Potential red-flag identification of colorectal adenomas with wide-field fluorescence molecular endoscopy
Hartmans E, Tjalma JJJ, Linssen MD, Allende PBG, Koller M, Jorritsma-Smit A, Nery MESDO, Elias SG, Karrenbeld A, De Vries EGE, Kleibeuker JH, Van Dam GM, Robinson DJ, Ntziachristos V, Nagengast WB (2018)
Publication Type: Journal article
Publication year: 2018
Journal
Book Volume: 8
Pages Range: 1458-1467
Journal Issue: 6
DOI: 10.7150/thno.22033
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.
Involved external institutions
University of Groningen / Rijksuniversiteit Groningen
Netherlands (NL)
Technische Universität München (TUM)
Germany (DE)
University Medical Centre Utrecht (UMC Utrecht)
Netherlands (NL)
Erasmus University Medical Center (MC)
Netherlands (NL)
Netherlands (NL)
Technische Universität München (TUM)
Germany (DE)
University Medical Centre Utrecht (UMC Utrecht)
Netherlands (NL)
Erasmus University Medical Center (MC)
Netherlands (NL)
How to cite
APA:
Hartmans, E., Tjalma, J.J.J., Linssen, M.D., Allende, P.B.G., Koller, M., Jorritsma-Smit, A.,... Nagengast, W.B. (2018). Potential red-flag identification of colorectal adenomas with wide-field fluorescence molecular endoscopy. Theranostics, 8(6), 1458-1467. https://doi.org/10.7150/thno.22033
MLA:
Hartmans, Elmire, et al. "Potential red-flag identification of colorectal adenomas with wide-field fluorescence molecular endoscopy." Theranostics 8.6 (2018): 1458-1467.
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