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Lwin TM, Minnix M, Li L, Sherman A, Hong T, Wong JYC, Olafsen T, Poku E, Bouvet M, Fong Y, Shively JE, Yazaki PJ. Multimodality PET and Near-Infrared Fluorescence Intraoperative Imaging of CEA-Positive Colorectal Cancer. Mol Imaging Biol 2023:10.1007/s11307-023-01831-8. [PMID: 37341873 DOI: 10.1007/s11307-023-01831-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 06/02/2023] [Accepted: 06/05/2023] [Indexed: 06/22/2023]
Abstract
PURPOSE Molecular imaging is a major diagnostic component for cancer management, enabling detection, staging of disease, targeting therapy, and monitoring the therapeutic response. The coordination of multimodality imaging techniques further enhances tumor localization. The development of a single agent for real-time non-invasive targeted positron emission tomography (PET) imaging and fluorescence guided surgery (FGS) will provide the next generation tool in the surgical management of cancer. PROCEDURES The humanized anti-CEA M5A-IR800 "sidewinder" (M5A-IR800-SW) antibody-dye conjugate was designed with a NIR 800 nm dye incorporated into a PEGylated linker and conjugated with the metal chelate p-SCN-Bn-deferoxamine (DFO) for zirconium-89 PET imaging (89Zr, half-life 78.4 h). The dual-labeled 89Zr-DFO-M5A-SW-IR800 was evaluated for near infrared (NIR) fluorescence imaging, PET/MRI imaging, terminal tissue biodistribution, and blood clearance in a human colorectal cancer LS174T xenograft mouse model. RESULTS The 89Zr-DFO-M5A-SW-IR800 NIR fluorescence imaging showed high tumor targeting with normal liver uptake. Serial PET/MRI imaging was performed at 24 h, 48 h, and 72 h and showed tumor localization visible at 24 h that persisted throughout the experiment. However, the PET scans showed higher activity for the liver than the tumor, compared to the NIR fluorescence imaging. This difference is an important finding as it quantifies the expected difference due to the sensitivity and depth of penetration between the 2 modalities. CONCLUSIONS This study demonstrates the potential of a pegylated anti-CEA M5A-IR800-Sidewinder for NIR fluorescence/PET/MR multimodality imaging for intraoperative fluorescence guided surgery.
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Affiliation(s)
- Thinzar M Lwin
- Department of Surgery, City of Hope National Medical Center, Duarte, CA, USA
| | - Megan Minnix
- Department of Immunology & Theranostics, Beckman Research Institute, City of Hope, 1500 Duarte Road, Duarte, CA, 91010, USA
| | - Lin Li
- Department of Immunology & Theranostics, Beckman Research Institute, City of Hope, 1500 Duarte Road, Duarte, CA, 91010, USA
| | - Anakim Sherman
- Department of Immunology & Theranostics, Beckman Research Institute, City of Hope, 1500 Duarte Road, Duarte, CA, 91010, USA
| | - Teresa Hong
- Department of Immunology & Theranostics, Beckman Research Institute, City of Hope, 1500 Duarte Road, Duarte, CA, 91010, USA
| | - Jeffery Y C Wong
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Tove Olafsen
- Small Animal Imaging Core, Beckman Research Institute, City of Hope, Duarte, CA, 91010, USA
| | - Erasmus Poku
- Radiopharmacy, Beckman Research Institute, City of Hope, CA, 91010, Duarte, USA
| | - Michael Bouvet
- Department of Surgery, University of California, San Diego, La Jolla, CA, USA
- VA San Diego Healthcare System, La Jolla, CA, USA
| | - Yuman Fong
- Department of Surgery, City of Hope National Medical Center, Duarte, CA, USA
| | - John E Shively
- Department of Immunology & Theranostics, Beckman Research Institute, City of Hope, 1500 Duarte Road, Duarte, CA, 91010, USA
| | - Paul J Yazaki
- Department of Immunology & Theranostics, Beckman Research Institute, City of Hope, 1500 Duarte Road, Duarte, CA, 91010, USA.
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Kapoor S, Lu G, van den Berg NS, Krishnan G, Pei J, Zhou Q, Martin BA, Baik FM, Rosenthal EL, Nishio N. Effect of Formalin Fixation for Near-Infrared Fluorescence Imaging with an Antibody-Dye Conjugate in Head and Neck Cancer Patients. Mol Imaging Biol 2021; 23:270-6. [PMID: 33078373 DOI: 10.1007/s11307-020-01553-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/20/2020] [Accepted: 10/13/2020] [Indexed: 12/09/2022]
Abstract
PURPOSE This study evaluated the effect of formalin fixation for near-infrared (NIR) fluorescence imaging of an antibody-dye complex (panitumumab-IRDye800CW) that was intravenously administered to patients with head and neck squamous cell carcinoma (HNSCC) scheduled to undergo surgery of curative intent. PROCEDURES HNSCC patients were infused with 25 or 50 mg of panitumumab-IRDye800CW followed by surgery 1-5 days later. Following resection, primary tumor specimens were imaged in a closed-field fluorescence imaging device, before and after formalin fixation. The fluorescence images of formalin-fixed specimens were compared with images prior to formalin fixation. Regions of interest were drawn on the primary tumor and on the adjacent normal tissue on the fluorescence images. The mean fluorescence intensity (MFI) and tumor-to-background ratios (TBRs) of the fresh and formalin-fixed tissues were compared. RESULTS Of the 30 enrolled patients, 20 tissue specimens were eligible for this study. Formalin fixation led to an average of 10 % shrinkage in tumor specimen size (p < 0.0001). Tumor MFI in formalin-fixed specimens was on average 10.9 % lower than that in the fresh specimens (p = 0.0002). However, no statistical difference was found between the TBRs of the fresh specimens and those of the formalin-fixed specimens (p = 0.85). CONCLUSIONS Despite the 11 % decrease in MFI between fresh and formalin-fixed tissue specimens, the relative difference between tumor and normal tissue as measured in TBR remained unchanged. This data suggests that evaluation of formalin-fixed tissue for assessing the accuracy of fluorescence-guided surgery approaches could provide a valid, yet more flexible, alternative to fresh tissue analysis. TRIAL REGISTRATION NCT02415881.
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