Page 144 - Fluorescence-guided cancer surgery

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Chapter 9
Table 3. Characteristics of false positive and false negative uorescent lesions in ovarian cancer
Patient ID
Location lesion
False positive or negative
False positive False positive False positive False negative False positive False positive False positive False negative False negative False positive False positive False positive False positive False positive False positive
False positive
Probable cause
FRα expression
FRβ expression activated macrophages Auto uorescence collagen containing structure Inadequate penetration depth Auto uorescence collagen containing structure Auto uorescence collagen containing structure Unknown
Inadequate penetration depth
Inadequate penetration depth
FRα expression
FRα expression
Auto uorescence collagen containing structure Auto uorescence collagen containing structure FRα expression
Auto uorescence collagen containing structure
FRα expression
1 Fallopian tube
2 Iliacal lymph node
2 Ligamentum rotundum
4 Omentum
5 Leiomyoma Uterus
5 Leiomyoma Uterus 5 Omentum biopsy
7 Omentum
8 Omentum
8 Fallopian tube
10 Fallopian tube
12 Cervix
12 Myometrium uterus 12 Fallopian tube
12 Infundibulopelvic
ligament
12 Ovary (contralateral)
Figure 4. Identi cation of breast cancer metastases using uorescence imaging
Identi cation of a bisected primary breast cancer lesion using uorescence imaging (dashed circles). The arrow indicated auto uorescence signal from normal breast tissue. The tumor was found histologically to be an in ltrating breast cancer of no special type.
In one patient with breast cancer, a tumor-positive SLN was found on histopathological evaluation. This SLN however was not detected with uorescence imaging. After HE and FRα staining, the metastasis appeared to be in the center of the SLN, and was therefore not detected due to lack of tissue penetration.
Pharmacokinetics
The maximal concentration for each dose was obtained directly after the end of the infusion and declined thereafter with a half-life of 86.8 minutes.