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Endoscopic Fluorescence-Guided Surgery for Sinonasal Cancer Using an Antibody-Dye Conjugate.
Zachary P Hart1, Naoki Nishio1,2, Giri Krishnan1,3
1Department of Otolaryngology, Stanford University School of Medicine, Stanford, California, U.S.A.
The Laryngoscope
|December 20, 2019
Summary
Endoscopic fluorescence-guided surgery (FGS) shows promise for improving sinonasal squamous cell carcinoma resection. This technique effectively identified tumor tissue in a human sinus model, aiding in achieving clear surgical margins.
Area of Science:
- Otolaryngology
- Surgical Oncology
- Medical Imaging
Background:
- Endoscopic resection is standard for sinonasal squamous cell carcinoma.
- Achieving clear resection margins remains a surgical challenge.
Purpose of the Study:
- To evaluate the feasibility of endoscopic fluorescence-guided surgery (FGS) for improving surgical resection in a human sinus model.
- To assess the effectiveness of near-infrared (NIR) fluorescence detection in identifying tumor tissue.
Main Methods:
- A fluorescence endoscope for NIR detection was tested in phantom and human sinus models.
- Tumor models were created using mouse-derived squamous cell carcinoma.
- Panitumumab-IRDye800CW was administered intravenously, and fluorescence metrics (MFI, TBR) were analyzed.
Main Results:
- A 10-mm diameter endoscope yielded significantly higher fluorescence intensity than a 4-mm scope.
- Optimal tumor detection was achieved at a 1-cm working distance in the human sinus model.
- Clinically acceptable tumor-to-background ratios (TBRs) were obtained, discriminating tumor from normal tissue.
Conclusions:
- Endoscopic FGS demonstrates potential for identifying residual tumor during surgery.
- This technique may enhance the precision of sinonasal cancer resection.
- Further validation in clinical settings is warranted.
