Near-Infrared Imaging with Second-Window Indocyanine Green in Newly Diagnosed High-Grade Gliomas Predicts Gadolinium Enhancement on Postoperative Magnetic Resonance Imaging
| Autor: | Jasmin Hussain, Clare W Teng, Carrie Li, Ryan D Salinas, Steve S. Cho, Love Buch, Fahad I Ahmed, Kalil G. Abdullah, Suyash Mohan, John Y K Lee, Steven Brem, Emma De Ravin, Sunil Singhal, Jay F. Dorsey |
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| Rok vydání: | 2019 |
| Předmět: |
Indocyanine Green
Cancer Research Gadolinium chemistry.chemical_element Postoperative mri Kaplan-Meier Estimate Article 030218 nuclear medicine & medical imaging Intraoperative MRI 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Biopsy medicine Humans Radiology Nuclear Medicine and imaging Near infrared imaging Postoperative Care Spectroscopy Near-Infrared medicine.diagnostic_test business.industry Brain Neoplasms Magnetic resonance imaging Glioma Magnetic Resonance Imaging Progression-Free Survival Tumor Burden Treatment Outcome Oncology chemistry Molecular imaging business Nuclear medicine Indocyanine green |
| Zdroj: | Mol Imaging Biol |
| ISSN: | 1860-2002 |
| Popis: | PURPOSE: Intraoperative molecular imaging with tumor-targeting fluorophores offers real-time detection of neoplastic tissue. The Second-Window-Indocyanine-Green (SWIG) technique relies on passive accumulation of indocyanine-green (ICG), a near-infrared fluorophore, in neoplastic tissues.In this study, we explore the ability of SWIG to detect neoplastic tissue and to predict postoperative Magnetic Resonance Imaging (MRI) findings intraoperatively. PROCEDURES: Retrospective data were collected from 36 patients with primary high-grade gliomas (HGG) enrolled as part of a larger trial between October 2014 and October 2018. Patients received systemic ICG infusions at 2.5–5mg/kg 24 h preoperatively. Near-infrared fluorescence was recorded throughout the case and from biopsy specimens. The presence/location of residual SWIG signal after resection was compared to the presence/location of residual gadolinium enhancement on postoperative MRI. The extent of resection was not changed based on near-infrared imaging. RESULTS: All 36 lesions demonstrated strong near-infrared fluorescence (signal-to-background = 6.8 ± 2.2) and 100% of tumors reaching the cortex were visualized before durotomy. In 78 biopsy specimens, near-infrared imaging demonstrated higher sensitivity and accuracy than white-light for diagnosing neoplastic tissue intraoperatively. Furthermore, near-infrared imaging predicted gadolinium enhancement on postoperative MRI with 91% accuracy, with visualization of residual enhancement as small as 0.3cm(3). Patients with no residual near-infrared signal after resection were significantly more likely to have complete resection on postoperative MRI (p-value < 0.0001). CONCLUSIONS: Intraoperative imaging with SWIG demonstrates highly sensitive detection of HGG tissue in real-time. Furthermore, post-resection near-infrared imaging correlates with postoperative MRI. Overall, our findings suggest that SWIG can provide surgeons with MRI-like results in real-time, potentially increasing resection rates. |
| Databáze: | OpenAIRE |
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