title: Intraoperative near-infrared fluorescence imaging and spectroscopy identifies residual tumor cells in wounds.
abstract: Surgery is the most effective method to cure patients with solid tumors, and 50% of all cancer patients undergo resection. Local recurrences are due to tumor cells remaining in the wound, thus we explore near-infrared (NIR) fluorescence spectroscopy and imaging to identify residual cancer cells after surgery. Fifteen canines and two human patients with spontaneously occurring sarcomas underwent intraoperative imaging. During the operation, the wounds were interrogated with NIR fluorescence imaging and spectroscopy. NIR monitoring identified the presence or absence of residual tumor cells after surgery in 14/15 canines with a mean fluorescence signal-to-background ratio (SBR) of ∼16 . Ten animals showed no residual tumor cells in the wound bed (mean SBR<2 , P<0.001 ). None had a local recurrence at >1-year follow-up. In five animals, the mean SBR of the wound was >15 , and histopathology confirmed tumor cells in the postsurgical wound in four/five canines. In the human pilot study, neither patient had residual tumor cells in the wound bed, and both remain disease free at >1.5-year follow up. Intraoperative NIR fluorescence imaging and spectroscopy identifies residual tumor cells in surgical wounds. These observations suggest that NIR imaging techniques may improve tumor resection during cancer operations.
authors.affiliation: University of Pennsylvania School of Veterinary Medicine, Department of Clinical Studies, Philadelphia, Pennsylvania 19104, United States.
authors.forename: David
authors.initials: D
authors.lastname: Holt
authors.affiliation: University of Pennsylvania, Department of Physics and Astronomy, Philadelphia, Pennsylvania 19104, United States.
authors.forename: Ashwin B
authors.initials: AB
authors.lastname: Parthasarathy
authors.affiliation: University of Pennsylvania School of Medicine, Department of Surgery, Philadelphia, Pennsylvania 19104, United States.
authors.forename: Olugbenga
authors.initials: O
authors.lastname: Okusanya
authors.affiliation: University of Pennsylvania School of Medicine, Department of Surgery, Philadelphia, Pennsylvania 19104, United States.
authors.forename: Jane
authors.initials: J
authors.lastname: Keating
authors.affiliation: University of Pennsylvania School of Medicine, Department of Surgery, Philadelphia, Pennsylvania 19104, United States.
authors.forename: Ollin
authors.initials: O
authors.lastname: Venegas
authors.affiliation: University of Pennsylvania School of Medicine, Department of Pathology, Philadelphia, Pennsylvania 19104, United States.
authors.forename: Charuhas
authors.initials: C
authors.lastname: Deshpande
authors.affiliation: University of Pennsylvania School of Medicine, Department of Pathology, Philadelphia, Pennsylvania 19104, United States.
authors.forename: Giorgos
authors.initials: G
authors.lastname: Karakousis
authors.affiliation: University of Pennsylvania School of Medicine, Department of Surgery, Philadelphia, Pennsylvania 19104, United States.
authors.forename: Brian
authors.initials: B
authors.lastname: Madajewski
authors.affiliation: University of Pennsylvania School of Veterinary Medicine, Department of Pathobiology, Philadelphia, Pennsylvania 19104, United States.
authors.forename: Amy
authors.initials: A
authors.lastname: Durham
authors.affiliation: Emory University, Departments of Biomedical Engineering and Chemistry, Atlanta, Georgia 30322, United States.
authors.forename: Shuming
authors.initials: S
authors.lastname: Nie
authors.affiliation: University of Pennsylvania, Department of Physics and Astronomy, Philadelphia, Pennsylvania 19104, United States.
authors.forename: Arjun G
authors.initials: AG
authors.lastname: Yodh
authors.affiliation: University of Pennsylvania School of Medicine, Department of Surgery, Philadelphia, Pennsylvania 19104, United States.
authors.forename: Sunil
authors.initials: S
authors.lastname: Singhal
mesh_terms: D000328:Adult; D000818:Animals; D004285:Dogs; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D007208:Indocyanine Green; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual / Q000473:pathology*; D061848:Optical Imaging / Q000379:methods*; D010865:Pilot Projects; D012509:Sarcoma / Q000473:pathology; D019265:Spectroscopy, Near-Infrared / Q000379:methods*
chemical_list: D007208:Indocyanine Green