Author of

• 20165

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  P1.16 - Surgery (ID 702)

  • Event: WCLC 2017
  • Type: Poster Session with Presenters Present
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)

  • 22820

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    P1.16-018 - Intraoperative Detection of Tumor Resection Margin via Inhalation of Fluorescent Imaging Agents (ID 9755)

    09:30 - 09:30  |  Author(s): J. Lim
    • Abstract

    Background:
    Near Infrared (NIR) fluorescent (Indocyanine green, ICG)-based EPR (enhanced permeability and retention) effects on identifying surgical margins are being used in lung cancer surgery. However, as ICG is equally likely to accumulate in tumors and inflamed tissue, this can cause false-positive results. In this study, we developed the novel method of Inhaled fluorescent based detection of intraoperative tumor resection margin by distinguishing cancerous tissue from normal tissue in mouse and rabbit lung cancer models.
    
    Method:
    ICG (1 mg/kg) was administered to healthy mice and mice with lung cancer via inhalation for 1h, and the lung distribution of ICG was investigated using a fluorescence imaging system. And, we established a computed tomography-guided VX2 lung cancer model in 6 rabbits. ICG was administered to these rabbits and resected tumor from lung cancer patients via nebulizer, and the lung cancer was resected under fluorescence imaging system after 1h. The resected tumor margins were investigated using confocal microscopy.
    
    Result:
    In normal mice, the inhaled ICG signal was significantly higher in lung compared to other organs (liver, brain, spleen, and kidneys), and this signal decreased over time. In metastatic lung cancer mouse models, the inhaled ICG was distributed only in normal tissues, except cancer. In the rabbit and resected cancer of human, the margin between cancer and normal tissue were distinguished clearly, and the tumor was successfully resected under ICFIS guidance in all 6 rabbits (Fig 3). Additionally, fluorescence and histological microscopy demonstrated that ICG was localized in normal lung tissue. The difference of fluorescent intensity between normal versus cancer tissue showed significantly higher in inhaled ICG Figure 1
    
    
    
    Conclusion:
    Fluorescent signal was dominantly observed in normal lung tissue comparing to cancer area after inhalation of ICG. The aerosolized ICG could provide better image information for intraoperative identification of resection margin during lung cancer surgery than the intravenous ICG injection.