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- W4254692772 abstract "Background: Achieving a radical resection in pancreatic ductal adenocarcinoma (PDAC) is currently the only chance of cure, but intraoperative identification of the exact tumor extent is challenging. Fluorescence imaging can enhance operative management, since the extent of locoregional dissection can be expanded, mainly in the direction of more comprehensive lymph node (LN) clearance, to include disease not visualized or resected initially. Here, we focus on diagnostic accuracy of targeted fluorescence imaging for tumor-specific LN detection. Methods: A dose-escalation study was performed to assess safety and feasibility of tumor-specific targeting of PDAC using cetuximab-IRDye800 in patients undergoing surgical resection. Patients received a loading dose of 100 mg unlabeled cetuximab prior to cetuximab-IRDye800 infusion (50 mg or 100 mg). Fluorescent imaging was performed throughout the surgery and ex vivo, together with histopathologic correlation. Results: A total of 144 LN were evaluated in the 7 patients included in this prospective study. Ex vivo, the sensitivity to detect tumor-positive LN in the 50 mg cohort was 100% (C.I. 73.5 – 100) and specificity 78% (C.I. 64.0 – 88.5), with a likelihood ratio of 4.55. On microscopic level, tumor lesions of 250 by 500 μm, e.g. 2 tumor ducts in close proximity, could be detected using fluorescence. Conclusion: This study provides proof-of-concept for the detection of tumor-positive LN with high sensitivity using targeted fluorescence, and has the potential to enhance the surgeon's visibility, enabling better intraoperative staging, and perhaps leading to a more precise and targeted lymph node dissection." @default.
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- W4254692772 date "2018-09-01" @default.
- W4254692772 modified "2023-10-16" @default.
- W4254692772 title "Detection of visually occult tumor-positive lymph nodes using molecularly targeted fluorescent imaging during surgical resection of pancreatic cancer" @default.
- W4254692772 doi "https://doi.org/10.1016/j.hpb.2018.06.2493" @default.
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