Narrow-Band Imaging Improves Detection of Colorectal Peritoneal Metastases: A Clinical Study Comparing Advanced Imaging Techniques
| Autor: | Henk Thijs Brandsma, Nina R. Sluiter, Geert Kazemier, Stijn L. Vlek, Nicole Cornelia Theodora van Grieken, Arthur Randolph Wijsmuller, Jurriaan B. Tuynman, Henrica C.W. de Vet |
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| Přispěvatelé: | Surgery, CCA - Imaging and biomarkers, APH - Methodology, CCA - Cancer Treatment and quality of life, Pathology, AGEM - Re-generation and cancer of the digestive system |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Indocyanine Green
Male medicine.medical_specialty Chromoendoscopy Narrow Band Imaging 03 medical and health sciences chemistry.chemical_compound Peritoneal Neoplasm 0302 clinical medicine Cytoreduction Surgical Procedures Image Processing Computer-Assisted Humans Medicine Prospective Studies Stage (cooking) Coloring Agents Prospective cohort study Peritoneal Neoplasms Spectroscopy Near-Infrared Gastrointestinal Oncology business.industry Cancer Hyperthermia Induced Middle Aged Prognosis medicine.disease Combined Modality Therapy Oncology chemistry Chemotherapy Cancer Regional Perfusion 030220 oncology & carcinogenesis Female 030211 gastroenterology & hepatology Surgery Hyperthermic intraperitoneal chemotherapy Radiology Colorectal Neoplasms business Indocyanine green Follow-Up Studies |
| Zdroj: | Sluiter, N R, Vlek, S L, Wijsmuller, A R, Brandsma, H T, de Vet, H C W, van Grieken, N C T, Kazemier, G & Tuynman, J B 2019, ' Narrow-Band Imaging Improves Detection of Colorectal Peritoneal Metastases: A Clinical Study Comparing Advanced Imaging Techniques ', Annals of Surgical Oncology, vol. 26, no. 1, pp. 156-164 . https://doi.org/10.1245/s10434-018-7005-5 Annals of Surgical Oncology, 26(1), 156-164. Springer New York Annals of Surgical Oncology |
| ISSN: | 1068-9265 |
| DOI: | 10.1245/s10434-018-7005-5 |
| Popis: | Background Colorectal peritoneal metastases (PM) are often diagnosed in an advanced disease stage. Cytoreduction and hyperthermic intraperitoneal chemotherapy (HIPEC) improve survival of patients with colorectal PM, although most benefit is seen in patients with limited peritoneal disease. Advanced imaging techniques might improve the detection of PM, potentially leading to earlier diagnosis and improved cytoreduction. This prospective clinical trial compared three advanced techniques with conventional white-light imaging for the detection of colorectal PM: narrow-band imaging (NBI), near-infrared indocyanine green fluorescent imaging (NIR-ICG), and spray-dye chromoendoscopy (SDCE). Methods Patients with colorectal PM were prospectively included. Prior to cytoreduction and HIPEC, all abdominal regions were inspected with white-light imaging, NBI, NIR-ICG, and SDCE during exploratory laparoscopy. Primary endpoints were sensitivity and specificity for the detection of PM, using pathological examination of biopsied lesions as the reference standard. The safety of all techniques was assessed. Results Between May 2016 and March 2018, four different techniques were analyzed in 28 patients, resulting in 169 biopsies. Sensitivity for the detection of PM significantly increased from 80.0% with white light to 96.0% with NBI (p = 0.008), without loss of specificity (74.8% vs. 73.1%, respectively, p = 0.804). The use of NIR-ICG and SDCE was discontinued after 10 patients had undergone treatment because the lesions were not fluorescent using NIR-ICG, and because SDCE did not visualize the whole peritoneum. No adverse events relating to the imaging techniques occurred. Conclusion NBI substantially increased the detection of PM. This method is safe and could improve the detection of metastatic lesions and help optimize cytoreduction in patients with colorectal PM. |
| Databáze: | OpenAIRE |
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