TY - JOUR
T1 - Potential Red-Flag Identification of Colorectal Adenomas with Wide-Field Fluorescence Molecular Endoscopy
AU - Hartmans, Elmire
AU - Tjalma, Jolien J. J.
AU - Linssen, Matthijs D.
AU - Allende, Pilar Beatriz Garcia
AU - Koller, Marjory
AU - Jorritsma-Smit, Annelies
AU - Nery, Mariana e Silva de Oliveira
AU - Elias, Sjoerd G.
AU - Karrenbeld, Arend
AU - de Vries, Elisabeth G. E.
AU - Kleibeuker, Jan H.
AU - van Dam, Gooitzen M.
AU - Robinson, Dominic J.
AU - Ntziachristos, Vasilis
AU - Nagengast, Wouter B.
PY - 2018/2/5
Y1 - 2018/2/5
N2 - 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 (Conclusion: These results suggest that NIR-FME is clinically feasible as a real-time, red-flag technique for detection of colorectal adenomas.
AB - 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 (Conclusion: These results suggest that NIR-FME is clinically feasible as a real-time, red-flag technique for detection of colorectal adenomas.
KW - optical molecular imaging
KW - spectroscopy
KW - vascular endothelial growth factor a
KW - near-infrared fluorescence
KW - GROWTH-FACTOR RECEPTOR
KW - COLONOSCOPIC SURVEILLANCE
KW - LYNCH-SYNDROME
KW - CANCER
KW - DIAGNOSIS
KW - LESIONS
U2 - 10.7150/thno.22033
DO - 10.7150/thno.22033
M3 - Article
C2 - 29556334
VL - 8
SP - 1458
EP - 1467
JO - Theranostics
JF - Theranostics
SN - 1838-7640
IS - 6
ER -