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- Title:
Potential Red-Flag Identification of Colorectal Adenomas with Wide-Field Fluorescence Molecular Endoscopy.
- Document type:
- Article
- Author(s):
- Hartmans, Elmire; Tjalma, Jolien J. J.; Linssen, Matthijs D.; Allende, Pilar Beatriz Garcia; Koller, Marjory; Jorritsma-Smit, Annelies; Nery, Mariana e Silva de Oliveira; Elias, Sjoerd G.; Karrenbeld, Arend; de Vries, Elisabeth G. E.; Kleibeuker, Jan H.; van Dam, Gooitzen M.; Robinson, Dominic J.; Ntziachristos, Vasilis; Nagengast, Wouter B.
- Abstract:
- Adenoma miss rates in colonoscopy are unacceptably high, especially for sessile serrated adenomas / polyps (SSA/Ps) and in high-risk populations, such as patients with Lynch syndrome. Detection rates may be improved by fluorescence molecular endoscopy (FME), which allows morphological visualization of lesions with high-definition white-light imaging as well as fluorescence-guided identification of lesions with a specific molecular marker. In a clinical proof-of-principal study, we investigated FME for colorectal adenoma detection, using a fluorescently labelled antibody (bevacizumab-800CW) against vascular endothelial growth factor A (VEGFA), which is highly upregulated in colorectal adenomas. Methods: Patients with familial adenomatous polyposis (n = 17), received an intravenous injection with 4.5, 10 or 25 mg of bevacizumab-800CW. Three days later, they received NIR-FME. Results: VEGFA-targeted NIR-FME detected colorectal adenomas at all doses. Best results were achieved in the highest (25 mg) cohort, which even detected small adenomas (<3 mm). Spectroscopy analyses of freshly excised specimen demonstrated the highest adenoma-to-normal ratio of 1.84 for the 25 mg cohort, with a calculated median tracer concentration in adenomas of 6.43 nmol/mL. Ex vivo signal analyses demonstrated NIR fluorescence within the dysplastic areas of the adenomas. Conclusion: These results suggest that NIR-FME is clinically feasible as a real-time, red-flag technique for detection of colorectal adenomas.
- Journal title abbreviation:
- Theranostics
- Year:
- 2018
- Journal volume:
- 8
- Journal issue:
- 6
- Pages contribution:
- 1458-1467
- Fulltext / DOI:
- doi:10.7150/thno.22033
- Pubmed ID:
- http://view.ncbi.nlm.nih.gov/pubmed/29556334
- TUM Institution:
- Lehrstuhl für Biologische Bildgebung - Zusammenarbeit mit dem Helmholtz-Zentrum München (Prof. Ntziachristos)
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