Endoscopic Fluorescence-Guided Surgery for Sinonasal Cancer Using an Antibody-Dye Conjugate.

Content Provider	Europe PMC
Author	Hart, Zachary P. Nishio, Naoki Krishnan, Giri Lu, Guolan Zhou, Quan Fakurnejad, Shayan Wormald, Peter John van den Berg, Nynke S. Rosenthal, Eben L. Baik, Fred M.
Abstract	ObjectiveEndoscopic resection of sinonasal squamous cell carcinoma has become the standard of care, but challenges remain in obtaining clear resection margins. The current study evaluated the feasibility of endoscopic fluorescence‐guided surgery (FGS) to improve surgical resection in a human sinus surgical model.MethodsA fluorescence endoscope optimized for near‐infrared (NIR) fluorescence detection was evaluated in a phantom study. Various endoscope diameters (4 and 10 mm) and viewing angles (0, 30, and 45 degrees) were evaluated to determine the sensitivity of the system for IRDye800CW detection at various working distances (1–5 cm). Endoscopic FGS was then validated in a three‐dimensional human sinus surgical model to which squamous cell tumors derived from mice were inserted. Mice had received intravenous panitumumab‐IRDye800CW and upon fluorescence‐guided tumor resection, mean fluorescence intensity (MFI) and tumor‐to‐background ratio (TBR) were calculated in in situ and ex vivo settings.ResultsA significantly higher fluorescence intensity was found when using the 10‐mm diameter endoscope compared to the 4mm diameter endoscope (P < .001). No significant difference in MFI was found among the viewing angles of the 4‐mm diameter endoscope. Using the human sinus model, the highest MFI and TBR were obtained at a 1‐cm working distance compared to longer working distances.ConclusionWe demonstrate that clinically acceptable TBRs were obtained with several working distances to discriminate tumor tissue from adjacent normal tissue in a human sinus model, and that endoscopic FGS may have great potential in identifying residual tumor tissue regions during surgery. Laryngoscope, 2019
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC7754277&blobtype=pdf
Page Count	7
ISSN	0023852X
Journal	The Laryngoscope [Laryngoscope]
Volume Number	130
DOI	10.1002/lary.28483
PubMed Central reference number	PMC7754277
Issue Number	12
PubMed reference number	31854462
e-ISSN	15314995
Language	English
Publisher	John Wiley & Sons, Inc.
Publisher Date	2019-12-19
Publisher Place	Hoboken, USA
Access Restriction	Open
Rights License	This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. © 2019 The Authors. The Laryngoscope published by Wiley Periodicals, Inc. on behalf of The American Laryngological, Rhinological and Otological Society, Inc.
Subject Keyword	Fluorescence‐guided surgery endoscope near‐infrared sinonasal cancer squamous cell carcinoma
Content Type	Text
Resource Type	Article
Subject	Otorhinolaryngology