is examined including applications focussed on image-guided lymph node detection and Cerenkov luminescence endoscopy, and the ongoing clinical studies and technological developments are highlighted. By intraoperatively guiding the oncosurgeon towards more accurate and complete resections, CLI has the potential to transform current surgical practice, and improve oncological and cosmetic outcomes for patients.

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89Zr-DFO-trastuzumab CLI-guided tumour excision. a Empty background image acquired prior to surgery. b Image acquired pre-incision and c post-incision after removal of the skin. An elevated tumour radiance is visible in the HER2/neu positive tumour (red circle); 89Zr-DFO-trastuzumab is not taken up in the HER2/neu negative tumour, and this tumour, therefore, does not display an elevated radiance (blue circle). Note the increase in radiance due to a reduction in tissue absorption and scattering after removal of the skin. d Image of the surgical cavity after excision of the HER2/neu positive tumour. An elevated radiance from the excised tumour specimen is visible (red circle). No CLI signal is left at the excision site indicating complete tumour resection. e Image of excised tumour alone. f Image acquired straight after the surgical wound was closed with sutures.This research was originally published in Molecular Imaging [1]
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Fig2: 89Zr-DFO-trastuzumab CLI-guided tumour excision. a Empty background image acquired prior to surgery. b Image acquired pre-incision and c post-incision after removal of the skin. An elevated tumour radiance is visible in the HER2/neu positive tumour (red circle); 89Zr-DFO-trastuzumab is not taken up in the HER2/neu negative tumour, and this tumour, therefore, does not display an elevated radiance (blue circle). Note the increase in radiance due to a reduction in tissue absorption and scattering after removal of the skin. d Image of the surgical cavity after excision of the HER2/neu positive tumour. An elevated radiance from the excised tumour specimen is visible (red circle). No CLI signal is left at the excision site indicating complete tumour resection. e Image of excised tumour alone. f Image acquired straight after the surgical wound was closed with sutures.This research was originally published in Molecular Imaging [1]

Mentions: The published studies show the ability to perform CLI-guided surgical excision of tumours using a variety of radiopharmaceuticals and different CLI embodiments, including standard IVIS optical imaging systems, custom-build flexible fibre endoscope systems, and clinically approved rigid laparoscope and flexible endoscope systems coupled to EMCCD cameras. An example that nicely illustrates CLI-guided tumour excision is shown in Fig. 2.Fig. 2


Cerenkov luminescence imaging (CLI) for image-guided cancer surgery
89Zr-DFO-trastuzumab CLI-guided tumour excision. a Empty background image acquired prior to surgery. b Image acquired pre-incision and c post-incision after removal of the skin. An elevated tumour radiance is visible in the HER2/neu positive tumour (red circle); 89Zr-DFO-trastuzumab is not taken up in the HER2/neu negative tumour, and this tumour, therefore, does not display an elevated radiance (blue circle). Note the increase in radiance due to a reduction in tissue absorption and scattering after removal of the skin. d Image of the surgical cavity after excision of the HER2/neu positive tumour. An elevated radiance from the excised tumour specimen is visible (red circle). No CLI signal is left at the excision site indicating complete tumour resection. e Image of excised tumour alone. f Image acquired straight after the surgical wound was closed with sutures.This research was originally published in Molecular Imaging [1]
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5037157&req=5

Fig2: 89Zr-DFO-trastuzumab CLI-guided tumour excision. a Empty background image acquired prior to surgery. b Image acquired pre-incision and c post-incision after removal of the skin. An elevated tumour radiance is visible in the HER2/neu positive tumour (red circle); 89Zr-DFO-trastuzumab is not taken up in the HER2/neu negative tumour, and this tumour, therefore, does not display an elevated radiance (blue circle). Note the increase in radiance due to a reduction in tissue absorption and scattering after removal of the skin. d Image of the surgical cavity after excision of the HER2/neu positive tumour. An elevated radiance from the excised tumour specimen is visible (red circle). No CLI signal is left at the excision site indicating complete tumour resection. e Image of excised tumour alone. f Image acquired straight after the surgical wound was closed with sutures.This research was originally published in Molecular Imaging [1]
Mentions: The published studies show the ability to perform CLI-guided surgical excision of tumours using a variety of radiopharmaceuticals and different CLI embodiments, including standard IVIS optical imaging systems, custom-build flexible fibre endoscope systems, and clinically approved rigid laparoscope and flexible endoscope systems coupled to EMCCD cameras. An example that nicely illustrates CLI-guided tumour excision is shown in Fig. 2.Fig. 2

View Article: PubMed Central - PubMed

ABSTRACT

Cerenkov luminescence imaging (CLI) is a novel molecular optical imaging technique based on the detection of optical Cerenkov photons emitted by positron emission tomography (PET) imaging agents. The ability to use clinically approved tumour-targeted tracers in combination with small-sized imaging equipment makes CLI a particularly interesting technique for image-guided cancer surgery. The past few years have witnessed a rapid increase in proof-of-concept preclinical studies in this field, and several clinical trials are currently underway. This article provides an overview of the basic principles of Cerenkov radiation and outlines the challenges of CLI-guided surgery for clinical use. The preclinical and clinical trial literature is examined including applications focussed on image-guided lymph node detection and Cerenkov luminescence endoscopy, and the ongoing clinical studies and technological developments are highlighted. By intraoperatively guiding the oncosurgeon towards more accurate and complete resections, CLI has the potential to transform current surgical practice, and improve oncological and cosmetic outcomes for patients.

No MeSH data available.


Related in: MedlinePlus