title: A Fluorescence-Guided Laser Ablation System for Removal of Residual Cancer in a Mouse Model of Soft Tissue Sarcoma.
abstract: The treatment of soft tissue sarcoma (STS) generally involves tumor excision with a wide margin. Although advances in fluorescence imaging make real-time detection of cancer possible, removal is limited by the precision of the human eye and hand. Here, we describe a novel pulsed Nd:YAG laser ablation system that, when used in conjunction with a previously described molecular imaging system, can identify and ablate cancer in vivo. Mice with primary STS were injected with the protease-activatable probe LUM015 to label tumors. Resected tissues from the mice were then imaged and treated with the laser using the paired fluorescence-imaging/ laser ablation device, generating ablation clefts with sub-millimeter precision and minimal underlying tissue damage. Laser ablation was guided by fluorescence to target tumor tissues, avoiding normal structures. The selective ablation of tumor implants in vivo improved recurrence-free survival after tumor resection in a cohort of 14 mice compared to 12 mice that received no ablative therapy. This prototype system has the potential to be modified so that it can be used during surgery to improve recurrence-free survival in patients with cancer.
authors.affiliation: 1. School of Medicine, Duke University, Durham, North Carolina.
authors.forename: Alexander L
authors.initials: AL
authors.lastname: Lazarides
authors.affiliation: 1. School of Medicine, Duke University, Durham, North Carolina; 2. Department of Pharmacology & Cancer Biology, Duke University Medical Center, Durham, North Carolina.
authors.forename: Melodi J
authors.initials: MJ
authors.lastname: Whitley
authors.affiliation: 3. Lumicell, Inc., Wellesley, MA.
authors.forename: David B
authors.initials: DB
authors.lastname: Strasfeld
authors.affiliation: 4. Department of Pathology, Duke University Medical Center, Durham, North Carolina.
authors.forename: Diana M
authors.initials: DM
authors.lastname: Cardona
authors.affiliation: 3. Lumicell, Inc., Wellesley, MA.
authors.forename: Jorge M
authors.initials: JM
authors.lastname: Ferrer
authors.affiliation: 5. Department of Biomedical Engineering, Duke University, Durham, North Carolina.
authors.forename: Jenna L
authors.initials: JL
authors.lastname: Mueller
authors.affiliation: 5. Department of Biomedical Engineering, Duke University, Durham, North Carolina.
authors.forename: Henry L
authors.initials: HL
authors.lastname: Fu
authors.affiliation: 6. Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Bartholf DeWitt
authors.affiliation: 6. Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: Brian E
authors.initials: BE
authors.lastname: Brigman
authors.affiliation: 5. Department of Biomedical Engineering, Duke University, Durham, North Carolina.
authors.forename: Nimmi
authors.initials: N
authors.lastname: Ramanujam
authors.affiliation: 2. Department of Pharmacology & Cancer Biology, Duke University Medical Center, Durham, North Carolina; 7. Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina.
authors.forename: David G
authors.initials: DG
authors.lastname: Kirsch
authors.affiliation: 6. Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: William C
authors.initials: WC
authors.lastname: Eward
mesh_terms: D000818:Animals; D053685:Laser Therapy / Q000379:methods*; D051379:Mice; D018365:Neoplasm, Residual; D012509:Sarcoma / Q000601:surgery*; D012983:Soft Tissue Neoplasms / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000379:methods*
keywords: Fluorescence Imaging; Image-Guided Surgery; Laser Ablation; Local Neoplasm Recurrence; Sarcoma