Effect of Formalin Fixation for Near-Infrared Fluorescence Imaging with an Antibody-Dye Conjugate in Head and Neck Cancer Patients,Molecular Imaging and Biology

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Effect of Formalin Fixation for Near-Infrared Fluorescence Imaging with an Antibody-Dye Conjugate in Head and Neck Cancer Patients
Molecular Imaging and Biology ( IF 3.0 ) Pub Date : 2020-10-19 , DOI: 10.1007/s11307-020-01553-1
Shrey Kapoor ₁ , Guolan Lu ₁ , Nynke S van den Berg ₁ , Giri Krishnan ₁ , Jacqueline Pei ₁ , Quan Zhou ₁ , Brock A Martin ₂ , Fred M Baik ₁ , Eben L Rosenthal ₁ , Naoki Nishio _{1,

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Affiliation

Purpose

This study evaluated the effect of formalin fixation for near-infrared (NIR) fluorescence imaging of an antibody-dye complex (panitumumab-IRDye800CW) that was intravenously administered to patients with head and neck squamous cell carcinoma (HNSCC) scheduled to undergo surgery of curative intent.

Procedures

HNSCC patients were infused with 25 or 50 mg of panitumumab-IRDye800CW followed by surgery 1–5 days later. Following resection, primary tumor specimens were imaged in a closed-field fluorescence imaging device, before and after formalin fixation. The fluorescence images of formalin-fixed specimens were compared with images prior to formalin fixation. Regions of interest were drawn on the primary tumor and on the adjacent normal tissue on the fluorescence images. The mean fluorescence intensity (MFI) and tumor-to-background ratios (TBRs) of the fresh and formalin-fixed tissues were compared.

Results

Of the 30 enrolled patients, 20 tissue specimens were eligible for this study. Formalin fixation led to an average of 10 % shrinkage in tumor specimen size (p < 0.0001). Tumor MFI in formalin-fixed specimens was on average 10.9 % lower than that in the fresh specimens (p = 0.0002). However, no statistical difference was found between the TBRs of the fresh specimens and those of the formalin-fixed specimens (p = 0.85).

Conclusions

Despite the 11 % decrease in MFI between fresh and formalin-fixed tissue specimens, the relative difference between tumor and normal tissue as measured in TBR remained unchanged. This data suggests that evaluation of formalin-fixed tissue for assessing the accuracy of fluorescence-guided surgery approaches could provide a valid, yet more flexible, alternative to fresh tissue analysis.

Trial Registration

NCT02415881

中文翻译：

福尔马林固定对头颈癌患者近红外荧光成像的影响

目的

本研究评估了福尔马林固定对抗体-染料复合物 (panitumumab-IRDye800CW) 近红外 (NIR) 荧光成像的影响，该复合物被静脉注射给计划接受根治性手术的头颈部鳞状细胞癌 (HNSCC) 患者意图。

程序

HNSCC 患者输注 25 或 50 毫克的帕尼单抗-IRDye800CW，然后在 1-5 天后进行手术。切除后，原发性肿瘤标本在福尔马林固定前后在闭场荧光成像设备中成像。将福尔马林固定标本的荧光图像与福尔马林固定前的图像进行比较。在荧光图像上的原发肿瘤和邻近的正常组织上绘制感兴趣区域。比较新鲜组织和福尔马林固定组织的平均荧光强度 (MFI) 和肿瘤背景比 (TBR)。

结果

在 30 名登记患者中，有 20 份组织标本符合这项研究的条件。福尔马林固定导致肿瘤样本大小平均缩小 10% ( p < 0.0001)。福尔马林固定标本中的肿瘤 MFI 平均比新鲜标本低 10.9% ( p = 0.0002)。然而，新鲜标本的 TBR 与福尔马林固定标本的 TBR 之间没有发现统计学差异 ( p = 0.85)。