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Nam K, Park N, Lee S, Jeon S, Lee J, Hong SM, Hwang SW, Park SH, Yang DH, Ye BD, Byeon JS, Yang SK, Lee JH, Kim DH, Kim KH, Myung SJ. Feasibility of moxifloxacin and proflavine dual fluorescence imaging for detecting gastrointestinal neoplastic lesions: A prospective study. Lasers Surg Med 2023; 55:378-389. [PMID: 36802075 DOI: 10.1002/lsm.23640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 12/27/2022] [Accepted: 01/27/2023] [Indexed: 02/19/2023]
Abstract
OBJECTIVES High-contrast and high-resolution imaging techniques would enable real-time sensitive detection of the gastrointestinal lesions. This study aimed to investigate the feasibility of novel dual fluorescence imaging using moxifloxacin and proflavine in the detection of neoplastic lesions of the human gastrointestinal tract. METHODS Patients with the colonic and gastric neoplastic lesions were prospectively enrolled. The lesions were biopsied with forceps or endoscopically resected. Dual fluorescence imaging was performed by using custom axially swept wide-field fluorescence microscopy after topical moxifloxacin and proflavine instillation. Imaging results were compared with both confocal imaging with cell labeling and conventional histological examination. RESULTS Ten colonic samples (one normal mucosa, nine adenomas) from eight patients and six gastric samples (one normal mucosa, five adenomas) from four patients were evaluated. Dual fluorescence imaging visualized detail cellular structures. Regular glandular structures with polarized cell arrangement were observed in normal mucosa. Goblet cells were preserved in normal colonic mucosa. Irregular glandular structures with scanty cytoplasm and dispersed elongated nuclei were observed in adenomas. Goblet cells were scarce or lost in the colonic lesions. Similarity analysis between moxifloxacin and proflavine imaging showed relatively high correlation values in adenoma compared with those in normal mucosa. Dual fluorescence imaging showed good detection accuracies of 82.3% and 86.0% in the colonic and the gastric lesions, respectively. CONCLUSIONS High-contrast and high-resolution dual fluorescence imaging was feasible for obtaining detail histopathological information in the gastrointestinal neoplastic lesions. Further studies are needed to develop dual fluorescence imaging as an in vivo real-time visual diagnostic method.
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Affiliation(s)
- Kwangwoo Nam
- Department of Gastroenterology, Dankook University Hospital, Dankook University College of Medicine, Cheonan, South Korea.,Digestive Diseases Research Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Noseong Park
- Division of Interdisciplinary Bioscience and Biotechnology, Pohang University of Science and Technology (POSTECH), Pohang, South Korea
| | - Seunghun Lee
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology (UNIST), Ulsan, South Korea
| | - Suil Jeon
- Department of Mechanical Engineering, Pohang University of Science and Technology (POSTECH), Pohang, South Korea
| | - Jungbin Lee
- Department of Mechanical Engineering, Pohang University of Science and Technology (POSTECH), Pohang, South Korea
| | - Seung-Mo Hong
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Sung Wook Hwang
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Sang Hyoung Park
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Dong-Hoon Yang
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Byong Duk Ye
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jeong-Sik Byeon
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Suk-Kyun Yang
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jeong Hoon Lee
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Do Hoon Kim
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Ki Hean Kim
- Division of Interdisciplinary Bioscience and Biotechnology, Pohang University of Science and Technology (POSTECH), Pohang, South Korea.,Department of Mechanical Engineering, Pohang University of Science and Technology (POSTECH), Pohang, South Korea
| | - Seung-Jae Myung
- Digestive Diseases Research Center, University of Ulsan College of Medicine, Seoul, South Korea.,Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.,EDIS Biotech, Seoul, South Korea
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Lambidis E, Chen CC, Lumen D, Sánchez AIF, Sarparanta M, Cheng RH, Airaksinen AJ. Biological evaluation of integrin α 3β 1-targeted 68Ga-labeled HEVNPs in HCT 116 colorectal tumor-bearing mice. Eur J Pharm Sci 2023; 180:106336. [PMID: 36403717 DOI: 10.1016/j.ejps.2022.106336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 11/10/2022] [Accepted: 11/16/2022] [Indexed: 11/18/2022]
Abstract
Integrins are cell surface receptors involved in multiple functions vital for cellular proliferation. Various tumor cells overexpress αβ-integrins, making them ideal biomarkers for diagnostic imaging and tumor-targeted drug delivery. LXY30 is a peptide that can specifically recognize and interact with the integrin α3β1, a molecule overexpressed in breast, ovarian and colorectal cancer. Hepatitis E virus nanoparticles (HEVNPs) are virus-like particles that have been investigated as drug delivery agents for the targeted delivery of nucleic acids and small proteins. HEVNPs can be a theranostic platform for monitoring and evaluating tumor-targeted therapies if tagged with a suitable diagnostic marker. Herein, we describe the radiolabeling and biological evaluation of integrin α3β1-targeted HEVNPs. HEVNPs were conjugated with DOTA and radiolabeled with gallium-68 (t1/2 = 67.7 min), a short-lived positron emitter used in positron emission tomography (PET). The synthesized [68Ga]Ga-DOTA-HEVNPs were used to evaluate the efficacy of conjugated LXY30 peptide to improve HEVNPs binding and internalization to integrin α3β1 expressing human colorectal HCT 116 cells. In vivo tumor accumulation of [68Ga]Ga-DOTA-HEVNP-LXY30 was evaluated in HCT 116 colorectal tumor-bearing mice. [68Ga]Ga-DOTA-HEVNP-LXY30 and non-targeted [68Ga]Ga-DOTA-HEVNP were radiolabeled with radiochemical yields (RCY) of 67.9 ± 3.3% and 73.7 ± 9.8%, respectively. [68Ga]Ga-DOTA-HEVNP-LXY30 exhibited significantly higher internalization in HCT 116 cells than the non-targeted [68Ga]Ga-DOTA-HEVNPs (21.0 ± 0.7% vs. 10.5 ± 0.3% at 3 h, ****P<0.0001). After intravenous administration to mice, accumulation of [68Ga]Ga-DOTA-HEVNP-LXY30 to HCT 116 xenograft tumors was at its highest rate of 0.8 ± 0.4%ID/g at 60 min. [68Ga]Ga-DOTA-HEVNP-LXY30 accumulated mainly in the liver and spleen (39.8 ± 13.0%%ID/g and 24.6 ± 24.1%ID/g, respectively). Despite the low targeting efficiency in vivo, we demonstrated that [68Ga]Ga-DOTA-HEVNP is a promising diagnostic platform for quantitative analysis of HEVNP distribution in vivo. This nanosystem can be utilized in future studies assessing the success of further engineered HEVNP structures with optimized targeting efficiency in vivo.
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Affiliation(s)
- Elisavet Lambidis
- Department of Chemistry, Radiochemistry, University of Helsinki, Helsinki FI-00014, Finland
| | - Chun-Chieh Chen
- Department of Molecular and Cellular Biology, University of California, Davis, CA 95616, U.S.A
| | - Dave Lumen
- Department of Chemistry, Radiochemistry, University of Helsinki, Helsinki FI-00014, Finland
| | | | - Mirkka Sarparanta
- Department of Chemistry, Radiochemistry, University of Helsinki, Helsinki FI-00014, Finland
| | - R Holland Cheng
- Department of Molecular and Cellular Biology, University of California, Davis, CA 95616, U.S.A..
| | - Anu J Airaksinen
- Department of Chemistry, Radiochemistry, University of Helsinki, Helsinki FI-00014, Finland; Turku PET Centre, Department of Chemistry, University of Turku, Turku FI-20520, Finland.
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Alfarone L, Parigi TL, Gabbiadini R, Dal Buono A, Spinelli A, Hassan C, Iacucci M, Repici A, Armuzzi A. Technological advances in inflammatory bowel disease endoscopy and histology. Front Med (Lausanne) 2022; 9:1058875. [PMID: 36438050 PMCID: PMC9691880 DOI: 10.3389/fmed.2022.1058875] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 10/26/2022] [Indexed: 09/29/2023] Open
Abstract
Accurate disease characterization is the pillar of modern treatment of inflammatory bowel disease (IBD) and endoscopy is the mainstay of disease assessment and colorectal cancer surveillance. Recent technological progress has enhanced and expanded the use of endoscopy in IBD. In particular, numerous artificial intelligence (AI)-powered systems have shown to support human endoscopists' evaluations, improving accuracy and consistency while saving time. Moreover, advanced optical technologies such as endocytoscopy (EC), allowing high magnification in vivo, can bridge endoscopy with histology. Furthermore, molecular imaging, through probe based confocal laser endomicroscopy allows the real-time detection of specific biomarkers on gastrointestinal surface, and could be used to predict therapeutic response, paving the way to precision medicine. In parallel, as the applications of AI spread, computers are positioned to resolve some of the limitations of human histopathology evaluation, such as interobserver variability and inconsistencies in assessment. The aim of this review is to summarize the most promising advances in endoscopic and histologic assessment of IBD.
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Affiliation(s)
- Ludovico Alfarone
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- IBD Center, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Tommaso Lorenzo Parigi
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- IBD Center, IRCCS Humanitas Research Hospital, Milan, Italy
| | | | | | - Antonino Spinelli
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Colon and Rectal Surgery Division, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Cesare Hassan
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Endoscopy Unit, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Marietta Iacucci
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, United Kingdom
- Department of Gastroenterology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Alessandro Repici
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Endoscopy Unit, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Alessandro Armuzzi
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- IBD Center, IRCCS Humanitas Research Hospital, Milan, Italy
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Jiang Y, Chen J, Gong C, Wang TD, Seibel EJ. Deep-Learning-Based Real-Time and Automatic Target-to-Background Ratio Calculation in Fluorescence Endoscopy for Cancer Detection and Localization. Diagnostics (Basel) 2022; 12:diagnostics12092031. [PMID: 36140433 PMCID: PMC9497969 DOI: 10.3390/diagnostics12092031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 08/15/2022] [Accepted: 08/15/2022] [Indexed: 12/24/2022] Open
Abstract
Esophageal adenocarcinoma (EAC) is a deadly cancer that is rising rapidly in incidence. The early detection of EAC with curative intervention greatly improves the prognoses of patients. A scanning fiber endoscope (SFE) using fluorescence-labeled peptides that bind rapidly to epidermal growth factor receptors showed a promising performance for early EAC detection. Target-to-background (T/B) ratios were calculated to quantify the fluorescence images for neoplasia lesion classification. This T/B calculation is generally based on lesion segmentation with the Chan–Vese algorithm, which may require hyperparameter adjustment when segmenting frames with different brightness and contrasts, which impedes automation to real-time video. Deep learning models are more robust to these changes, while accurate pixel-level segmentation ground truth is challenging to establish in the medical field. Since within our dataset the ground truth contained only a frame-level diagnosis, we proposed a computer-aided diagnosis (CAD) system to calculate the T/B ratio in real time. A two-step process using convolutional neural networks (CNNs) was developed to achieve automatic suspicious frame selection and lesion segmentation for T/B calculation. In the segmentation model training for Step 2, the lesion labels were generated with a manually tuned Chan–Vese algorithm using the labeled and predicted suspicious frames from Step 1. In Step 1, we designed and trained deep CNNs to select suspicious frames using a diverse and representative set of 3427 SFE images collected from 25 patient videos from two clinical trials. We tested the models on 1039 images from 10 different SFE patient videos and achieved a sensitivity of 96.4%, a specificity of 96.6%, a precision of 95.5%, and an area under the receiver operating characteristic curve of 0.989. In Step 2, 1006 frames containing suspicious lesions were used for training for fluorescence target segmentation. The segmentation models were tested on two clinical datasets with 100 SFE frames each and achieved mean intersection-over-union values of 0.89 and 0.88, respectively. The T/B ratio calculations based on our segmentation results were similar to the manually tuned Chan–Vese algorithm, which were 1.71 ± 0.22 and 1.72 ± 0.28, respectively, with a p-value of 0.872. With the graphic processing unit (GPU), the proposed two-step CAD system achieved 50 fps for frame selection and 15 fps for segmentation and T/B calculation, which showed that the frame rejection in Step 1 improved the diagnostic efficiency. This CAD system with T/B ratio as the real-time indicator is designed to guide biopsies and surgeries and to serve as a reliable second observer to localize and outline suspicious lesions highlighted by fluorescence probes topically applied in organs where cancer originates in the epithelia.
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Affiliation(s)
- Yang Jiang
- Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA
| | - Jing Chen
- Division of Gastroenterology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - Chen Gong
- Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA
| | - Thomas D. Wang
- Division of Gastroenterology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI 48109, USA
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, USA
| | - Eric J. Seibel
- Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA
- Correspondence:
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Waldner MJ, Neurath MF. Molecular Endoscopy for the Diagnosis and Therapeutic Monitoring of Colorectal Cancer. Front Oncol 2022; 12:835256. [PMID: 35280747 PMCID: PMC8913894 DOI: 10.3389/fonc.2022.835256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 01/26/2022] [Indexed: 11/23/2022] Open
Abstract
Colorectal cancer (CRC) is one of the leading causes of cancer related death in the western world. Its successful treatment requires early detection and removal of precursor lesions as well as individualized treatment of advanced disease. During recent years, molecular imaging techniques have shown promising results to improve current clinical practice. For instance, molecular endoscopy resulted in higher detection rates of precursors in comparison to conventional endoscopy in preclinical and clinical studies. Molecular confocal endomicroscopy allowed a further classification of suspect lesions as well as the prediction and monitoring of the therapeutic response. In this review, we summarize recent achievements for molecular imaging of CRC in preclinical studies, initial clinical trials and the remaining challenges for future translation into clinical practice.
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Affiliation(s)
- Maximilian J Waldner
- Department of Medicine 1, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.,Deutsches Zentrum Immuntherapie (DZI), Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Markus F Neurath
- Department of Medicine 1, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.,Deutsches Zentrum Immuntherapie (DZI), Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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6
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Shang W, Peng L, He K, Guo P, Deng H, Liu Y, Chen Z, Tian J, Xu W. A clinical study of a CD44v6-targeted fluorescent agent for the detection of non-muscle invasive bladder cancer. Eur J Nucl Med Mol Imaging 2022; 49:3033-3045. [PMID: 35190862 DOI: 10.1007/s00259-022-05701-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 01/20/2022] [Indexed: 01/16/2023]
Abstract
BACKGROUND Bladder cancer is the fifth most common malignancy in humans. Cystoscopy under white light imaging is the gold standard for bladder cancer diagnosis, but some tumors are difficult to visualize and can be overlooked, resulting in high recurrence rates. We previously developed a phage display-derived peptide-based near-infrared imaging probe, PLSWT7-DMI, which binds specifically to bladder cancer cells and is nontoxic to animals. Here, we report a clinical research of this probe for near-infrared fluorescence endoscopic detection of bladder cancer. RESULTS The purity, efficacy, safety, and nontoxicity of PLSWT7-DMI were confirmed prior to its clinical application. Twenty-two patients diagnosed with suspected non-muscle invasive bladder cancer were enrolled in the present study. Following intravesical administration of the probe, the entire mucosa was imaged under white and near-infrared imaging using an in-house developed endoscope that could switch between these two modes. The illuminated lesions under near-infrared light were biopsied and sent for histopathological examination. We observed a 5.1-fold increase in the fluorescence intensity in the tumor samples compared to normal tissue, and the probe demonstrated a sensitivity and specificity of 91.2% and 90%, respectively. Common diagnostic challenges, such as small satellite tumors, carcinoma in situ, and benign suspicious mucosa, were visualized and could be distinguished from cancer. Furthermore, no adverse effects were observed in humans. These first-in-human results indicate that PLSWT7-DMI-based near-infrared fluorescence endoscopy is a safe and effective approach for the improved detection of bladder cancer, and may enable thorough resection to prevent recurrence.
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Affiliation(s)
- Wenting Shang
- CAS Key Laboratory of Molecular Imaging, Beijing Key Laboratory of Molecular Imaging, the State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China
| | - Li Peng
- Urology Surgery Department, The Fourth Hospital of Harbin Medical University, Harbin, Heilongjiang, 150001, People's Republic of China.,NHC Key Laboratory of Molecular Probes and Targeted Diagnosis and Therapy, Yiyuan Street #37, Nangang District, Harbin, Heilongjiang, 150001, People's Republic of China
| | - Kunshan He
- CAS Key Laboratory of Molecular Imaging, Beijing Key Laboratory of Molecular Imaging, the State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China.,Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, School of Medicine and Engineering, Beihang University, Zhongguancun East Road #95, Haidian Dist., Beijing, 100191, China
| | - Pengyu Guo
- Urology Surgery Department, The Fourth Hospital of Harbin Medical University, Harbin, Heilongjiang, 150001, People's Republic of China.,NHC Key Laboratory of Molecular Probes and Targeted Diagnosis and Therapy, Yiyuan Street #37, Nangang District, Harbin, Heilongjiang, 150001, People's Republic of China
| | - Han Deng
- CAS Key Laboratory of Molecular Imaging, Beijing Key Laboratory of Molecular Imaging, the State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China
| | - Yu Liu
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, School of Medicine and Engineering, Beihang University, Zhongguancun East Road #95, Haidian Dist., Beijing, 100191, China
| | - Ziyin Chen
- Urology Surgery Department, The Fourth Hospital of Harbin Medical University, Harbin, Heilongjiang, 150001, People's Republic of China.,NHC Key Laboratory of Molecular Probes and Targeted Diagnosis and Therapy, Yiyuan Street #37, Nangang District, Harbin, Heilongjiang, 150001, People's Republic of China
| | - Jie Tian
- CAS Key Laboratory of Molecular Imaging, Beijing Key Laboratory of Molecular Imaging, the State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China. .,Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, School of Medicine and Engineering, Beihang University, Zhongguancun East Road #95, Haidian Dist., Beijing, 100191, China.
| | - Wanhai Xu
- Urology Surgery Department, The Fourth Hospital of Harbin Medical University, Harbin, Heilongjiang, 150001, People's Republic of China. .,NHC Key Laboratory of Molecular Probes and Targeted Diagnosis and Therapy, Yiyuan Street #37, Nangang District, Harbin, Heilongjiang, 150001, People's Republic of China.
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Parigi TL, Mastrorocco E, Da Rio L, Allocca M, D’Amico F, Zilli A, Fiorino G, Danese S, Furfaro F. Evolution and New Horizons of Endoscopy in Inflammatory Bowel Diseases. J Clin Med 2022; 11:jcm11030872. [PMID: 35160322 PMCID: PMC8837111 DOI: 10.3390/jcm11030872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 01/30/2022] [Accepted: 02/01/2022] [Indexed: 12/15/2022] Open
Abstract
Endoscopy is the mainstay of inflammatory bowel disease (IBD) evaluation and the pillar of colorectal cancer surveillance. Endoscopic equipment, both hardware and software, are advancing at an incredible pace. Virtual chromoendoscopy is now widely available, allowing the detection of subtle inflammatory changes, thus reducing the gap between endoscopic and histologic assessment. The progress in the field of artificial intelligence (AI) has been remarkable, and numerous applications are now in an advanced stage of development. Computer-aided diagnosis (CAD) systems are likely to reshape most of the evaluations that are now prerogative of human endoscopists. Furthermore, sophisticated tools such as endocytoscopy and probe-based confocal laser endomicroscopy (pCLE) are enhancing our assessment of inflammation and dysplasia. Finally, pCLE combined with molecular labeling could pave the way to a new paradigm of personalized medicine. This review aims to summarize the main changes that occurred in the field of IBD endoscopy and to explore the most promising novelties.
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Affiliation(s)
- Tommaso Lorenzo Parigi
- Department of Biomedical Sciences, Humanitas University, 20090 Milan, Italy; (T.L.P.); (E.M.); (L.D.R.)
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham B15 2TT, UK
| | - Elisabetta Mastrorocco
- Department of Biomedical Sciences, Humanitas University, 20090 Milan, Italy; (T.L.P.); (E.M.); (L.D.R.)
| | - Leonardo Da Rio
- Department of Biomedical Sciences, Humanitas University, 20090 Milan, Italy; (T.L.P.); (E.M.); (L.D.R.)
| | - Mariangela Allocca
- Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, 20132 Milan, Italy; (M.A.); (F.D.); (A.Z.); (G.F.); (S.D.)
| | - Ferdinando D’Amico
- Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, 20132 Milan, Italy; (M.A.); (F.D.); (A.Z.); (G.F.); (S.D.)
| | - Alessandra Zilli
- Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, 20132 Milan, Italy; (M.A.); (F.D.); (A.Z.); (G.F.); (S.D.)
| | - Gionata Fiorino
- Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, 20132 Milan, Italy; (M.A.); (F.D.); (A.Z.); (G.F.); (S.D.)
| | - Silvio Danese
- Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, 20132 Milan, Italy; (M.A.); (F.D.); (A.Z.); (G.F.); (S.D.)
| | - Federica Furfaro
- IBD Center, Humanitas Research Hospital, 20089 Milan, Italy
- Correspondence: ; Tel.: +39-0282245555
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Kwak MH, Yang SM, Yun SK, Kim S, Choi MG, Park JM. Identification and validation of LGR5-binding peptide for molecular imaging of gastric cancer. Biochem Biophys Res Commun 2021; 580:93-99. [PMID: 34628260 DOI: 10.1016/j.bbrc.2021.09.073] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 09/28/2021] [Indexed: 12/27/2022]
Abstract
Leucine-rich repeat-containing G-protein coupled receptor 5 (LGR5) is a stem cell marker in gastric cancer. In this study, we aimed to produce the LGR5-targeting peptide probe for the use of molecular imaging for gastric cancer. We used phage display libraries to produce a LGR5-specific peptide probe. This peptide was validated for targeting gastric cancer with in vitro and in vivo studies. This peptide was tagged with fluorescein isothiocyanate (FITC) and cyanine 5.5 (Cy5.5). We used two normal and three gastric cancer cell lines. Immunocytochemistry (ICC) and fluorescence-activated cell sorting (FACS) analysis were used to validate the target specificity of the peptide. After three rounds of bio-panning, we found a novel 7-mer peptides, IPQILSI (IPQ∗). FITC-conjugated IPQ∗ showed 2 to 10 times higher fluorescence in gastric cancer cells vs. control cells in ICC. This discrimination was consistently observed using Cy5.5-conjugated IPQ∗ in ICC. FACS analysis showed right shift of peak point in gastric cancers compared to the control cells. In the peritoneal metastasis animal model, we could find Cy5.5-conjugated IPQ∗ accumulated specifically to gastric tumors. In conclusion, IPQ∗ peptide showed a specific probe for gastric cancer diagnosis. This probe can be applied to theragnosis for gastric cancer diagnosis including peritoneal metastasis.
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Affiliation(s)
- Moon Hwa Kwak
- Catholic Photomedicine Research Institute, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea; Department of Medical Life Sciences, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Seung Mok Yang
- Catholic Photomedicine Research Institute, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Seul Ki Yun
- Catholic Photomedicine Research Institute, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea; Department of Medical Life Sciences, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Sol Kim
- Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Myung-Gyu Choi
- Catholic Photomedicine Research Institute, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea; Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jae Myung Park
- Catholic Photomedicine Research Institute, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea; Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
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9
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Kim HI, Kim J, Kim H, Lee H, Yoon YS, Hwang SW, Park SH, Yang DH, Ye BD, Byeon JS, Yang SK, Kim SY, Myung SJ. Biomolecular imaging of colorectal tumor lesions using a FITC-labeled scFv-Cκ fragment antibody. Sci Rep 2021; 11:17155. [PMID: 34433835 PMCID: PMC8387423 DOI: 10.1038/s41598-021-96281-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 08/03/2021] [Indexed: 12/20/2022] Open
Abstract
For the sensitive diagnosis of colorectal cancer lesions, advanced molecular imaging techniques using cancer-specific targets have emerged. However, issues regarding the clearance of unbound probes and immunogenicity remain unresolved. To overcome these limitations, we developed a small-sized scFv antibody fragment conjugated with FITC for the real-time detection of colorectal cancer by in vivo molecular endoscopy imaging. A small-sized scFv fragment can target colon cancer secreted protein-2 (CCSP-2), highly expressed in colorectal adenocarcinoma tissues; moreover, its full-length IgG probe has been used for molecular imaging previously. To assess the efficacy of anti-CCSP-2 scFv-FITC, surgical specimens were obtained from 21 patients with colorectal cancer for ex vivo molecular fluorescence analysis, histology, and immunohistochemistry. Orthotopic mice were administered with anti-CCSP-2 scFv-FITC topically and intravenously, and distinct tumor lesions were observed by real-time fluorescence colonoscopy. The fluorescence imaging of human colon cancer specimens allowed the differentiation of malignant tissues from non-malignant tissues (p < 0.05), and the CCSP-2 expression level was found to be correlated with the fluorescence intensity. Here, we demonstrated the feasibility and safety of anti-CCSP-2 scFv-FITC for molecular imaging as well as its potential in real-time fluorescence colonoscopy for the differential diagnosis of tumor lesions.
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Affiliation(s)
- Hyung Il Kim
- Department of Medical Science, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.,Digestive Diseases Research Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jinhyeon Kim
- Edisbiotech, Songpa-gu, Seoul, Republic of Korea
| | - Hyori Kim
- Convergence Medicine Research Center, Asan Medical Center, Seoul, Republic of Korea
| | - Hyeri Lee
- Edisbiotech, Songpa-gu, Seoul, Republic of Korea
| | - Yong Sik Yoon
- Department of Colon and Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sung Wook Hwang
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sang Hyoung Park
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Dong-Hoon Yang
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Byong Duk Ye
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jeong-Sik Byeon
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Suk-Kyun Yang
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sun Young Kim
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
| | - Seung-Jae Myung
- Edisbiotech, Songpa-gu, Seoul, Republic of Korea. .,Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. .,Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea. .,Digestive Diseases Research Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
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10
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Solitano V, D’Amico F, Allocca M, Fiorino G, Zilli A, Loy L, Gilardi D, Radice S, Correale C, Danese S, Peyrin-Biroulet L, Furfaro F. Rediscovering histology: what is new in endoscopy for inflammatory bowel disease? Therap Adv Gastroenterol 2021; 14:17562848211005692. [PMID: 33948114 PMCID: PMC8053840 DOI: 10.1177/17562848211005692] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 03/08/2021] [Indexed: 02/04/2023] Open
Abstract
The potential of endoscopic evaluation in the management of inflammatory bowel diseases (IBD) has undoubtedly grown over the last few years. When dealing with IBD patients, histological remission (HR) is now considered a desirable target along with symptomatic and endoscopic remission, due to its association with better long-term outcomes. Consequently, the ability of endoscopic techniques to reflect microscopic findings in vivo without having to collect biopsies has become of upmost importance. In this context, a more accurate evaluation of inflammatory disease activity and the detection of dysplasia represent two mainstay targets for IBD endoscopists. New diagnostic technologies have been developed, such as dye-less chromoendoscopy, endomicroscopy, and molecular imaging, but their real incorporation in daily practice is not yet well defined. Although dye-chromoendoscopy is still recommended as the gold standard approach in dysplasia surveillance, recent research questioned the superiority of this technique over new advanced dye-less modalities [narrow band imaging (NBI), Fuji intelligent color enhancement (FICE), i-scan, blue light imaging (BLI) and linked color imaging (LCI)]. The endoscopic armamentarium might also be enriched by new video capsule endoscopy for monitoring disease activity, and high expectations are placed on the application of artificial intelligence (AI) systems to reduce operator-subjectivity and inter-observer variability. The goal of this review is to provide an updated insight on contemporary knowledge regarding new endoscopic techniques and devices, with special focus on their role in the assessment of disease activity and colorectal cancer surveillance.
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Affiliation(s)
- Virginia Solitano
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Ferdinando D’Amico
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy,IBD Center, Humanitas Clinical and Research Center, IRCCS, Rozzano, Milan, Italy
| | - Mariangela Allocca
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy,IBD Center, Humanitas Clinical and Research Center, IRCCS, Rozzano, Milan, Italy
| | - Gionata Fiorino
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy,IBD Center, Humanitas Clinical and Research Center, IRCCS, Rozzano, Milan, Italy
| | - Alessandra Zilli
- IBD Center, Humanitas Clinical and Research Center, IRCCS, Rozzano, Milan, Italy
| | - Laura Loy
- IBD Center, Humanitas Clinical and Research Center, IRCCS, Rozzano, Milan, Italy
| | - Daniela Gilardi
- IBD Center, Humanitas Clinical and Research Center, IRCCS, Rozzano, Milan, Italy
| | - Simona Radice
- IBD Center, Humanitas Clinical and Research Center, IRCCS, Rozzano, Milan, Italy
| | - Carmen Correale
- IBD Center, Humanitas Clinical and Research Center, IRCCS, Rozzano, Milan, Italy
| | - Silvio Danese
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy,IBD Center, Humanitas Clinical and Research Center, IRCCS, Rozzano, Milan, Italy
| | - Laurent Peyrin-Biroulet
- Department of Gastroenterology and Inserm NGERE U1256, University Hospital of Nancy, University of Lorraine, Vandoeuvre-lès-Nancy, France
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11
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Ham NS, Myung SJ. Endoscopic molecular imaging in inflammatory bowel disease. Intest Res 2021; 19:33-44. [PMID: 32299156 PMCID: PMC7873406 DOI: 10.5217/ir.2019.09175] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 01/31/2020] [Indexed: 12/12/2022] Open
Abstract
Molecular imaging is a technique for imaging the processes occurring in a living body at a molecular level in real-time, combining molecular cell biology with advanced imaging technologies using molecular probes and fluorescence. Gastrointestinal endoscopic molecular imaging shows great promise for improving the identification of neoplasms, providing characterization for patient stratification and assessing the response to molecular targeted therapy. In inflammatory bowel disease, endoscopic molecular imaging can be used to assess disease severity and predict therapeutic response and prognosis. Endoscopic molecular imaging is also able to visualize dysplasia in the presence of background inflammation. Several preclinical and clinical trials have evaluated endoscopic molecular imaging; however, this area is just beginning to evolve, and many issues have not been solved yet. In the future, it is expected that endoscopic molecular imaging will be of increasing interest among clinicians as a new technology for the identification and evaluation of colorectal neoplasm and colitis-associated cancer.
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Affiliation(s)
- Nam Seok Ham
- Department of Gastroenterology, Veterans Health Service Medical Center, Seoul, Korea
| | - Seung-Jae Myung
- Department of Gastroenterology, Digestive Diseases Research Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Correspondence to Seung-Jae Myung, Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea. Tel: +82-2-3010-3917, Fax: +82-2- 476-0824, E-mail:
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12
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Zhang D, Huang J, Li W, Zhang Z, Zhu M, Feng Y, Zhao Y, Li Y, Lu S, He S. Screening and identification of a CD44v6 specific peptide using improved phage display for gastric cancer targeting. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:1442. [PMID: 33313187 PMCID: PMC7723568 DOI: 10.21037/atm-19-4781] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background Peptide probes can be applied for biomarker targeting to improve the diagnostic accuracy. Cluster of differentiation 44 (CD44) is up-regulated in gastric cancer (GC). Among all the variants of CD44, CD44v6 is reported the most promising biomarker for GC. The purpose of this study was generating and identification a peptide ligand specific to CD44v6. Methods A 12-mer phage peptide library was screened on CD44v overexpressed HEK-293 cells with an improved subtractive method. Five candidate sequences emerged. Candidate phages were selected using enzyme-linked immunosorbent assay and competitive inhibition assays. Then the sequence (designated ELT) was chosen for further study. Its binding affinity and specificity were verified on recombinant protein, GC cells, GC tissues and xenograft models based on BALB/c-nu/nu mice using dissociation constant calculation, immunofluorescence, immunohistochemistry and in vivo imaging separately. Results The dissociation constant of ELT with recombinant protein was 611.2 nM. ELT stained CD44v overexpressed HEK-293 but not the cell expressing wild-type CD44s. On GC cell lines, ELT co-stained with anti-CD44v6 antibody. ELT binding on tumor tissues significantly increased compared with that of paracancer tissues, also showed a linear positive correlation with CD44v6 expression. ELT specifically accumulated in tumor and eliminated in short time in vivo. Conclusions ELT can target GC in vitro and in vivo via CD44v6, indicating its potential to serve as a probe for GC targeting diagnosis and therapy.
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Affiliation(s)
- Dan Zhang
- Department of Gastroenterology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jin Huang
- School of Electronic Information and Artificial Intelligence, Shannxi University of Science &Technology, Xi'an, China.,School of Materials Science and Engineering, Shannxi Normal University, Xi'an, China
| | - Weiming Li
- Department of Vascular Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Zhiyong Zhang
- Department of Gastroenterology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Meng Zhu
- Department of Gastroenterology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yun Feng
- Department of Gastroenterology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yan Zhao
- Department of Gastroenterology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yarui Li
- Department of Gastroenterology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Shaoying Lu
- Department of Vascular Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Shuixiang He
- Department of Gastroenterology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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13
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Mortensen OE, Nerup N, Thorsteinsson M, Svendsen MBS, Shiwaku H, Achiam MP. Fluorescence guided intraluminal endoscopy in the gastrointestinal tract: A systematic review. World J Gastrointest Endosc 2020; 12:388-400. [PMID: 33133375 PMCID: PMC7579525 DOI: 10.4253/wjge.v12.i10.388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/29/2020] [Accepted: 09/08/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Conventional endoscopy is based on full spectrum white light. However, different studies have investigated the use of fluorescence based endoscopy systems where the white light has been supplemented by infrared light and the use of relevant fluorophores. Fluorescence endoscopy utilizes the fluorescence emitted from a fluorophore, visualizing what is not visible to the naked eye.
AIM To explore the feasibility of fluorescence endoscopy and evaluate its use in diagnosing and evaluating gastrointestinal disease.
METHODS We followed the PRISMA guidelines for this systematic review. The research covered five databases; PubMed, Scopus, Web of Science, Embase, and the Cochrane Collection, including only studies in English and Scandinavian languages. Authors screened title and abstract for inclusion, subsequently full-text for inclusion according to eligibility criteria listed in the protocol. The risk of bias was assessed for all studies according to the Newcastle-Ottawa Scale. The authors extracted the data and reported the results in both text and tables.
RESULTS We included seven studies in the systematic review after screening a total of 2769 papers. The most prominent fluorophore was indocyanine green (n = 6), and whereas one study (n = 1) used Bevacizumab 800-CW. Three studies investigated fluorescence endoscopy in detecting varices, adenomas in patients with familial adenomatous polyposis and neoplasms in the gastrointestinal tract. Four studies evaluated the usefulness of fluorescence endoscopy in assessing tumor invasion. Three of the four studies reported an exceptional diagnostic accuracy (93%, 89% and 88%) in assessing tumor invasion, thus representing better visualization and more correct diagnosis by fluorescence endoscopy compared with the conventional endoscopy. The relationship between the endoscopic findings, tumor invasion, and tumor vascularity was evaluated in two studies showing a significant correlation (dP < 0.05 and bP < 0.01).
CONCLUSION The use of fluorescence endoscopy is a promising method adding diagnostic value in the detection of neoplasia, adenomas, and assessment of tumor invasion within the gastrointestinal tract. More studies are needed to utilize the feasibility of fluorescence endoscopy compared with other endoscopic methods.
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Affiliation(s)
- Olivia Engholt Mortensen
- Department of Surgical Gastroenterology, Copenhagen University Hospital, Copenhagen 2100, Denmark
| | - Nikolaj Nerup
- Department of Surgical Gastroenterology, Copenhagen University Hospital, Copenhagen 2100, Denmark
| | - Morten Thorsteinsson
- Department of Surgical Gastroenterology, Copenhagen University Hospital, Copenhagen 2100, Denmark
| | | | - Hironari Shiwaku
- Department of Surgical Gastroenterology, Fukuoka University Faculty of Medicine, Fukuoka 814-0133, Japan
| | - Michael Patrick Achiam
- Department of Surgical Gastroenterology, Copenhagen University Hospital, Copenhagen 2100, Denmark
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14
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15
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Hoffman A, Atreya R, Rath T, Neurath MF. Use of Fluorescent Dyes in Endoscopy and Diagnostic Investigation. Visc Med 2020; 36:95-103. [PMID: 32355666 DOI: 10.1159/000506241] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 01/15/2020] [Indexed: 12/25/2022] Open
Abstract
Background The advancement of innovative endoscopic technology in terms of improving the visualization of the mucosa has been of significant benefit. Summary Advancements in image resolution, software processing, and optical filter technology have resulted in several techniques complemental to traditional white light endoscopy. These new techniques provide a real-time optical diagnosis as well as virtual histology of detected lesions. Optical molecular imaging permits a functional assessment within cells. Key Message Optical molecular imaging provides an understanding of cellular processes and permits validation of the specificity of fluorescent tracers and the possibility of quantifying the signal.
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Affiliation(s)
- Arthur Hoffman
- Department of Internal Medicine III, Clinic Aschaffenburg-Alzenau, Aschaffenburg, Germany
| | - Raja Atreya
- First Department of Medicine, Friedrich Alexander University Erlangen-Nuernberg, Erlangen, Germany
| | - Timo Rath
- First Department of Medicine, Friedrich Alexander University Erlangen-Nuernberg, Erlangen, Germany
| | - Markus F Neurath
- First Department of Medicine, Friedrich Alexander University Erlangen-Nuernberg, Erlangen, Germany
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16
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Frickenstein AN, Jones MA, Behkam B, McNally LR. Imaging Inflammation and Infection in the Gastrointestinal Tract. Int J Mol Sci 2019; 21:ijms21010243. [PMID: 31905812 PMCID: PMC6981656 DOI: 10.3390/ijms21010243] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 12/23/2019] [Accepted: 12/25/2019] [Indexed: 02/06/2023] Open
Abstract
A variety of seemingly non-specific symptoms manifest within the gastrointestinal (GI) tract, particularly in the colon, in response to inflammation, infection, or a combination thereof. Differentiation between symptom sources can often be achieved using various radiologic studies. Although it is not possible to provide a comprehensive survey of imaging gastrointestinal GI tract infections in a single article, the purpose of this review is to survey several topics on imaging of GI tract inflammation and infections. The review discusses such modalities as computed tomography, positron emission tomography, ultrasound, endoscopy, and magnetic resonance imaging while looking at up-an-coming technologies that could improve diagnoses and patient comfort. The discussion is accomplished through examining a combination of organ-based and organism-based approaches, with accompanying selected case examples. Specific focus is placed on the bacterial infections caused by Shigella spp., Escherichia coli, Clostridium difficile, Salmonella, and inflammatory conditions of diverticulitis and irritable bowel disease. These infectious and inflammatory diseases and their detection via molecular imaging will be compared including the appropriate differential diagnostic considerations.
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Affiliation(s)
- Alex N. Frickenstein
- Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, OK 73019, USA; (A.N.F.); (M.A.J.)
- Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK 73104, USA
| | - Meredith A. Jones
- Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, OK 73019, USA; (A.N.F.); (M.A.J.)
- Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK 73104, USA
| | - Bahareh Behkam
- Department of Mechanical Engineering, Virginia Tech University, Blacksburg, VA 24061, USA;
| | - Lacey R. McNally
- Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, OK 73019, USA; (A.N.F.); (M.A.J.)
- Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK 73104, USA
- Department of Surgery, University of Oklahoma, Oklahoma City, OK 73104, USA
- Correspondence:
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17
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Optoacoustic imaging in gastroenterology. TRANSLATIONAL BIOPHOTONICS 2019. [DOI: 10.1002/tbio.201900002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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18
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Byun MR, Lee SW, Paulson B, Lee S, Lee W, Lee KK, Kim YR, Kim JK, Choi JW. Micro-endoscopic In Vivo Monitoring in the Blood and Lymphatic Vessels of the Oral Cavity after Radiation Therapy. Int J Med Sci 2019; 16:1525-1533. [PMID: 31673245 PMCID: PMC6818205 DOI: 10.7150/ijms.36470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 08/23/2019] [Indexed: 11/30/2022] Open
Abstract
Radiotherapy, although used worldwide for the treatment of head, neck, and oral cancers, causes acute complications, including effects on vasculature and immune response due to cellular stress. Thus, the ability to diagnose side-effects and monitor vascular response in real-time during radiotherapy would be highly beneficial for clinical and research applications. In this study, recently-developed fluorescence micro-endoscopic technology provides non-invasive, high-resolution, real-time imaging at the cellular level. Moreover, with the application of high-resolution imaging technologies and micro-endoscopy, which enable improved monitoring of adverse effects in GFP-expressing mouse models, changes in the oral vasculature and lymphatic vessels are quantified in real time for 10 days following a mild localized single fractionation, 10 Gy radiotherapy treatments. Fluorescence micro-endoscopy enables quantification of the cardiovascular recovery and immune response, which shows short-term reduction in mean blood flow velocity, in lymph flow, and in transient immune infiltration even after this mild radiation dose, in addition to long-term reduction in blood vessel capacity. The data provided may serve as a reference for the expected cellular-level physiological, cardiovascular, and immune changes in animal disease models after radiotherapy.
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Affiliation(s)
- Mi Ran Byun
- Department of Pharmacology, College of Pharmacy, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Seok Won Lee
- Department of Pharmacology, College of Pharmacy, Kyung Hee University, Seoul, 02447, Republic of Korea.,Department of Life and Nanopharmaceutical Science, Graduate School, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Bjorn Paulson
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea
| | - Sanghwa Lee
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea
| | - Wan Lee
- Department of Oral and Maxillofacial Radiology, College of Dentistry, Wonkwang University, Iksan, 54538, Republic of Korea
| | - Kang Kyoo Lee
- Department of Radiation Oncology, School of Medicine, Wonkwang University, Iksan, 54538, Republic of Korea
| | - Yi Rang Kim
- Department of Hemato-Oncology, Yuseong Sun Hospital, Daejeon, 34084, Republic of Korea
| | - Jun Ki Kim
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea.,Department of Convergence Medicine, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea
| | - Jin Woo Choi
- Department of Pharmacology, College of Pharmacy, Kyung Hee University, Seoul, 02447, Republic of Korea.,Department of Life and Nanopharmaceutical Science, Graduate School, Kyung Hee University, Seoul, 02447, Republic of Korea
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Nagengast WB, Hartmans E, Garcia-Allende PB, Peters FTM, Linssen MD, Koch M, Koller M, Tjalma JJJ, Karrenbeld A, Jorritsma-Smit A, Kleibeuker JH, van Dam GM, Ntziachristos V. Near-infrared fluorescence molecular endoscopy detects dysplastic oesophageal lesions using topical and systemic tracer of vascular endothelial growth factor A. Gut 2019; 68:7-10. [PMID: 29247063 PMCID: PMC6839834 DOI: 10.1136/gutjnl-2017-314953] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 10/25/2017] [Accepted: 11/16/2017] [Indexed: 01/07/2023]
Affiliation(s)
- Wouter B Nagengast
- Department of Gastroenterology and Hepatology, University of Groningen, University Medical Center, Groningen, The Netherlands
| | - Elmire Hartmans
- Department of Gastroenterology and Hepatology, University of Groningen, University Medical Center, Groningen, The Netherlands
| | - Pilar B Garcia-Allende
- Chair for Biological Imaging and Institute for Biological and Medical Imaging, Technical University of Munich and Helmholtz Centre Munich, Munich, Germany
| | - Frans T M Peters
- Department of Gastroenterology and Hepatology, University of Groningen, University Medical Center, Groningen, The Netherlands
| | - Matthijs D Linssen
- Department of Gastroenterology and Hepatology, University of Groningen, University Medical Center, Groningen, The Netherlands,Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center, Groningen, The Netherlands
| | - Maximilian Koch
- Chair for Biological Imaging and Institute for Biological and Medical Imaging, Technical University of Munich and Helmholtz Centre Munich, Munich, Germany
| | - Marjory Koller
- Department of Surgery, University of Groningen, University Medical Center, Groningen, The Netherlands
| | - Jolien J J Tjalma
- Department of Gastroenterology and Hepatology, University of Groningen, University Medical Center, Groningen, The Netherlands
| | - Arend Karrenbeld
- Department of Pathology, University of Groningen, University MedicalCenter, Groningen, The Netherlands
| | - Annelies Jorritsma-Smit
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center, Groningen, The Netherlands
| | - Jan H Kleibeuker
- Department of Gastroenterology and Hepatology, University of Groningen, University Medical Center, Groningen, The Netherlands
| | - Gooitzen M van Dam
- Department of Surgery, University of Groningen, University Medical Center, Groningen, The Netherlands,Department of Nuclear Medicine & Molecular Imaging and Intensive Care, University of Groningen, University Medical Center, Groningen, The Netherlands
| | - Vasilis Ntziachristos
- Chair for Biological Imaging and Institute for Biological and Medical Imaging, Technical University of Munich and Helmholtz Centre Munich, Munich, Germany
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20
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Bae SM, Bae DJ, Do EJ, Oh G, Yoo SW, Lee GJ, Chae JS, Yun Y, Kim S, Kim KH, Chung E, Kim JK, Hwang SW, Park SH, Yang DH, Ye BD, Byeon JS, Yang SK, Joo J, Kim SY, Myung SJ. Multi-Spectral Fluorescence Imaging of Colon Dysplasia InVivo Using a Multi-Spectral Endoscopy System. Transl Oncol 2018; 12:226-235. [PMID: 30419540 PMCID: PMC6231290 DOI: 10.1016/j.tranon.2018.10.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 10/07/2018] [Accepted: 10/11/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND AND STUDY AIM: To develop a molecular imaging endoscopic system that eliminates tissue autofluorescence and distinguishes multiple fluorescent markers specifically on the cancerous lesions. METHODS: Newly developed multi-spectral fluorescence endoscope device has the potential to eliminate signal interference due to autofluorescence and multiplex fluorophores in fluorescent probes. The multiplexing capability of the multi-spectral endoscope device was demonstrated in the phantom studies and multi-spectral imaging with endoscopy and macroscopy was performed to analyze fluorescence signals after administration of fluorescent probe that targets cancer in the colon. Because of the limitations in the clinical application using rigid-type small animal endoscope, we developed a flexible channel insert-type fluorescence endoscope, which was validated on the colonoscopy of dummy and porcine model. RESULTS: We measured multiple fluorescent signals simultaneously, and the fluorescence spectra were unmixed to separate the fluorescent signals of each probe, in which multiple fluorescent probes clearly revealed spectral deconvolution at the specific targeting area in the mouse colon. The positive area of fluorescence signal for each probe over the whole polyp was segmented with analyzing software, and showed distinctive patterns and significantly distinguishable values: 0.46 ± 0.04, 0.39 ± 0.08 and 0.73 ± 0.12 for HMRG, CET-553 and TRA-675 probes, respectively. The spectral unmixing was finally demonstrated in the dummy and porcine model, corroborating the targeted multi-spectral fluorescence imaging of colon dysplasia. CONCLUSION: The multi-spectral endoscopy system may allow endoscopists to clearly identify cancerous lesion that has different patterns of various target expression using multiple fluorescent probes.
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Affiliation(s)
- Sang Mun Bae
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, South Korea; Department of Medicine, University of Ulsan College of Medicine, Seoul 138-736, South Korea
| | - Dong-Jun Bae
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, South Korea
| | - Eun-Ju Do
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, South Korea
| | - Gyungseok Oh
- School of Mechanical Engineering, Gwangju Institute of Science and Technology, Gwangju 61005, South Korea
| | - Su Woong Yoo
- Department of Biomedical Science and Engineering, Institute of Integrated Technology (IIT), Gwangju, Institute of Science and Technology, Gwangju 61005, South Korea
| | - Gil-Je Lee
- Discovery and Analytic Solution, PerkinElmer Korea, Seoul 08380, South Korea
| | - Ji Soo Chae
- Discovery and Analytic Solution, PerkinElmer Korea, Seoul 08380, South Korea
| | - Youngkuk Yun
- Discovery and Analytic Solution, PerkinElmer Korea, Seoul 08380, South Korea
| | - Sungjee Kim
- Department of Chemistry, Pohang University of Science and Technology, Pohang 790-784, South Korea
| | - Ki Hean Kim
- Department of Mechanical Engineering, Pohang University of Science and Technology, Pohang 790-784, South Korea
| | - Euiheon Chung
- School of Mechanical Engineering, Gwangju Institute of Science and Technology, Gwangju 61005, South Korea; Department of Biomedical Science and Engineering, Institute of Integrated Technology (IIT), Gwangju, Institute of Science and Technology, Gwangju 61005, South Korea
| | - Jun Ki Kim
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, South Korea
| | - Sung Wook Hwang
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, South Korea
| | - Sang Hyoung Park
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, South Korea
| | - Dong-Hoon Yang
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, South Korea
| | - Byong Duk Ye
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, South Korea
| | - Jeong-Sik Byeon
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, South Korea
| | - Suk-Kyun Yang
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, South Korea
| | - Jinmyoung Joo
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, South Korea; Department of Gastroenterology and Convergence Medicine, University of Ulsan College of Medicine, Seoul 138-736, South Korea
| | - Sang-Yeob Kim
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, South Korea; Department of Gastroenterology and Convergence Medicine, University of Ulsan College of Medicine, Seoul 138-736, South Korea.
| | - Seung-Jae Myung
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, South Korea; Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, South Korea; Department of Gastroenterology and Convergence Medicine, University of Ulsan College of Medicine, Seoul 138-736, South Korea.
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21
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Abe S, Saito Y, Oono Y, Tanaka Y, Sakamoto T, Yamada M, Nakajima T, Matsuda T, Ikematsu H, Yano T, Sekine S, Kojima M, Yamagishi H, Kato H. Pilot study on probe-based confocal laser endomicroscopy for colorectal neoplasms: an initial experience in Japan. Int J Colorectal Dis 2018; 33:1071-1078. [PMID: 29700599 DOI: 10.1007/s00384-018-3059-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/13/2018] [Indexed: 02/04/2023]
Abstract
BACKGROUND The aim of this pilot study is to investigate the diagnostic yield of probe-based confocal laser endomicroscopy (pCLE) in the evaluation of depth of invasion in colorectal lesions. METHODS Patients with colorectal lesions eligible for either endoscopic treatment or surgery were enrolled in the study. Tumor's depth of invasion was classified as mucosal or slight submucosal (M-SM1) and deep submucosal invasion or deeper (SM2 or deeper). White light endoscopy (WLE), magnifying narrow band imaging (M-NBI), and magnifying chromoendoscopy (M-CE) were used to assess colorectal lesions, and pCLE was used to identify tumor's features related to SM2 or deeper. The diagnostic classification of depth of invasion was obtained by correlating pCLE findings with histology results (on-site diagnosis). All colorectal lesions were stratified by a second endoscopist who was blinded to any clinical and histological information with the use of WLE, M-NBI, M-CE, and pCLE (off-line review). RESULTS A total of 22 colorectal lesions were analyzed: seven were adenoma, ten intramucosal cancer, and five SM2 or deeper cancer. With respect to pCLE findings, loss of crypt structure was seen in all SM2 or deeper cancers and only in one M-SM1 lesion. Sensitivity, specificity, and accuracy of WLE, M-NBI, and M-CE in off-line review were 60/94/86, 60/94/86, and 80/94/91%, respectively. Sensitivity/specificity/accuracy of pCLE in off-line review were 80/94/91%, respectively. The inter-observer agreement of pCLE between on-site diagnosis and off-line review was 0.64 (95%CI 0.27-1.0). CONCLUSIONS pCLE may represent a useful tool to evaluate the depth of invasion in colorectal lesions.
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Affiliation(s)
- Seiichiro Abe
- Department of Surgery I, Dokkyo Medical University, Tochigi, Japan.,Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Yutaka Saito
- Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
| | - Yasuhiro Oono
- Division of Gastrointestinal Endoscopy, National Cancer Center Hospital East, Kashiwa, Japan
| | - Yusaku Tanaka
- Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Taku Sakamoto
- Department of Surgery I, Dokkyo Medical University, Tochigi, Japan.,Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Masayoshi Yamada
- Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Takeshi Nakajima
- Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Takahisa Matsuda
- Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Hiroaki Ikematsu
- Division of Gastrointestinal Endoscopy, National Cancer Center Hospital East, Kashiwa, Japan
| | - Tomonori Yano
- Division of Gastrointestinal Endoscopy, National Cancer Center Hospital East, Kashiwa, Japan
| | - Shigeki Sekine
- Department of pathology, National Cancer Center Hospital, Tokyo, Japan
| | - Motohiro Kojima
- Department of Pathology, National Cancer Center Hospital, East, Kashiwa, Japan
| | | | - Hiroyuki Kato
- Department of Surgery I, Dokkyo Medical University, Tochigi, Japan
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22
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Li W, Jia H, Wang J, Guan H, Li Y, Zhang D, Tang Y, Wang TD, Lu S. A CD44-specific peptide, RP-1, exhibits capacities of assisting diagnosis and predicting prognosis of gastric cancer. Oncotarget 2018; 8:30063-30076. [PMID: 28415792 PMCID: PMC5444726 DOI: 10.18632/oncotarget.16275] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 03/09/2017] [Indexed: 12/18/2022] Open
Abstract
Early diagnosis and evaluation of prognosis are both crucial for preventing poor prognosis of patients with gastric cancer (GC), a leading cause of cancer-related deaths worldwide. Cluster of differentiation 44 (CD44), an indicator of cancer stem cells, can be specifically targeted by molecular probes and detected in tissues of GC in a large quantity. In current study we found that RP-1, a specific peptide binding to CD44 protein, exhibited the potentials of specific binding to CD44 high-expressing cancer cells both in vitro and in vivo, and the capacity of predicting prognosis of human GC in a microarray assay. Results showed that RP-1 was characterized by high affinity, sensitivity and specificity, and low toxicity, suggesting RP-1 could be an ideal bio-probe for accessory diagnosis of GC. Further immunohistochemical studies and statistical analysis of tissue microarray of human GC demonstrated similar sensitivity and specificity of RP-1 with the monoclonal anti-CD44 antibody in the diagnosis of GC, and even proved that positive RP-1 could be an independent risk factor. Therefore, this study suggests RP-1 has the potentials of binding to CD44 protein expressed on the membrane of GC cells, and demonstrates the feasibility and reliability of its further application in molecular diagnosis and prognostic prediction of GC.
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Affiliation(s)
- Weiming Li
- Department of Vascular Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, 710061, P.R.China
| | - Huan Jia
- Department of General Surgery, The First Affiliated Hospital of Xi'an Medical University, Xi'an, Shaanxi Province, 710077, P.R.China
| | - Jichang Wang
- Department of Vascular Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, 710061, P.R.China
| | - Hao Guan
- Department of Vascular Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, 710061, P.R.China
| | - Yan Li
- Department of Vascular Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, 710061, P.R.China
| | - Dan Zhang
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, 710061, P.R.China
| | - Yanan Tang
- Department of Vascular Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, 710061, P.R.China
| | - Thomas D Wang
- Division of Gastroenterology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - Shaoying Lu
- Department of Vascular Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, 710061, P.R.China
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23
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CEACAM6 is upregulated by Helicobacter pylori CagA and is a biomarker for early gastric cancer. Oncotarget 2018; 7:55290-55301. [PMID: 27421133 PMCID: PMC5342417 DOI: 10.18632/oncotarget.10528] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 05/23/2016] [Indexed: 12/21/2022] Open
Abstract
Early detection of gastric cancers saves lives, but remains a diagnostic challenge. In this study, we aimed to identify cell-surface biomarkers of early gastric cancer. We hypothesized that a subset of plasma membrane proteins induced by the Helicobacter pylori oncoprotein CagA will be retained in early gastric cancers through non-oncogene addiction. An inducible system for expression of CagA was used to identify differentially upregulated membrane protein transcripts in vitro. The top hits were then analyzed in gene expression datasets comparing transcriptome of gastric cancer with normal tissue, to focus on markers retained in cancer. Among the transcripts enriched upon CagA induction in vitro, a significant elevation of CEACAM6 was noted in gene expression datasets of gastric cancer. We used quantitative digital immunohistochemistry to measure CEACAM6 protein levels in tissue microarrays of gastric cancer. We demonstrate an increase in CEACAM6 in early gastric cancers, when compared to matched normal tissue, with an AUC of 0.83 for diagnostic validity. Finally, we show that a fluorescently conjugated CEACAM6 antibody binds avidly to freshly resected gastric cancer xenograft samples and can be detected by endoscopy in real time. Together, these results suggest that CEACAM6 upregulation is a cell surface response to H. pylori CagA, and is retained in early gastric cancers. They highlight a novel link between CEACAM6 expression and CagA in gastric cancer, and suggest CEACAM6 to be a promising biomarker to aid with the fluorescent endoscopic diagnosis of early neoplastic lesions in the stomach.
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24
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Nunes A, Pansare VJ, Beziere N, Ntoukas AK, Reber J, Bruzek M, Anthony J, Prud’homme RK, Ntziachristos V. Quenched hexacene optoacoustic nanoparticles. J Mater Chem B 2018; 6:44-55. [DOI: 10.1039/c7tb02633a] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Flash NanoPrecipitation allows for the creation of optoacoustic imaging agents with tunable size and strong signal for biomedical imaging and therapy.
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Affiliation(s)
- Antonio Nunes
- Institute for Biological and Medical Imaging
- Helmholtz Zentrum München and Technische Universität München
- D-85764 Neuherberg
- Germany
| | - Vikram J. Pansare
- Department of Chemical and Biological Engineering
- Princeton University
- Princeton
- USA
| | - Nicolas Beziere
- Institute for Biological and Medical Imaging
- Helmholtz Zentrum München and Technische Universität München
- D-85764 Neuherberg
- Germany
| | - Argiris Kolokithas Ntoukas
- Institute for Biological and Medical Imaging
- Helmholtz Zentrum München and Technische Universität München
- D-85764 Neuherberg
- Germany
| | - Josefine Reber
- Institute for Biological and Medical Imaging
- Helmholtz Zentrum München and Technische Universität München
- D-85764 Neuherberg
- Germany
| | - Matthew Bruzek
- Department of Chemistry
- University of Kentucky
- Lexington
- USA
| | - John Anthony
- Department of Chemistry
- University of Kentucky
- Lexington
- USA
| | - Robert K. Prud’homme
- Department of Chemical and Biological Engineering
- Princeton University
- Princeton
- USA
| | - Vasilis Ntziachristos
- Institute for Biological and Medical Imaging
- Helmholtz Zentrum München and Technische Universität München
- D-85764 Neuherberg
- Germany
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25
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Mücke MM, Bettenworth D, Geyer C, Schwegmann K, Poremba C, Schäfers M, Domagk D, Höltke C, Lenz P. Targeting Mucosal Endothelin-A-Receptor Expression by Fluorescence Endoscopy is Feasible to Detect and Characterize Colitis-Associated Cancer in Mice. Inflamm Bowel Dis 2017; 24:111-122. [PMID: 29272493 DOI: 10.1093/ibd/izx032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND To facilitate onsite decision-making during endoscopy, both accurate detection and in vivo characterization of preneoplasia are prerequisites. However, no endoscopy technique is available that meets both demands satisfactorily. We evaluated endothelin-receptor A (ETAR)-guided fluorescence endoscopy (FE) in vivo and fluorescence reflectance imaging (FRI) ex vivo for detection and characterization of early dysplastic colitis-associated colonic lesions. METHODS Colorectal cancerogenesis was investigated in the inflammatory driven AOM-DSS model and spontaneous adenoma development in ApcMin mice. A Cy5.5-labeled nonpeptidic ETAR-specific imaging probe was injected intravenously to assess tumor development in vivo by white light endoscopy (WLE) and FE. Ex vivo tumors were evaluated by FRI, histological examination, and western blot analysis. In addition, tissue samples from patients with colitis-associated malignant and nonmalignant mucosal alterations were analyzed. Specificity experiments were performed using an unspecific Cy3.5-glycine tracer. RESULTS Overall, 62 adenomas were observed. FE was able to detect and quantify ETAR expression targeting the ETAR-specific photoprobe. A significantly higher fluorescent contrast was detected in colonic adenomas compared to adjacent nonmalignant mucosa by FE (64.3 ± 7.9 vs. 56.6. ± 7.0; P < 0.001). These results were confirmed by FRI examination, immunochemistry, and western blot analysis. Additionally, ETAR expression in samples from human patients with colitis-associated cancer was highly elevated compared to nonmalignant alterations. Specificity experiments indicated a high binding-specificity of the applied ETAR photoprobe (1.4 ± 0.3 vs. 2.5 ± 0.7; P < 0.001). CONCLUSIONS We introduced ETAR guided FE in mice for successful in vivo detection and characterization of colorectal neoplasia on a molecular level.
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Affiliation(s)
- Marcus M Mücke
- University Hospital Frankfurt, Department of Internal Medicine 1, Frankfurt a. M., Germany
| | | | - Christiane Geyer
- University of Münster, Department of Clinical Radiology, Münster, Germany
| | - Katrin Schwegmann
- University of Münster, European Institute for Molecular Imaging, Münster, Germany
| | | | - Michael Schäfers
- University of Münster, European Institute for Molecular Imaging, Münster, Germany
| | - Dirk Domagk
- Josephs-Hospital Warendorf, Warendorf, Germany
| | - Carsten Höltke
- University of Münster, Department of Clinical Radiology, Münster, Germany
| | - Philipp Lenz
- University of Münster, Department of Medicine B, Münster, Germany.,University of Münster, European Institute for Molecular Imaging, Münster, Germany.,Institute of Palliative Care, University Hospital of Münster, Münster, Germany
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26
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Waldner MJ, Rath T, Schürmann S, Bojarski C, Atreya R. Imaging of Mucosal Inflammation: Current Technological Developments, Clinical Implications, and Future Perspectives. Front Immunol 2017; 8:1256. [PMID: 29075256 PMCID: PMC5641553 DOI: 10.3389/fimmu.2017.01256] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Accepted: 09/21/2017] [Indexed: 12/12/2022] Open
Abstract
In recent years, various technological developments markedly improved imaging of mucosal inflammation in patients with inflammatory bowel diseases. Although technological developments such as high-definition-, chromo-, and autofluorescence-endoscopy led to a more precise and detailed assessment of mucosal inflammation during wide-field endoscopy, probe-based and stationary confocal laser microscopy enabled in vivo real-time microscopic imaging of mucosal surfaces within the gastrointestinal tract. Through the use of fluorochromes with specificity against a defined molecular target combined with endoscopic techniques that allow ultrastructural resolution, molecular imaging enables in vivo visualization of single molecules or receptors during endoscopy. Molecular imaging has therefore greatly expanded the clinical utility and applications of modern innovative endoscopy, which include the diagnosis, surveillance, and treatment of disease as well as the prediction of the therapeutic response of individual patients. Furthermore, non-invasive imaging techniques such as computed tomography, magnetic resonance imaging, scintigraphy, and ultrasound provide helpful information as supplement to invasive endoscopic procedures. In this review, we provide an overview on the current status of advanced imaging technologies for the clinical non-invasive and endoscopic evaluation of mucosal inflammation. Furthermore, the value of novel methods such as multiphoton microscopy, optoacoustics, and optical coherence tomography and their possible future implementation into clinical diagnosis and evaluation of mucosal inflammation will be discussed.
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Affiliation(s)
- Maximilian J Waldner
- Department of Medicine 1, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Timo Rath
- Department of Medicine 1, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Sebastian Schürmann
- Institute of Medical Biotechnology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Christian Bojarski
- Department of Gastroenterology, Infectiology and Rheumatology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Raja Atreya
- Department of Medicine 1, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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27
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Alam MW, Hasan MM, Mohammed SK, Deeba F, Wahid KA. Are Current Advances of Compression Algorithms for Capsule Endoscopy Enough? A Technical Review. IEEE Rev Biomed Eng 2017; 10:26-43. [PMID: 28961125 DOI: 10.1109/rbme.2017.2757013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The recent technological advances in capsule endoscopy system have revolutionized the healthcare system by introducing new techniques and functionalities to diagnose gastrointestinal tract. These techniques improve diagnostic accuracy and reduce the risk of hospitalization. Although many benefits of capsule endoscopy are known, there are still limitations including lower battery life, higher bandwidth, poor image quality and lower frame rate, which have restricted its wide use. In order to solve these limitations, the importance of a low-cost compression algorithm, that produces higher frame rate with better image quality and yet consumes lower bandwidth and transmission power, is paramount. While several review papers have been published describing the capability of capsule endoscope in terms of its functionality and emerging features, an extensive review on the compression algorithms from past and for future applications is still of great interest. Hence, in this review, we aim to address the issue by exploring the characteristics of endoscopic images, analyzing the strengths and weaknesses of useful compression techniques, and making suggestions for possible future adaptation.
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28
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Kim J, Do EJ, Moinova H, Bae SM, Kang JY, Hong SM, Fink SP, Joo J, Suh YA, Jang SJ, Hwang SW, Park SH, Yang DH, Ye BD, Byeon JS, Choe J, Yang SK, Markowitz SD, Kim SY, Myung SJ. Molecular Imaging of Colorectal Tumors by Targeting Colon Cancer Secreted Protein-2 (CCSP-2). Neoplasia 2017; 19:805-816. [PMID: 28886423 PMCID: PMC5587890 DOI: 10.1016/j.neo.2017.07.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 07/17/2017] [Accepted: 07/24/2017] [Indexed: 12/31/2022] Open
Abstract
A versatile biomarker for detecting colonic adenoma and colon cancer has yet to be developed. Colon cancer secreted protein-2 (CCSP-2) is a protein specifically expressed and secreted in colon adenomas and cancers. We developed a fluorescent imaging method based on CCSP-2 targeting for a more sensitive and specific detection of colorectal tumors. CCSP-2 expression was evaluated in human colon adenoma and colorectal specimens. Anti–CCSP-2 antibody was labeled with a near-infrared fluorescent dye, FPR-675, and molecular imaging of surgical human colorectal tumors was performed. Immunohistochemistry identified CCSP-2 expression in 87.0% of colorectal cancer specimens and 89.5% of colon adenoma specimens. Fluorescence imaging of surgical human colon specimens after spraying treatment with the probe permitted a clear distinction of cancer from paired normal colon tissue (target-to-background ratio, 4.09 ± 0.42; P < .001). CCSP-2 targeting imaging was also evaluated in patient-derived colon cancer xenograft mouse and liver metastasis murine models. CCSP-2–positive colon cancer xenografts and liver metastases were visualized by near-infrared fluorescence imaging after intravenous injection of the probe, which showed significantly higher fluorescence. Our results show that CCSP-2 is a promising marker for colorectal tumor detection in clinical settings and that a CCSP-2–targeting molecular imaging strategy might improve the diagnosis of colorectal tumors in metastatic or recurrent cancers and aid in early colonoscopic detection of premalignant lesions.
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Affiliation(s)
- Jaeil Kim
- Health Screening & Promotion Center, Asan Medical Center, Seoul, Republic of Korea
| | - Eun-Ju Do
- Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea
| | - Helen Moinova
- Department of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Sang Mun Bae
- Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea
| | - Ja Young Kang
- Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea
| | - Seung-Mo Hong
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Stephen P Fink
- Department of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Jinmyoung Joo
- Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea; Department of Medicine, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Young-Ah Suh
- Institute for Innovative Cancer Research, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea
| | - Se Jin Jang
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sung Wook Hwang
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sang Hyoung Park
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Dong-Hoon Yang
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Byong Duk Ye
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jeong-Sik Byeon
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jaewon Choe
- Health Screening & Promotion Center, Asan Medical Center, Seoul, Republic of Korea; Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Suk-Kyun Yang
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sanford D Markowitz
- Department of Medicine, Case Western Reserve University, Cleveland, OH, USA; University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, OH, USA.
| | - Sang-Yeob Kim
- Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea; Department of Medicine, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Seung-Jae Myung
- Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea; Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
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29
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Use of confocal laser endomicroscopy with a fluorescently labeled fatty acid to diagnose colorectal neoplasms. Oncotarget 2017; 8:58934-58947. [PMID: 28938608 PMCID: PMC5601704 DOI: 10.18632/oncotarget.19515] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 07/11/2017] [Indexed: 01/14/2023] Open
Abstract
Endoscopic treatment for early colorectal cancer closely correlates with patient prognosis. However, endoscopic differentiation between carcinomas and non-neoplastic lesions remains difficult. Here, we topically stained colorectal neoplasms with a fatty acid analogue (BODIPY-FA) and quantified the fluorescent signals using confocal laser endomicroscopy (CLE) and fluorescence microscopy. We also analyzed protein expression in colorectal cancer tissues. We found that expression of fatty acid synthase was elevated, while the expression of fatty acid transporters was reduced in colorectal cancer. In colorectal cancer mouse models and patients, the BODIPY-FA signals were higher in normal epithelia than in carcinomas or colonic intraepithelial neoplasias. BODIPY-FA staining revealed both the arrangement of intestinal glands and the intracellular structures under CLE screening. In a double-blind trial, CLE images stained with BODIPY-FA exhibited greater consistency (κ = 0.68) and overall validity (74.65%) than those stained using intravenous fluorescein sodium (κ = 0.43, 55.88%) when the results were compared with histological diagnoses. These findings suggest that topical use of BODIPY-FA with CLE is a promising imaging approach for early colorectal neoplasm screening.
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30
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Hoffman A, Manner H, Rey JW, Kiesslich R. A guide to multimodal endoscopy imaging for gastrointestinal malignancy - an early indicator. Nat Rev Gastroenterol Hepatol 2017; 14:421-434. [PMID: 28611477 DOI: 10.1038/nrgastro.2017.46] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Multimodality imaging is an essential aspect of endoscopic surveillance for the detection of neoplastic lesions, such as dysplasia or intramucosal cancer, because it improves the efficacy of endoscopic surveillance and therapeutic procedures in the gastrointestinal tract. This approach reveals mucosal abnormalities that cannot be detected by standard endoscopy. Currently, these imaging techniques are divided into those for primary detection and those for targeted imaging and characterization, the latter being used to visualize areas of interest in detail and permit histological evaluation. This Review outlines the use of virtual chromoendoscopy, narrow-band imaging, autofluorescence imaging, optical coherence tomography, confocal endomicroscopy and volumetric laser endomicroscopy as new imaging techniques for diagnostic investigation of the gastrointestinal tract. Insights into use of multimodal endoscopic imaging for early disease detection, in particular for pre-malignant lesions, in the oesophagus, stomach and colon are described.
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Affiliation(s)
- Arthur Hoffman
- Department of Internal Medicine II, HSK Hospital, Teaching Hospital of the University Medicine of Mainz, Ludwig-Erhard-Strasse 100, 65199 Wiesbaden, Germany
| | - Henrik Manner
- Department of Internal Medicine II, HSK Hospital, Teaching Hospital of the University Medicine of Mainz, Ludwig-Erhard-Strasse 100, 65199 Wiesbaden, Germany
| | - Johannes W Rey
- Department of Internal Medicine II, HSK Hospital, Teaching Hospital of the University Medicine of Mainz, Ludwig-Erhard-Strasse 100, 65199 Wiesbaden, Germany
| | - Ralf Kiesslich
- Department of Internal Medicine II, HSK Hospital, Teaching Hospital of the University Medicine of Mainz, Ludwig-Erhard-Strasse 100, 65199 Wiesbaden, Germany
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Simultaneous Detection of EGFR and VEGF in Colorectal Cancer using Fluorescence-Raman Endoscopy. Sci Rep 2017; 7:1035. [PMID: 28432289 PMCID: PMC5430917 DOI: 10.1038/s41598-017-01020-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 03/24/2017] [Indexed: 12/14/2022] Open
Abstract
Fluorescence endomicroscopy provides quick access to molecular targets, while Raman spectroscopy allows the detection of multiple molecular targets. Using a simultaneous fluorescence-Raman endoscopic system (FRES), we herein demonstrate its potential in cancer diagnosis in an orthotopically induced colorectal cancer (CRC) xenograft model. In the model, epidermal growth factor receptor (EGFR) and vascular endothelial growth factor (VEGF) were targeted with antibody-conjugated fluorescence and surface-enhanced Raman scattering (F-SERS) dots. FRES demonstrated fast signal detection and multiplex targeting ability using fluorescence and Raman signals to detect the F-SERS dots. In addition, FRES showed a multiplex targeting ability even on a subcentimeter-sized CRC after spraying with a dose of 50 µg F-SERS dots. In conclusion, molecular characteristics of tumor cells (EGFR in cancer cell membranes) and tumor microenvironments (VEGF in the extracellular matrix) could be simultaneously investigated when performing a colonoscopy.
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Joshi BP, Dai Z, Gao Z, Lee JH, Ghimire N, Chen J, Prabhu A, Wamsteker EJ, Kwon RS, Elta GH, Stoffel EM, Pant A, Kaltenbach T, Soetikno RM, Appelman HD, Kuick R, Turgeon DK, Wang TD. Detection of Sessile Serrated Adenomas in the Proximal Colon Using Wide-Field Fluorescence Endoscopy. Gastroenterology 2017; 152:1002-1013.e9. [PMID: 28012848 PMCID: PMC5771498 DOI: 10.1053/j.gastro.2016.12.009] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 12/13/2016] [Accepted: 12/13/2016] [Indexed: 12/19/2022]
Abstract
BACKGROUND & AIMS Many cancers in the proximal colon develop via from sessile serrated adenomas (SSAs), which have flat, subtle features that are difficult to detect with conventional white-light colonoscopy. Many SSA cells have the V600E mutation in BRAF. We investigated whether this feature could be used with imaging methods to detect SSAs in patients. METHODS We used phage display to identify a peptide that binds specifically to SSAs, using subtractive hybridization with HT29 colorectal cancer cells containing the V600E mutation in BRAF and Hs738.St/Int cells as a control. Binding of fluorescently labeled peptide to colorectal cancer cells was evaluated with confocal fluorescence microscopy. Rats received intra-colonic 0.0086 mg/kg, 0.026 mg/kg, or 0.86 mg/kg peptide or vehicle and morbidity, mortality, and injury were monitored twice daily to assess toxicity. In the clinical safety study, fluorescently labeled peptide was topically administered, using a spray catheter, to the proximal colon of 25 subjects undergoing routine outpatient colonoscopies (3 subjects were given 2.25 μmol/L and 22 patients were given 76.4 μmol/L). We performed blood cell count, chemistry, liver function, and urine analyses approximately 24 hours after peptide administration. In the clinical imaging study, 38 subjects undergoing routine outpatient colonoscopies, at high risk for colorectal cancer, or with a suspected unresected proximal colonic polyp, were first evaluated by white-light endoscopy to identify suspicious regions. The fluorescently labeled peptide (76.4 μmol/L) was administered topically to proximal colon, unbound peptide was washed away, and white-light, reflectance, and fluorescence videos were recorded digitally. Fluorescence intensities of SSAs were compared with those of normal colonic mucosa. Endoscopists resected identified lesions, which were analyzed histologically by gastrointestinal pathologists (reference standard). We also analyzed the ability of the peptide to identify SSAs vs adenomas, hyperplastic polyps, and normal colonic mucosa in specimens obtained from the tissue bank at the University of Michigan. RESULTS We identified the peptide sequence KCCFPAQ and measured an apparent dissociation constant of Kd = 72 nM and an apparent association time constant of K = 0.174 min-1 (5.76 minutes). During fluorescence imaging of patients during endoscopy, regions of SSA had 2.43-fold higher mean fluorescence intensity than that for normal colonic mucosa. Fluorescence labeling distinguished SSAs from normal colonic mucosa with 89% sensitivity and 92% specificity. The peptide had no observed toxic effects in animals or patients. In the analysis of ex vivo specimens, peptide bound to SSAs had significantly higher mean fluorescence intensity than to hyperplastic polyps. CONCLUSIONS We have identified a fluorescently labeled peptide that has no observed toxic effects in animals or humans and can be used for wide-field imaging of lesions in the proximal colon. It distinguishes SSAs from normal colonic mucosa with 89% sensitivity and 92% specificity. This targeted imaging method might be used in early detection of premalignant serrated lesions during routine colonoscopies. ClinicalTrials.gov ID: NCT02156557.
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Affiliation(s)
- Bishnu P. Joshi
- Division of Gastroenterology, Department of Medicine, University of Michigan, Ann Arbor, Michigan
| | - Zhenzhen Dai
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan
| | - Zhenghong Gao
- Division of Gastroenterology, Department of Medicine, University of Michigan, Ann Arbor, Michigan
| | - Jeong Hoon Lee
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Navin Ghimire
- Division of Gastroenterology, Department of Medicine, University of Michigan, Ann Arbor, Michigan
| | - Jing Chen
- Division of Gastroenterology, Department of Medicine, University of Michigan, Ann Arbor, Michigan
| | - Anoop Prabhu
- Division of Gastroenterology, Department of Medicine, University of Michigan, Ann Arbor, Michigan
| | - Erik J. Wamsteker
- Division of Gastroenterology, Department of Medicine, University of Michigan, Ann Arbor, Michigan
| | - Richard S. Kwon
- Division of Gastroenterology, Department of Medicine, University of Michigan, Ann Arbor, Michigan
| | - Grace H. Elta
- Division of Gastroenterology, Department of Medicine, University of Michigan, Ann Arbor, Michigan
| | - Elena M. Stoffel
- Division of Gastroenterology, Department of Medicine, University of Michigan, Ann Arbor, Michigan
| | - Asha Pant
- Division of Gastroenterology, Department of Medicine, University of Michigan, Ann Arbor, Michigan
| | - Tonya Kaltenbach
- Division of Gastroenterology, Department of Medicine, VA Palo Alto Health Care System, 3801 Miranda Avenue GI-111 Palo Alto, CA 94304
| | - Roy M. Soetikno
- Division of Gastroenterology, Department of Medicine, VA Palo Alto Health Care System, 3801 Miranda Avenue GI-111 Palo Alto, CA 94304
| | - Henry D. Appelman
- Department of Pathology, University of Michigan, Ann Arbor, Michigan
| | - Rork Kuick
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan
| | - D. Kim Turgeon
- Division of Gastroenterology, Department of Medicine, University of Michigan, Ann Arbor, Michigan
| | - Thomas D. Wang
- Division of Gastroenterology, Department of Medicine, University of Michigan, Ann Arbor, Michigan,Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan,Department of Mechanical Engineering, University of Michigan, Ann Arbor, Michigan
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Li W, Li Y, Li G, Zhou Z, Chang X, Xia Y, Dong X, Liu Z, Ren B, Liu W, Li Y. Ectopic expression of the ATP synthase β subunit on the membrane of PC-3M cells supports its potential role in prostate cancer metastasis. Int J Oncol 2017; 50:1312-1320. [PMID: 28259978 DOI: 10.3892/ijo.2017.3878] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 12/20/2016] [Indexed: 11/05/2022] Open
Abstract
Metastatic prostate cancer is associated with high mortality rates. Identification of metastasis-related proteins may facilitate the development of novel therapies for the treatment of metastatic disease. In the present study, we aimed to identify prostate cancer metastasis-associated membrane proteins. We developed a phage-displayed 7-mer peptide library to screen the target peptides that were specifically bound to PC-3M cells with subtractive panning from normal prostate cells and PC-3 prostate cancer cells. A novel short peptide (B04) was found to have high affinity to highly metastatic PC-3M cells. ATP synthase β subunit (ATP5B) was then identified as a binding partner of B04 on the PC-3M cell surface. ATP5B was expressed on the PC-3M cell membrane and on highly malignant human prostate cancer specimens, as shown using multiple methodologies. Furthermore, ATP5B-positive gold particles were detected on the cellular and mitochondrial membranes by immunoelectromicroscopy. These results implied the possibility that ATP5B may translocate from the inner mitochondrial membrane to the outer surface of PC-3M cells. Additional analysis showed that incubation of B04 with PC-3M cells reduced the detection of ATP5B by western blotting and flow cytometry and significantly inhibited the proliferation, invasion and metastasis of PC-3M cells. In conclusion, ATP5B, as a binding partner of a metastasis-related short peptide (B04) on prostate cancer cells, is involved in promoting prostate cancer metastasis. In conclusion, ATP5B may be a promising biomarker and therapeutic target for highly metastatic malignancies.
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Affiliation(s)
- Wei Li
- The Key Laboratory of Pathobiology, Ministry of Education, The College of Basic Medical Sciences, Jilin University, Changchun, Jilin 130021, P.R. China
| | - Yulin Li
- The Key Laboratory of Pathobiology, Ministry of Education, The College of Basic Medical Sciences, Jilin University, Changchun, Jilin 130021, P.R. China
| | - Gaiyun Li
- The Key Laboratory of Pathobiology, Ministry of Education, The College of Basic Medical Sciences, Jilin University, Changchun, Jilin 130021, P.R. China
| | - Zilong Zhou
- The Key Laboratory of Pathobiology, Ministry of Education, The College of Basic Medical Sciences, Jilin University, Changchun, Jilin 130021, P.R. China
| | - Xiaona Chang
- The Key Laboratory of Pathobiology, Ministry of Education, The College of Basic Medical Sciences, Jilin University, Changchun, Jilin 130021, P.R. China
| | - Yang Xia
- Department of Pathology, the Second Clinical Hospital, Jilin University, Changchun, Jilin 130021, P.R. China
| | - Xinjie Dong
- Department of Pathology, the First Clinical Hospital, Jilin University, Changchun, Jilin 130021, P.R. China
| | - Zhijing Liu
- The Key Laboratory of Pathobiology, Ministry of Education, The College of Basic Medical Sciences, Jilin University, Changchun, Jilin 130021, P.R. China
| | - Bo Ren
- The Key Laboratory of Pathobiology, Ministry of Education, The College of Basic Medical Sciences, Jilin University, Changchun, Jilin 130021, P.R. China
| | - Wei Liu
- Department of Pathology, Longgang District Central Hospital of Shenzhen, Shenzhen, Guangdong 518116, P.R. China
| | - Yilei Li
- The Key Laboratory of Pathobiology, Ministry of Education, The College of Basic Medical Sciences, Jilin University, Changchun, Jilin 130021, P.R. China
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Hartmans E, Orian-Rousseau V, Matzke-Ogi A, Karrenbeld A, de Groot DJA, de Jong S, van Dam GM, Fehrmann RS, Nagengast WB. Functional Genomic mRNA Profiling of Colorectal Adenomas: Identification and in vivo Validation of CD44 and Splice Variant CD44v6 as Molecular Imaging Targets. Am J Cancer Res 2017; 7:482-492. [PMID: 28255344 PMCID: PMC5327362 DOI: 10.7150/thno.16816] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 11/07/2016] [Indexed: 12/17/2022] Open
Abstract
Colorectal cancer (CRC) is the third leading cause of cancer-related deaths worldwide. High adenoma miss rates, especially seen in high-risk patients, demand for better endoscopic detection. By fluorescently 'highlighting' specific molecular characteristics, endoscopic molecular imaging has great potential to fulfill this need. To implement this technique effectively, target proteins that distinguish adenomas from normal tissue must be identified. In this study we applied in silico Functional Genomic mRNA (FGmRNA) profiling, which is a recently developed method that results in an enhanced view on the downstream effects of genomic alterations occurring in adenomas on gene expression levels. FGmRNA profiles of sporadic adenomas were compared to normal colon tissue to identify overexpressed genes. We validated the protein expression of the top identified genes, AXIN2, CEMIP, CD44 and JUN, in sporadic adenoma patient samples via immunohistochemistry (IHC). CD44 was identified as the most attractive target protein for imaging purposes and we proved its relevance in high-risk patients by demonstrating CD44 protein overexpression in Lynch lesions. Subsequently, we show that the epithelial splice variant CD44V6 is highly overexpressed in our patient samples and we demonstrated the feasibility of visualizing adenomas in ApcMin/+ mice in vivo by using a fluorescently labeled CD44v6 targeting peptide. In conclusion, via in silico functional genomics and ex vivo protein validation, this study identified CD44 as an attractive molecular target for both sporadic and high-risk Lynch adenomas, and demonstrates the in vivo applicability of a small peptide drug directed against splice variant CD44v6 for adenoma imaging.
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Lee HH, Choi MG, Hasan T. Application of photodynamic therapy in gastrointestinal disorders: an outdated or re-emerging technique? Korean J Intern Med 2017; 32:1-10. [PMID: 28049283 PMCID: PMC5214731 DOI: 10.3904/kjim.2016.200] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 12/19/2016] [Indexed: 01/03/2023] Open
Abstract
Photodynamic therapy (PDT) is a promising therapeutic modality that involves the administration of a photosensitizer followed by local illumination with a specific wavelength of light in the presence of oxygen. PDT is minimally invasive, has high selectivity for cancer, and has good patient compliance due to the simplicity of the procedure; therefore, PDT is widely used as a palliative and salvage treatment in patients with various gastrointestinal malignancies. When used as a salvage treatment for locoregional failures after definitive chemoradiotherapy for esophageal cancer, favorable results have been reported. PDT in conjunction with biliary stenting is a promising palliative treatment for unresectable cholangiocarcinoma, and can be used as an advanced diagnostic and therapeutic strategy in peritoneal dissemination of gastric cancer. Recent clinical reports of PDT for treating non-resectable pancreatic cancer also show promising results. To widen the application of PDT, the integration of PDT with molecular imaging and nanotechnology is being extensively studied. Based on these new developments, PDT is likely to re-emerge as a valuable technique in the treatment of diverse gastrointestinal diseases.
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Affiliation(s)
- Han Hee Lee
- Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Myung-Gyu Choi
- Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Correspondence to Myung-Gyu Choi, M.D. Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea Tel: +82-2-2258-2083 Fax: +82-2-2258-2089 E-mail:
| | - Tayyaba Hasan
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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A Low-Cost Digital Microscope with Real-Time Fluorescent Imaging Capability. PLoS One 2016; 11:e0167863. [PMID: 27977709 PMCID: PMC5158004 DOI: 10.1371/journal.pone.0167863] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 11/21/2016] [Indexed: 11/19/2022] Open
Abstract
This paper describes the development of a prototype of a low-cost digital fluorescent microscope built from commercial off-the-shelf (COTS) components. The prototype was tested to detect malignant tumor cells taken from a living organism in a preclinical setting. This experiment was accomplished by using Alexa Fluor 488 conjugate dye attached to the cancer cells. Our prototype utilizes a torch along with an excitation filter as a light source for fluorophore excitation, a dichroic mirror to reflect the excitation and pass the emitted green light from the sample under test and a barrier filter to permit only appropriate wavelength. The system is designed out of a microscope using its optical zooming property and an assembly of exciter filter, dichroic mirror and transmitter filter. The microscope is connected to a computer or laptop through universal serial bus (USB) that allows real-time transmission of captured florescence images; this also offers real-time control of the microscope. The designed system has comparable features of high-end commercial fluorescent microscopes while reducing cost, power, weight and size.
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37
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Molecular endoscopy for targeted imaging in the digestive tract. Lancet Gastroenterol Hepatol 2016; 1:147-155. [PMID: 28404071 DOI: 10.1016/s2468-1253(16)30027-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 07/05/2016] [Accepted: 07/05/2016] [Indexed: 12/22/2022]
Abstract
Endoscopy uses optical imaging methods to investigate tissue in a non-destructive manner with high resolution over a broad range of wavelengths, thus providing a powerful tool to rapidly visualise mucosal surfaces in the digestive tract. Molecular imaging is an important advancement that has been clinically demonstrated for early cancer detection and guidance of therapy. With this approach, imaging can be used to observe expression patterns of molecular targets to improve understanding of key biological mechanisms that drive disease progression. Prototype devices that collect fluorescence for wide-field or microscopic images have been developed. Several targeting moieties, including enzyme-activatable probes, antibodies, peptides, and lectins, have been administered in preclinical and clinical imaging studies in vivo. These emerging technologies provide useful approaches to study molecular events in different signalling pathways, producing insights that could lead to improved interventions to prevent and treat gastrointestinal diseases. In this Review, we introduce the basic concepts that form the foundation for development of molecular endoscopy and summarise key results from preclinical and clinical studies.
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Knieling F, Waldner MJ. Light and sound - emerging imaging techniques for inflammatory bowel disease. World J Gastroenterol 2016; 22:5642-5654. [PMID: 27433080 PMCID: PMC4932202 DOI: 10.3748/wjg.v22.i25.5642] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 05/02/2016] [Accepted: 05/23/2016] [Indexed: 02/06/2023] Open
Abstract
Patients with inflammatory bowel disease are known to have a high demand of recurrent evaluation for therapy and disease activity. Further, the risk of developing cancer during the disease progression is increasing from year to year. New, mostly non-radiant, quick to perform and quantitative methods are challenging, conventional endoscopy with biopsy as gold standard. Especially, new physical imaging approaches utilizing light and sound waves have facilitated the development of advanced functional and molecular modalities. Besides these advantages they hold the promise to predict personalized therapeutic responses and to spare frequent invasive procedures. Within this article we highlight their potential for initial diagnosis, assessment of disease activity and surveillance of cancer development in established techniques and recent advances such as wide-view full-spectrum endoscopy, chromoendoscopy, autofluorescence endoscopy, endocytoscopy, confocal laser endoscopy, multiphoton endoscopy, molecular imaging endoscopy, B-mode and Doppler ultrasound, contrast-enhanced ultrasound, ultrasound molecular imaging, and elastography.
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Abstract
PURPOSE OF REVIEW Standard structural imaging procedures such as endoscopy, ultrasonography, or MRI are an integral part of the rational management of patients with inflammatory bowel diseases (IBDs). There is nevertheless the need for further refined imaging approaches that are able to overcome the limitations of currently used formats. The advent of molecular imaging modalities that allow real-time visualization of cellular processes not only in the preclinical setting but also in clinical trials has demonstrated its ability to improve current therapeutic strategies. The purpose of this review is to present and discuss advancements in the field of molecular imaging approaches in the IBD field. RECENT FINDINGS Recent preclinical and clinical studies have addressed the applicability of molecular imaging for improving the differentiation between benign and malignant mucosal alterations, increasing the detection of dysplastic intestinal lesions, and predicting individual responses to biological therapies. SUMMARY Molecular imaging in IBD represents an exciting and evolving field that has the potential to impact on current diagnostic and therapeutic algorithms in the treatment of IBD patients by analyzing and visualizing the molecular mechanisms that drive mucosal inflammation. It might enable us to base individualized therapeutic decisions on preceded molecular level analysis by suitable imaging modalities.
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40
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Atreya R, Neurath MF. Predicting Therapeutic Response by in vivo Molecular Imaging in Inflammatory Bowel Diseases. Dig Dis 2016; 34:552-7. [PMID: 27333283 DOI: 10.1159/000445262] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Different invasive and non-invasive imaging modalities are indispensable tools in the management of inflammatory bowel disease (IBD) patients. Standard imaging procedures like white light endoscopy or MRI are used to define gut inflammation based on structural changes and altered morphology of the mucosa. Nevertheless, it has thus far not been possible to analyse biological processes at the cellular level, which drive intestinal inflammation in IBD patients. The recent advent of molecular imaging in the field of IBD has opened new promising avenues to allow personalized medicine approaches based on in vivo-detected molecular findings. KEY MESSAGES Recent clinical studies have attempted to address the issue of predicting therapeutic response to anti-tumor necrosis factor (TNF) treatment in IBD patients based on the molecular mechanism of action of these agents and corresponding in vivo assessment of mucosal immune responses. Several experimental studies have indicated that one of the main functions of efficacious anti-TNF therapy in IBD is the induction of intestinal cell apoptosis. Fittingly, a corresponding molecular-imaging study using single-photon emission CT for the localization and quantification of cell apoptosis, demonstrated that induction of mucosal T-cell apoptosis correlated with the therapeutic response to anti-TNF therapy in Crohn's disease patients. There was moreover a predictive capacity regarding therapeutic efficacy. As the main biological properties of anti-TNF antibodies in IBD are mediated through binding to membrane-bound TNF (mTNF) expressing intestinal cells, another study used molecular imaging for in vivo visualization of these cells via fluorescent anti-TNF antibodies to predict therapeutic efficacy of these agents. It could be shown that patients with high amounts of mTNF positive cells showed significantly better response rates compared to patients with low amounts of mTNF positive cells. CONCLUSION In vivo molecular imaging in IBD has the potential to have an impact on our current treatment approaches and may allow us to individualize specific therapies based on molecular level analysis.
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Affiliation(s)
- Raja Atreya
- Medical Clinic I, Friedrich-Alexander Universitx00E4;t Erlangen-Nx00FC;rnberg, Erlangen, Germany
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Liu F, Wang J, Yang L, Liu L, Ding S, Fu M, Deng L, Gao LQ. Developing a fluorescence-coupled capillary electrophoresis based method to probe interactions between QDs and colorectal cancer targeting peptides. Electrophoresis 2016; 37:2170-4. [DOI: 10.1002/elps.201600165] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Revised: 04/16/2016] [Accepted: 05/02/2016] [Indexed: 11/08/2022]
Affiliation(s)
- Feifei Liu
- School of Pharmaceutical Engineering and Life Science; Changzhou University; Changzhou Jiangsu P. R. China
| | - Jianhao Wang
- School of Pharmaceutical Engineering and Life Science; Changzhou University; Changzhou Jiangsu P. R. China
| | - Li Yang
- School of Pharmaceutical Engineering and Life Science; Changzhou University; Changzhou Jiangsu P. R. China
| | - Li Liu
- School of Pharmaceutical Engineering and Life Science; Changzhou University; Changzhou Jiangsu P. R. China
| | - Shumin Ding
- School of Pharmaceutical Engineering and Life Science; Changzhou University; Changzhou Jiangsu P. R. China
| | - Minli Fu
- School of Pharmaceutical Engineering and Life Science; Changzhou University; Changzhou Jiangsu P. R. China
| | - Linhong Deng
- School of Pharmaceutical Engineering and Life Science; Changzhou University; Changzhou Jiangsu P. R. China
- Institute of Biomedical Engineering and Health Sciences; Changzhou University; Changzhou Jiangsu P. R. China
| | - Li-qian Gao
- Department of Chemistry; National University of Singapore; Singapore
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Endoscopy-guided orthotopic implantation of colorectal cancer cells results in metastatic colorectal cancer in mice. Clin Exp Metastasis 2016; 33:551-62. [PMID: 27146063 DOI: 10.1007/s10585-016-9797-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 04/26/2016] [Indexed: 01/07/2023]
Abstract
Advanced stage colorectal cancer (CRC) is still associated with limited prognosis. For preclinical evaluation of novel therapeutic approaches, murine models with orthotopic tumor growth and distant metastases are required. However, these models usually require surgical procedures possibly influencing tumor immunogenicity and development. The aim of this study was to establish a minimal-invasive endoscopy-based murine orthotopic model of metastatic CRC. During colonoscopy of CD-1 nude and non-obese diabetic/severe combined immunodeficiency (NOD/SCID) mice, implantation of Caco-2 and HT-29 CRC cells was performed subcutaneously (s.c.) or orthotopic into the colonic submucosa. White light endoscopy (WLE) and fluorescence endoscopy (FE) were applied for tumor detection in vivo. Ex vivo, resected tumors were examined by fluorescence reflectance imaging (FRI), histology, gelatin zymography and immunohistochemistry. In CD-1 nude mice, marked tumor growth was observed within 14 days after subcutaneous implantation while submucosal implantation failed to induce CRC after 17 weeks. In contrast, in NOD/SCID mice submucosal injection of HT-29 cells resulted in pronounced tumor growth 12 days post injectionem. Subsequently, rapid tumor expansion occurred, occupying the entire colonic circumference. Importantly, post mortem histological analyses confirmed liver metastases in 28.6 % and peritoneal metastases in 14.3 % of all mice. FRI and gelatin zymography did not detect a significantly increased matrix metalloproteinases (MMPs) expression in s.c. implanted tumors while MMP-tracer uptake was significantly enhanced in orthotopic implanted tumors. Neither s.c. nor orthotopic Caco-2 cell implantation resulted in tumor development. We successfully established an endoscopy-based model of metastatic CRC in immunodeficient mice.
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Kuo JCH, Ibrahim AEK, Dawson S, Parashar D, Howat WJ, Guttula K, Miller R, Fearnhead NS, Winton DJ, Neves AA, Brindle KM. Detection of colorectal dysplasia using fluorescently labelled lectins. Sci Rep 2016; 6:24231. [PMID: 27071814 PMCID: PMC4829854 DOI: 10.1038/srep24231] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Accepted: 03/22/2016] [Indexed: 12/26/2022] Open
Abstract
Colorectal cancer screening using conventional colonoscopy lacks molecular information and can miss dysplastic lesions. We tested here the ability of fluorescently labelled lectins to distinguish dysplasia from normal tissue when sprayed on to the luminal surface epithelium of freshly resected colon tissue from the Apc(min) mouse and when applied to fixed human colorectal tissue sections. Wheat germ agglutinin (WGA) showed significantly decreased binding to adenomas in the mouse tissue and in sections of human colon from 47 patients. Changes in WGA binding to the human surface epithelium allowed regions containing normal epithelium (NE) or hyperplastic polyps (HP) to be distinguished from regions containing low-grade dysplasia (LGD), high-grade dysplasia (HGD) or carcinoma (C), with 81% sensitivity, 87% specificity and 93% positive predictive value (PPV). Helix pomatia agglutinin (HGA) distinguished epithelial regions containing NE from regions containing HP, LGD, HGD or C, with 89% sensitivity, 87% specificity and 97% PPV. The decreased binding of WGA and HPA to the luminal surface epithelium in human dysplasia suggests that these lectins may enable more sensitive detection of disease in the clinic using fluorescence colonoscopy.
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Affiliation(s)
- Joe Chin-Hun Kuo
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, UK
- Department of Biochemistry, University of Cambridge, Cambridge, UK
| | - Ashraf E. K. Ibrahim
- Department of Pathology, Division of Molecular Histopathology, University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK
- MRC, Laboratory of Molecular Biology, Hills Road, Cambridge, UK
| | - Sarah Dawson
- Cambridge Clinical Trials Unit, University of Cambridge, Cambridge, UK
| | - Deepak Parashar
- Statistics and Epidemiology Unit & Cancer Research Centre, Division of Health Sciences, Warwick Medical School, The University of Warwick, Coventry, UK
| | - William J. Howat
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, UK
| | - Kiran Guttula
- Department of Pathology, Division of Molecular Histopathology, University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK
| | - Richard Miller
- Cambridge Colorectal Unit, Addenbrooke’s Hospital, Cambridge, UK
| | | | - Douglas J. Winton
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, UK
| | - André A. Neves
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, UK
| | - Kevin M. Brindle
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, UK
- Department of Biochemistry, University of Cambridge, Cambridge, UK
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Kossatz S, Brand C, Gutiontov S, Liu JTC, Lee NY, Gönen M, Weber WA, Reiner T. Detection and delineation of oral cancer with a PARP1 targeted optical imaging agent. Sci Rep 2016; 6:21371. [PMID: 26900125 PMCID: PMC4761964 DOI: 10.1038/srep21371] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 01/20/2016] [Indexed: 12/01/2022] Open
Abstract
Earlier and more accurate detection of oral squamous cell carcinoma (OSCC) is essential to improve the prognosis of patients and to reduce the morbidity of surgical therapy. Here, we demonstrate that the nuclear enzyme Poly(ADP-ribose)Polymerase 1 (PARP1) is a promising target for optical imaging of OSCC with the fluorescent dye PARPi-FL. In patient-derived OSCC specimens, PARP1 expression was increased 7.8 ± 2.6-fold when compared to normal tissue. Intravenous injection of PARPi-FL allowed for high contrast in vivo imaging of human OSCC models in mice with a surgical fluorescence stereoscope and high-resolution imaging systems. The emitted signal was specific for PARP1 expression and, most importantly, PARPi-FL can be used as a topical imaging agent, spatially resolving the orthotopic tongue tumors in vivo. Collectively, our results suggest that PARP1 imaging with PARPi-FL can enhance the detection of oral cancer, serve as a screening tool and help to guide surgical resections.
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Affiliation(s)
- Susanne Kossatz
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Christian Brand
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Stanley Gutiontov
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Jonathan T C Liu
- Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA
| | - Nancy Y Lee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Mithat Gönen
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Wolfgang A Weber
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.,Department of Radiology, Weill Cornell Medical College, New York, NY 10065, USA.,Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Thomas Reiner
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.,Department of Radiology, Weill Cornell Medical College, New York, NY 10065, USA
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45
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Pilot Clinical Trial of Indocyanine Green Fluorescence-Augmented Colonoscopy in High Risk Patients. Gastroenterol Res Pract 2016; 2016:6184842. [PMID: 26989406 PMCID: PMC4773548 DOI: 10.1155/2016/6184842] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Accepted: 01/24/2016] [Indexed: 01/14/2023] Open
Abstract
White light colonoscopy is the current gold standard for early detection and treatment of colorectal cancer, but emerging data suggest that this approach is inherently limited. Even the most experienced colonoscopists, under optimal conditions, miss at least 15-25% of adenomas. There is an unmet clinical need for an adjunctive modality to white light colonoscopy with improved lesion detection and characterization. Optical molecular imaging with exogenously administered organic fluorochromes is a burgeoning imaging modality poised to advance the capabilities of colonoscopy. In this proof-of-principle clinical trial, we investigated the ability of a custom-designed fluorescent colonoscope and indocyanine green, a clinically approved fluorescent blood pool imaging agent, to visualize polyps in high risk patients with polyposis syndromes or known distal colonic masses. We demonstrate (1) the successful performance of real-time, wide-field fluorescence endoscopy using off-the-shelf equipment, (2) the ability of this system to identify polyps as small as 1 mm, and (3) the potential for fluorescence imaging signal intensity to differentiate between neoplastic and benign polyps.
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46
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Guan Q, Sun S, Li X, Lv S, Xu T, Sun J, Feng W, Zhang L, Li Y. Preparation, in vitro and in vivo evaluation of mPEG-PLGA nanoparticles co-loaded with syringopicroside and hydroxytyrosol. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2016; 27:24. [PMID: 26704541 DOI: 10.1007/s10856-015-5641-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 11/27/2015] [Indexed: 06/05/2023]
Abstract
This study investigated the therapeutic efficiency of monomethoxy polyethylene glycol-poly(lactic-co-glycolic acid) (mPEG-PLGA) co-loaded with syringopicroside and hydroxytyrosol as a drug with effective targeting and loading capacity as well as persistent circulation in vivo. The nanoparticles were prepared using a nanoprecipitation method with mPEG-PLGA as nano-carrier co-loaded with syringopicroside and hydroxytyrosol (SH-NPs). The parameters like in vivo pharmacokinetics, biodistribution in vivo, fluorescence in vivo endomicroscopy, and cellular uptake of SH-NPs were investigated. Results showed that the total encapsulation efficiency was 32.38 ± 2.76 %. Total drug loading was 12.01 ± 0.42 %, particle size was 91.70 ± 2.11 nm, polydispersity index was 0.22 ± 0.01, and zeta potential was -24.5 ± 1.16 mV for the optimized SH-NPs. The nanoparticle morphology was characterized using transmission electron microscopy, which indicated that the particles of SH-NPs were in uniformity within the nanosize range and of spherical core shell morphology. Drug release followed Higuchi kinetics. Compared with syringopicroside and hydroxytyrosol mixture (SH), SH-NPs produced drug concentrations that persisted for a significantly longer time in plasma following second-order kinetics. The nanoparticles moved gradually into the cell, thereby increasing the quantity. ALT, AST, and MDA levels were significantly lower on exposure to SH-NPs than in controls. SH-NPs could inhibit the proliferation of HepG2.2.15 cells and could be taken up by HepG2.2.15 cells. The results confirmed that syringopicroside and hydroxytyrosol can be loaded simultaneously into mPEG-PLGA nanoparticles. Using mPEG-PLGA as nano-carrier, sustained release, high distribution in the liver, and protective effects against hepatic injury were observed in comparison to SH.
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Affiliation(s)
- Qingxia Guan
- College of Pharmacy, Heilongjiang University of Chinese Medicine, Harbin, 150000, China
| | - Shuang Sun
- College of Pharmacy, Heilongjiang University of Chinese Medicine, Harbin, 150000, China
| | - Xiuyan Li
- College of Pharmacy, Heilongjiang University of Chinese Medicine, Harbin, 150000, China
| | - Shaowa Lv
- College of Pharmacy, Heilongjiang University of Chinese Medicine, Harbin, 150000, China
| | - Ting Xu
- College of Pharmacy, Heilongjiang University of Chinese Medicine, Harbin, 150000, China
| | - Jialin Sun
- College of Pharmacy, Heilongjiang University of Chinese Medicine, Harbin, 150000, China
| | - Wenjing Feng
- College of Pharmacy, Heilongjiang University of Chinese Medicine, Harbin, 150000, China
| | - Liang Zhang
- College of Pharmacy, Heilongjiang University of Chinese Medicine, Harbin, 150000, China
| | - Yongji Li
- College of Pharmacy, Heilongjiang University of Chinese Medicine, Harbin, 150000, China.
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47
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Dassie E, Arcidiacono D, Wasiak I, Damiano N, Dall'Olmo L, Giacometti C, Facchin S, Cassaro M, Guido E, De Lazzari F, Marin O, Ciach T, Fery-Forgues S, Alberti A, Battaglia G, Realdon S. Detection of fluorescent organic nanoparticles by confocal laser endomicroscopy in a rat model of Barrett's esophageal adenocarcinoma. Int J Nanomedicine 2015; 10:6811-23. [PMID: 26586943 PMCID: PMC4636176 DOI: 10.2147/ijn.s86640] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
For many years, novel strategies for cancer detection and treatment using nanoparticles (NPs) have been developed. Esophageal adenocarcinoma is the sixth leading cause of cancer-related deaths in Western countries, and despite recent advances in early detection and treatment, its prognosis is still very poor. This study investigated the use of fluorescent organic NPs as potential diagnostic tool in an experimental in vivo model of Barrett’s esophageal adenocarcinoma. NPs were made of modified polysaccharides loaded with [4-(dicyanomethylene)-2-methyl-6-(4-dimethylaminostyryl)-4H-pyran] (DCM), a well-known fluorescent dye. The NP periphery might or might not be decorated with ASYNYDA peptide that has an affinity for esophageal cancer cells. Non-operated and operated rats in which gastroesophageal reflux was surgically induced received both types of NPs (NP-DCM and NP-DCM-ASYNYDA) by intravenous route. Localization of mucosal NPs was assessed in vivo by confocal laser endomicroscopy, a technique which enables a “real time” and in situ visualization of the tissue at a cellular level. After injection of NP-DCM and NP-DCM-ASYNYDA, fluorescence was observed in rats affected by esophageal cancer, whereas no signal was observed in control non-operated rats, or in rats with simple esophagitis or Barrett’s esophagus mucosa. Fluorescence was observable in vivo 30 minutes after the administration of NPs. Interestingly, NP-DCM-ASYNYDA induced strong fluorescence intensity 24 hours after administration. These observations suggested that NPs could reach the tumor cells, likely by enhanced permeability and retention effect, and the peptide ASYNYDA gave them high specificity for esophageal cancer cells. Thus, the combination of NP platform and confocal laser endomicroscopy could play an important role for highlighting esophageal cancer conditions. This result supports the potential of this strategy as a targeted carrier for photoactive and bioactive molecules in esophageal cancer diagnosis and treatment.
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Affiliation(s)
- Elisa Dassie
- Department of Molecular Medicine, University of Padua, Padua, Italy ; Venetian Institute of Molecular Medicine, University of Padua, Padua, Italy
| | - Diletta Arcidiacono
- Venetian Institute of Molecular Medicine, University of Padua, Padua, Italy ; Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Iga Wasiak
- Faculty of Chemical and Process Engineering, Warsaw University of Technology, Warsaw, Poland
| | - Nunzio Damiano
- Department of Biomedical Sciences, University of Padua, Padua, Italy
| | - Luigi Dall'Olmo
- Department of Emergency Medicine, "Santi Giovanni e Paolo" Hospital, Venice, University of Padua, Italy
| | - Cinzia Giacometti
- Anatomic Pathology Unit, ULSS 15, Alta Padovana, Camposampiero, University of Padua, Italy
| | - Sonia Facchin
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Mauro Cassaro
- Anatomic Pathology Unit, ULSS 15, Alta Padovana, Camposampiero, University of Padua, Italy
| | - Ennio Guido
- Gastroenterology Unit, Sant'Antonio Hospital, University of Padua, Italy
| | - Franca De Lazzari
- Gastroenterology Unit, Sant'Antonio Hospital, University of Padua, Italy
| | - Oriano Marin
- Interdepartmental Research Centre for Innovative Biotechnologies (CRIBI), University of Padua, Italy ; Proteomics Facility, Azienda Ospedaliera di Padova, Padua, Italy
| | - Tomasz Ciach
- Faculty of Chemical and Process Engineering, Warsaw University of Technology, Warsaw, Poland
| | - Suzanne Fery-Forgues
- CNRS, ITAV-USR 3505, Toulouse, France ; Université de Toulouse, ITAV-USR 3505, Toulouse, France
| | - Alfredo Alberti
- Department of Molecular Medicine, University of Padua, Padua, Italy ; Venetian Institute of Molecular Medicine, University of Padua, Padua, Italy
| | - Giorgio Battaglia
- Endoscopy Unit, Veneto Institute of Oncology (IOV-IRCCS), Padua, Italy
| | - Stefano Realdon
- Endoscopy Unit, Veneto Institute of Oncology (IOV-IRCCS), Padua, Italy
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48
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Coda S, Siersema PD, Stamp GWH, Thillainayagam AV. Biophotonic endoscopy: a review of clinical research techniques for optical imaging and sensing of early gastrointestinal cancer. Endosc Int Open 2015; 3:E380-92. [PMID: 26528489 PMCID: PMC4612244 DOI: 10.1055/s-0034-1392513] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Accepted: 05/07/2015] [Indexed: 02/08/2023] Open
Abstract
Detection, characterization, and staging constitute the fundamental elements in the endoscopic diagnosis of gastrointestinal diseases, but histology still remains the diagnostic gold standard. New developments in endoscopic techniques may challenge histopathology in the near future. An ideal endoscopic technique should combine a wide-field, "red flag" screening technique with an optical contrast or microscopy method for characterization and staging, all simultaneously available during the procedure. In theory, biophotonic advances have the potential to unite these elements to allow in vivo "optical biopsy." These techniques may ultimately offer the potential to increase the rates of detection of high risk lesions and the ability to target biopsies and resections, and so reduce the need for biopsy, costs, and uncertainty for patients. However, their utility and sensitivity in clinical practice must be evaluated against those of conventional histopathology. This review describes some of the most recent applications of biophotonics in endoscopic optical imaging and metrology, along with their fundamental principles and the clinical experience that has been acquired in their deployment as tools for the endoscopist. Particular emphasis has been placed on translational label-free optical techniques, such as fluorescence spectroscopy, fluorescence lifetime imaging microscopy (FLIM), two-photon and multi-photon microscopy, second harmonic generation (SHG) and third harmonic generation (THG) imaging, optical coherence tomography (OCT), diffuse reflectance, Raman spectroscopy, and molecular imaging.
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Affiliation(s)
- Sergio Coda
- Section of Gastroenterology and Hepatology, Department of Medicine, Imperial College London, London, United Kingdom,Photonics Group, Department of Physics, Imperial College London, London, United Kingdom,Endoscopy Unit, Department of Gastroenterology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom,Department of Endoscopy, North East London NHS Treatment Centre, Care UK, London, United Kingdom,Corresponding author Sergio Coda, MD, PhD Imperial College London – Medicine and PhysicsPrince Consort RoadLondon SW7 2AZUnited Kingdom+44-20-75947714
| | - Peter D. Siersema
- Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Gordon W. H. Stamp
- Photonics Group, Department of Physics, Imperial College London, London, United Kingdom,Experimental Histopathology Laboratory, Cancer Research UK London Research Institute, London, United Kingdom,Department of Histopathology, Imperial College London, London, United Kingdom
| | - Andrew V. Thillainayagam
- Section of Gastroenterology and Hepatology, Department of Medicine, Imperial College London, London, United Kingdom,Photonics Group, Department of Physics, Imperial College London, London, United Kingdom,Endoscopy Unit, Department of Gastroenterology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
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49
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Detection of colorectal polyps in humans using an intravenously administered fluorescent peptide targeted against c-Met. Nat Med 2015; 21:955-61. [DOI: 10.1038/nm.3641] [Citation(s) in RCA: 201] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Accepted: 04/14/2014] [Indexed: 12/17/2022]
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50
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Thekkek N, Lee MH, Polydorides AD, Rosen DG, Anandasabapathy S, Richards-Kortum R. Quantitative evaluation of in vivo vital-dye fluorescence endoscopic imaging for the detection of Barrett's-associated neoplasia. JOURNAL OF BIOMEDICAL OPTICS 2015; 20:56002. [PMID: 25950645 PMCID: PMC4423850 DOI: 10.1117/1.jbo.20.5.056002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Accepted: 04/20/2015] [Indexed: 05/21/2023]
Abstract
Current imaging tools are associated with inconsistent sensitivity and specificity for detection of Barrett's-associated neoplasia. Optical imaging has shown promise in improving the classification of neoplasia in vivo. The goal of this pilot study was to evaluate whether in vivo vital dye fluorescence imaging (VFI) has the potential to improve the accuracy of early-detection of Barrett's-associated neoplasia. In vivo endoscopic VFI images were collected from 65 sites in 14 patients with confirmed Barrett's esophagus (BE), dysplasia, oresophageal adenocarcinoma using a modular video endoscope and a high-resolution microendoscope(HRME). Qualitative image features were compared to histology; VFI and HRME images show changes in glandular structure associated with neoplastic progression. Quantitative image features in VFI images were identified for objective image classification of metaplasia and neoplasia, and a diagnostic algorithm was developed using leave-one-out cross validation. Three image features extracted from VFI images were used to classify tissue as neoplastic or not with a sensitivity of 87.8% and a specificity of 77.6% (AUC = 0.878). A multimodal approach incorporating VFI and HRME imaging can delineate epithelial changes present in Barrett's-associated neoplasia. Quantitative analysis of VFI images may provide a means for objective interpretation of BE during surveillance.
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Affiliation(s)
- Nadhi Thekkek
- Rice University, Department of Bioengineering, MS-142, Box 1892, Houston, Texas 77251-1892, United States
- Address all correspondence to: Nadhi Thekkek, E-mail:
| | - Michelle H. Lee
- Icahn School of Medicine, Mount Sinai Medical Center, One Gustave L. Levy Place, Box 1069, New York, New York 10029-6574, United States
| | - Alexandros D. Polydorides
- Icahn School of Medicine, Mount Sinai Medical Center, Department of Pathology, One Gustave L. Levy Place, Box 1194, New York, New York 10029-6574, United States
| | - Daniel G. Rosen
- Baylor College of Medicine, Department of Pathology, One Baylor Plaza, Cullen 271A, Houston, Texas 77030, United States
| | - Sharmila Anandasabapathy
- Baylor College of Medicine, Department of Medicine, One Baylor Plaza, Cullen 271A, Houston, Texas 77030, United States
| | - Rebecca Richards-Kortum
- Rice University, Department of Bioengineering, MS-142, Box 1892, Houston, Texas 77251-1892, United States
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