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Intraoperative fluorescence imaging for the assessment of excision margins and lymph node involvement in breast cancer using EMI-137

Jurrius, P.A.G.T. (2018) Intraoperative fluorescence imaging for the assessment of excision margins and lymph node involvement in breast cancer using EMI-137.

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Abstract:Introduction: Failure to obtain clear margins and under-diagnose lymph nodes in cancer surgery is the main risk factor for local recurrence. Therefore, a new technique to accurately assess resection margins and to identify tumour-positive sentinel lymph nodes intraoperatively in patients undergoing breast conserving surgery is required. For the assessment of intraoperative tumour margins and lymph nodes EMI-137 fluorescence imaging is proposed. EMI-137 is a peptide labelled with a fluorescent dye. It has high affinity for the c-Met receptor, overexpressed in breast cancer. Material & Methods: EMI-137 dose regimen and imaging windows were established, auto-fluorescence was explored and sources of it identified, quality of c-Met expression and histopathology tests were assessed, and the functionality and efficacy of the fluorescence imaging device was investigated. Results: The main sources of auto-fluorescence (blue dye and histopathology inks) are due to a non-suitable fluorescence imaging device. Moreover, at low settings oversaturation was achieved when imaging samples without a fluorophore present. Hence, a new fluorescence imaging system is essential. Quality assessment on TMAs showed a 3-11% c-Met (over)expression requiring pre-operative c-Met testing. Discussion & conclusion: With the obtained improvements the EMI-137 pilot study will provide robust data to assess the feasibility of EMI-137 fluorescence imaging.
Item Type:Essay (Master)
Clients:
Guy's and St. Thomas' NHS Trust Hospital London, London, United Kingdom
King's College London, London, United Kingdom
Edinburgh Molecular Imaging, Edinburgh, Scotland
Faculty:TNW: Science and Technology
Subject:30 exact sciences in general, 44 medicine, 50 technical science in general
Programme:Technical Medicine MSc (60033)
Link to this item:http://purl.utwente.nl/essays/75807
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