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排序方式: 共有78条查询结果,搜索用时 15 毫秒
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Martin C. Boonstra Pieter B.A.A. van Driel Danny M. van Willigen Marieke A. Stammes Hendrica A.J.M. Prevoo Quirijn R.J.G. Tummers Andrew P. Mazar Freek J. Beekman Peter J.K. Kuppen Cornelis J.H. van de Velde Clemens W.G.M. L?wik John V. Frangioni Fijs W.B. van Leeuwen Cornelis F.M. Sier Alexander L. Vahrmeijer 《Oncotarget》2015,6(16):14260-14273
Pre- and intraoperative diagnostic techniques facilitating tumor staging are of paramount importance in colorectal cancer surgery. The urokinase receptor (uPAR) plays an important role in the development of cancer, tumor invasion, angiogenesis, and metastasis and over-expression is found in the majority of carcinomas. This study aims to develop the first clinically relevant anti-uPAR antibody-based imaging agent that combines nuclear (111In) and real-time near-infrared (NIR) fluorescent imaging (ZW800-1). Conjugation and binding capacities were investigated and validated in vitro using spectrophotometry and cell-based assays. In vivo, three human colorectal xenograft models were used including an orthotopic peritoneal carcinomatosis model to image small tumors. Nuclear and NIR fluorescent signals showed clear tumor delineation between 24h and 72h post-injection, with highest tumor-to-background ratios of 5.0 ± 1.3 at 72h using fluorescence and 4.2 ± 0.1 at 24h with radioactivity. 1-2 mm sized tumors could be clearly recognized by their fluorescent rim. This study showed the feasibility of an uPAR-recognizing multimodal agent to visualize tumors during image-guided resections using NIR fluorescence, whereas its nuclear component assisted in the pre-operative non-invasive recognition of tumors using SPECT imaging. This strategy can assist in surgical planning and subsequent precision surgery to reduce the number of incomplete resections. 相似文献
23.
Floris P. R. Verbeek Joost R. van der Vorst Boudewijn E. Schaafsma Merlijn Hutteman Bert A. Bonsing Fijs W. B. van Leeuwen John V. Frangioni Cornelis J. H. van de Velde Rutger-Jan Swijnenburg Alexander L. Vahrmeijer 《Journal of hepato-biliary-pancreatic sciences》2012,19(6):626-637
Background
Improved imaging methods and surgical techniques have created a new era in hepatopancreatobiliary (HPB) surgery. Despite these developments, visual inspection, palpation, and intraoperative ultrasound remain the most utilized tools during surgery today. This is problematic, though, especially in laparoscopic HPB surgery, where palpation is not possible. Optical imaging using near-infrared (NIR) fluorescence can be used for the real-time assessment of both anatomy (e.g., sensitive detection and demarcation of tumours and vital structures) and function (e.g., assessment of luminal flow and tissue perfusion) during both open and minimally invasive surgeries.Methods
This article reviews the published literature related to preclinical development and clinical applications of NIR fluorescence imaging during HPB surgery.Results
NIR fluorescence imaging combines the use of otherwise invisible NIR fluorescent contrast agents and specially designed camera systems, which are capable of detecting these contrast agents during surgery. Unlike visible light, NIR fluorescent light can penetrate several millimetres through blood and living tissue, thus providing improved detectability. Applications of this technique during HPB surgery include tumour imaging in liver and pancreas, and real-time imaging of the biliary tree.Conclusions
NIR fluorescence imaging is a promising new technique that may someday improve surgical accuracy and lower complications. 相似文献24.
25.
J.R. van der Vorst B.E. Schaafsma F.P.R. Verbeek R.J. Swijnenburg M. Hutteman G.J. Liefers C.J.H. van de Velde J.V. Frangioni A.L. Vahrmeijer 《The British journal of dermatology》2013,168(1):93-98
Background Regional lymph node involvement is the most important prognostic factor in cutaneous melanoma. As only 20% of patients with melanoma have occult nodal disease and would benefit from a regional lymphadenectomy, the sentinel lymph node (SLN) biopsy was introduced. Near‐infrared (NIR) fluorescence has been hypothesized to improve SLN mapping. Objectives To assess the potential of intraoperative NIR fluorescence imaging to improve SLN mapping in patients with melanoma and to examine the optimal dose of indocyanine green adsorbed to human serum albumin (ICG:HSA). Methods Fifteen consecutive patients with cutaneous melanoma underwent the standard SLN procedure using 99mtechnetium‐nancolloid and patent blue. In addition, intraoperative NIR fluorescence imaging was performed after injection of 1·6 mL of 600, 800, 1000 or 1200 μmol L?1 of ICG:HSA in four quadrants around the primary excision scar. Results NIR fluorescence SLN mapping was successful in 93% of patients. In one patient, no SLN could be identified using either conventional methods or NIR fluorescence. A total of 30 SLNs (average 2·0, range 1–7) were detected, 30 radioactive (100%), 27 blue (73%) and 30 NIR fluorescent (100%). With regard to the effect of concentration on signal‐to‐background ratios a trend (P = 0·066) was found favouring the 600, 800 and 1000 μmol L?1 groups over the 1200 μmol L?1 group. Conclusion This study demonstrates feasibility and accuracy of SLN mapping using ICG:HSA. Considering safety, cost and pharmacological characteristics, an ICG:HSA concentration of 600 μmol L?1 appears optimal for SLN mapping in cutaneous melanoma, although lower doses need to be assessed. 相似文献
26.
Brouwer OR Buckle T Bunschoten A Kuil J Vahrmeijer AL Wendler T Valdés-Olmos RA van der Poel HG van Leeuwen FW 《Physics in medicine and biology》2012,57(10):3123-3136
Hybrid tracers that are both radioactive and fluorescent help extend the use of fluorescence-guided surgery to deeper structures. Such hybrid tracers facilitate preoperative surgical planning using (3D) scintigraphic images and enable synchronous intraoperative radio- and fluorescence guidance. Nevertheless, we previously found that improved orientation during laparoscopic surgery remains desirable. Here we illustrate how intraoperative navigation based on optical tracking of a fluorescence endoscope may help further improve the accuracy of hybrid surgical guidance. After feeding SPECT/CT images with an optical fiducial as a reference target to the navigation system, optical tracking could be used to position the tip of the fluorescence endoscope relative to the preoperative 3D imaging data. This hybrid navigation approach allowed us to accurately identify marker seeds in a phantom setup. The multispectral nature of the fluorescence endoscope enabled stepwise visualization of the two clinically approved fluorescent dyes, fluorescein and indocyanine green. In addition, the approach was used to navigate toward the prostate in a patient undergoing robot-assisted prostatectomy. Navigation of the tracked fluorescence endoscope toward the target identified on SPECT/CT resulted in real-time gradual visualization of the fluorescent signal in the prostate, thus providing an intraoperative confirmation of the navigation accuracy. 相似文献
27.
J. Sven D. Mieog Merlijn Hutteman Joost R. van der Vorst Peter J. K. Kuppen Ivo Que Jouke Dijkstra Eric L. Kaijzel Frans Prins Clemens W. G. M. L?wik Vincent T. H. B. M. Smit Cornelis J. H. van de Velde Alexander L. Vahrmeijer 《Breast cancer research and treatment》2011,128(3):679-689
Tumor involvement of resection margins is found in a large proportion of patients who undergo breast-conserving surgery. Near-infrared (NIR) fluorescence imaging is an experimental technique to visualize cancer cells during surgery. To determine the accuracy of real-time NIR fluorescence imaging in obtaining tumor-free resection margins, a protease-activatable NIR fluorescence probe and an intraoperative camera system were used in the EMR86 orthotopic syngeneic breast cancer rat model. Influence of concentration, timing and number of tumor cells were tested in the MCR86 rat breast cancer cell line. These variables were significantly associated with NIR fluorescence probe activation. Dosing and tumor size were also significantly associated with fluorescence intensity in the EMR86 rat model, whereas time of imaging was not. Real-time NIR fluorescence guidance of tumor resection resulted in a complete resection of 17 out of 17 tumors with minimal excision of normal healthy tissue (mean minimum and a mean maximum tumor-free margin of 0.2 ± 0.2 mm and 1.3 ± 0.6 mm, respectively). Moreover, the technique enabled identification of remnant tumor tissue in the surgical cavity. Histological analysis revealed that the NIR fluorescence signal was highest at the invasive tumor border and in the stromal compartment of the tumor. In conclusion, NIR fluorescence detection of breast tumor margins was successful in a rat model. This study suggests that clinical introduction of intraoperative NIR fluorescence imaging has the potential to increase the number of complete tumor resections in breast cancer patients undergoing breast-conserving surgery. 相似文献
28.
Boonstra MC Verspaget HW Ganesh S Kubben FJ Vahrmeijer AL van de Velde CJ Kuppen PJ Quax PH Sier CF 《Current pharmaceutical design》2011,17(19):1890-1910
Since decades the urokinase plasminogen activator (uPA) system has been associated with the invasion of malignant cells. The receptor of urokinase (uPAR) is one of the key players in this proteolytic cascade, because it focuses uPA's proteolytic activity to the cell surface and in addition functions as a signaling receptor. uPAR is highly expressed in virtually all human cancers, suggesting possible clinical applications as diagnostic marker, predictive tool of survival or clinical response, and as a target for therapy and imaging. This review summarizes the possibilities of uPAR in clinical applications for cancer patients. 相似文献
29.
J.W.T. Dekker K.C. Peeters H. Putter A.L. Vahrmeijer C.J.H. van de Velde 《European journal of surgical oncology》2010
Aims
Optimal staging in rectal cancer is indispensable for the decision on further treatment and estimation of prognosis. This study assesses the prognostic capacity of the metastatic lymph node ratio (LNR) in addition to the new TNM classification.Methods
LNR was determined, in stage III patients from the Dutch TME-trial. Six year median follow up data from the trial database were used to analyse the relation of LNR to overall survival (OS) and local recurrence (LR). The relation of LNR to lymph node yield was assessed and appropriate cut off values of LNR for clinical use were determined.Results
605 patients were analyzed. 278 underwent pre-operative radiotherapy. 82 patients developed a local recurrence and 289 distant metastases. LNR was an independent risk factor for OS, hazard ratio (HR) 2.10 (95% CI 1.35–3.27) (in addition to age >= 65 years, involved circumferential resection margin (CRM) and new TNM stage) and LR, HR 2.25 (95% CI 1.02–4.56) (in addition to pre-operative radiotherapy and involved CRM). LNR is predictive of OS and LR from a lymph node yield of more than one and more than five respectively. A LNR value of 0.60 offers the best cut off to identify high risk patients (5-years OS was 61 vs. 32%, HR 2.45 (95% CI 1.96–3.08) and 5-years LR rate 12.6 versus 16.3%, HR 1.65 (95% CI 1.03–2.64)).Conclusions
LNR is an independent risk factor for OS and LR in addition to the 7th edition of the TNM classification. It can aid in predicting prognosis and identifying patients that should be considered for adjuvant treatment. 相似文献30.
I J Goossens-Beumer E C M Zeestraten A Benard T Christen M S Reimers R Keijzer C F M Sier G J Liefers H Morreau H Putter A L Vahrmeijer C J H van de Velde P J K Kuppen 《British journal of cancer》2014,110(12):2935-2944