title: Evaluation of intraoperative fluorescence imaging-guided surgery in cancer-bearing dogs: a prospective proof-of-concept phase II study in 9 cases.
abstract: The objective was to prospectively evaluate the application of intraoperative fluorescence imaging (IOFI) in the surgical excision of malignant masses in dogs, using a novel lipid nanoparticle contrast agent. Dogs presenting with spontaneous soft-tissue sarcoma or subcutaneous tumors were prospectively enrolled. Clinical staging and whole-body computed tomography (CT) were performed. All the dogs received an intravenous injection of dye-loaded lipid nanoparticles, LipImage 815. Wide or radical resection was realized after CT examination. Real-time IOFI was performed before skin incision and after tumor excision. In cases of radical resection, the lymph nodes (LNs) were imaged. The margin/healthy tissues fluorescence ratio or LN/healthy tissues fluorescence ratio was measured and compared with the histologic margins or LN status. Nine dogs were included. Limb amputation was performed in 3 dogs, and wide resection in 6. No adverse effect was noted. Fluorescence was observed in all 9 of the tumors. The margins were clean in 5 of 6 dogs after wide surgical resection, and the margin/healthy tissues fluorescence ratio was close to 1.0 in all these dogs. Infiltrated margins were observed in 1 case, with a margin/healthy tissues fluorescence ratio of 3.2. Metastasis was confirmed in 2 of 3 LNs, associated with LN/healthy tissues fluorescence ratios of 2.1 and 4.2, whereas nonmetastatic LN was associated with a ratio of 1.0. LipImage 815 used as a contrast agent during IOFI seemed to allow for good discrimination between tumoral and healthy tissues. Future studies are scheduled to evaluate the sensitivity and specificity of IOFI using LipImage 815 as a tracer.
authors.affiliation: From the Surgery and Anesthesia Unit, VetAgro-Sup Campus Vétérinaire de Lyon, Marcy l'Etoile, France. Electronic address: quentin.cabon@vetagro-sup.fr.
authors.forename: Quentin
authors.initials: Q
authors.lastname: Cabon
authors.affiliation: Clinical Oncology Department, Small Animal Internal Medicine Unit, VetAgro-Sup Campus Vétérinaire de Lyon, Marcy l'Etoile, France.
authors.forename: David
authors.initials: D
authors.lastname: Sayag
authors.affiliation: Université Grenoble Alpes, Grenoble, France; CEA-LETI MINATEC/ DTBS, Grenoble, France. Electronic address: isabelle.texier-nogues@cea.fr.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Texier
authors.affiliation: Université Grenoble Alpes, Grenoble, France; CEA-LETI MINATEC/ DTBS, Grenoble, France.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Navarro
authors.affiliation: SHFJ, CEA Orsay, Orsay, France.
authors.forename: Raphaël
authors.initials: R
authors.lastname: Boisgard
authors.affiliation: Anatomical Pathology Unit, VetAgro-Sup Campus Vétérinaire de Lyon, Marcy l'Etoile, France.
authors.forename: Dorothée
authors.initials: D
authors.lastname: Virieux-Watrelot
authors.affiliation: Clinical Oncology Department, Small Animal Internal Medicine Unit, VetAgro-Sup Campus Vétérinaire de Lyon, Marcy l'Etoile, France.
authors.forename: Frédérique
authors.initials: F
authors.lastname: Ponce
authors.affiliation: From the Surgery and Anesthesia Unit, VetAgro-Sup Campus Vétérinaire de Lyon, Marcy l'Etoile, France.
authors.forename: Claude
authors.initials: C
authors.lastname: Carozzo
mesh_terms: D000818:Animals; D003287:Contrast Media / Q000008:administration & dosage; D004283:Dog Diseases / Q000601:surgery*; D004285:Dogs; D005260:Female; D005453:Fluorescence; D005456:Fluorescent Dyes / Q000008:administration & dosage; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D007211:Indoles / Q000008:administration & dosage; D007430:Intraoperative Care / Q000379:methods; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D053758:Nanoparticles / Q000008:administration & dosage; D011446:Prospective Studies; D012509:Sarcoma / Q000473:pathology / Q000601:surgery / Q000662:veterinary; D012983:Soft Tissue Neoplasms / Q000473:pathology / Q000601:surgery / Q000662:veterinary*; D019265:Spectroscopy, Near-Infrared / Q000379:methods; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed
chemical_list: C548458:2-(2-(2-chloro-3-((1,3-dihydro-3,3-dimethyl-1-propyl-2H-indol-2-ylidene)ethylidene)-1-cyclohexen-1-yl)ethenyl)-3,3-dimethyl-1-propylindolium; D003287:Contrast Media; D005456:Fluorescent Dyes; D007211:Indoles