The Optimal Imaging Window for Dysplastic Colorectal Polyp Detection Using c-Met-Targeted Fluorescence Molecular...

Area of Science:

• Medical imaging
• Gastroenterology
• Molecular diagnostics

Background:

• Colorectal polyp detection miss-rate is 22%.
• Fluorescence molecular endoscopy (FME) is an emerging technique to improve detection.
• EMI-137 is a c-Met-targeted fluorescent peptide for FME.

Purpose of the Study:

• Determine the optimal dose-to-imaging interval for FME using EMI-137.
• Assess the safety and feasibility of FME with EMI-137.
• Evaluate EMI-137's efficacy in high-risk colorectal cancer patients.

Main Methods:

• In vivo FME and fluorescence quantification using spectroscopy in 15 patients.
• EMI-137 (0.13 mg/kg) administered intravenously at 1-, 2-, or 3-h intervals.
• Correlation of fluorescence with histopathology, c-Met expression, and in vitro binding specificity.

Main Results:

• FME with EMI-137 was safe and well-tolerated.
• Significantly higher fluorescence in colorectal lesions vs. surrounding tissue across all intervals (TBR 1.53-1.74).
• Fluorescence correlated with histopathology and c-Met overexpression; dose-dependent specific binding confirmed in vitro.

Conclusions:

• FME using EMI-137 is safe and feasible within a 1- to 3-h dose-to-imaging interval.
• No significant clinical differences observed among intervals, but 1-h preferred.
• Future studies to investigate EMI-137 for improved colorectal polyp detection in screening colonoscopies.