Your Impact: Near-Infrared Fluorescence Imaging Identifies Residual Cancer During Surgery to Remove Sarcomas


Update on Grant 1683-A: Improving Resection of Tumors Through Enhanced Imaging
Dr. David Holt, BVSC, Diplomate ACVS; University of Pennsylvania School of Veterinary Medicine

Surgery is the most effective method to treat solid tumors. Local recurrences happen when tumor cells are left in the wound during surgery. Dr. Holt and his team investigated near-infrared (NIR) fluorescence imaging to identify cancer and cancer cells remaining in surgical incisions. Fifteen dogs and two human patients with spontaneously occurring sarcomas underwent intraoperative imaging. During the operation, the wounds were evaluated with NIR fluorescence imaging.   

NIR monitoring identified the presence or absence of residual tumor cells after surgery in 14/15 dogs. Tumors fluoresced an average of 16 times brighter than normal tissues. Ten dogs had no residual NIR fluorescence of their surgical incisions. Clean surgical margins were confirmed in these dogs by histopathology. Five dogs had substantial fluorescence in their surgical incisions after tumor removal; NIR fluorescence was 15 times greater than normal tissue. Histopathology confirmed tumor cells in the post-surgical wound in 4/5 of these dogs. In a subsequent human pilot study, 2 patients had sarcomas removed. Both tumors could be identified with NIR fluorescence. Neither patient had residual tumor cells in the wound bed and both remain disease free at >1.5-year follow up. 

Outcome: Intraoperative NIR fluorescence imaging identifies residual tumor cells in surgical wounds, providing veterinary and human oncologists with pinpoint accuracy. These observations suggest that NIR imaging techniques may improve tumor resection during cancer operations.

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