Quantitative fluorescence endoscopy: An innovative endoscopy approach to evaluate neoadjuvant treatment response in locally advanced rectal cancer
| Autor: | Matthijs D. Linssen, Klaas Havenga, Patrick H. J. Hemmer, Jan Pieter Pennings, Vasilis Ntziachristos, Jan H. Kleibeuker, Geke A. P. Hospers, Arend Karrenbeld, Gooitzen M. van Dam, Elisabeth G.E. de Vries, Elmire Hartmans, Annelies Jorritsma-Smit, Boudewijn van Etten, Marjory Koller, Jolien J J Tjalma, Wouter B. Nagengast, Steven J de Jongh, Dominic J. Robinson |
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| Přispěvatelé: | Guided Treatment in Optimal Selected Cancer Patients (GUTS), Microbes in Health and Disease (MHD), Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE), Robotics and image-guided minimally-invasive surgery (ROBOTICS), Otorhinolaryngology and Head and Neck Surgery |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Vascular Endothelial Growth Factor A Neoplasm Residual Endoscope Colorectal cancer medicine.medical_treatment Pilot Projects Endoscopy Gastrointestinal CHEMORADIATION 0302 clinical medicine STAGE Medicine Stage (cooking) Neoadjuvant therapy medicine.diagnostic_test Gastroenterology imaging Magnetic Resonance Imaging Colorectal surgery Neoadjuvant Therapy 3. Good health Endoscopy News Treatment Outcome Area Under Curve 030211 gastroenterology & hepatology Radiology medicine.medical_specialty WAIT colorectal cancer Fluorescence 03 medical and health sciences molecular oncology SDG 3 - Good Health and Well-being fluorescence endoscopy Predictive Value of Tests Humans business.industry Rectal Neoplasms COMPLETE CLINICAL-RESPONSE Rectum Magnetic resonance imaging Chemoradiotherapy Adjuvant medicine.disease Fibrosis Endoscopy Colorectal Cancer Colorectal Surgery Fluorescence Endoscopy Imaging Molecular Oncology 030104 developmental biology ROC Curve colorectal surgery business Chemoradiotherapy |
| Zdroj: | Gut 69, 406-410 (2020) Gut Gut, 69(3), 406-410. BMJ PUBLISHING GROUP Gut, 69(3), 406-410. BMJ Publishing Group |
| ISSN: | 0017-5749 |
| Popis: | Quantitative fluorescence endoscopy (QFE) is a new technique that can visualise and quantify fluorescently tagged tumour tissue. In 25 patients with locally advanced rectal cancer (LARC), we evaluated QFE targeting vascular endothelial growth factor A (VEGFA) to detect residual tumour after neoadjuvant chemoradiotherapy (nCRT). QFE detected significantly higher fluorescence in tumour compared with normal rectal tissue and fibrosis, and improved prediction of final pathology results in 16% of patients compared with standard MRI and white-light endoscopy. QFE is a promising technique to aid clinical response assessment in patients with LARC and warrants further validation in larger clinical trials. ClinicalTrials.gov (NCT01972373). Patients with LARC receive nCRT followed by surgery to achieve local disease control. Interestingly, 15%–27% of patients have a pathological complete response, that is, no residual cancer cells are found in the surgical specimen.1–3 There is an increasing interest in identifying patients with a clinical complete response before surgery, as non-operative management for these patients is associated with high survival rates, reduced morbidity and improved functional outcomes.4–8 However, assessing tumour response after nCRT is challenging. White-light endoscopy provides only morphological information, while MRI cannot always distinguish viable tumour from fibrosis.9–11 QFE is a novel endoscopy technique that visualises and quantitatively measures the presence of targeted fluorescence tracers in tissue. We hypothesised that VEGFA-targeted QFE can be of additional value in restaging patients with LARC. In untreated patients, QFE showed clearly enhanced fluorescence in all rectal tumours compared with normal rectal tissue (figure 1A). The tumour-to-normal ratio of 3.1 (figure 1B) signifies QFE can be used to localise rectal cancer. Figure 1 (A) Representative fluorescence images of the quantitative fluorescence endoscopy (QFE) procedure in untreated rectal cancer. From left to right: a high-definition white-light video endoscope image; a white-light image from the QFE fibreoptic, followed by the corresponding near-infrared … |
| Databáze: | OpenAIRE |
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