Multiscale PET/Cerenkov Image-Guided Surgery: Demonstration in An Invasive Mouse Tumor Model
CM Carpenter*, C Sun, G Pratx, L Xing, Stanford Univ School of Medicine, Stanford, CAMO-D-141-6 Monday 2:00PM - 3:50PM Room: 141
Purpose: Real-time biological imaging is being investigated to delineate positive tumor margins which during oncological surgery. We investigated the ability of Cerenkov optical emission from Fluorodeoxyglucose (FDG) to resect neoplastic tissue, as guided by Positron Emission Tomography (PET). This technique was demonstrated in a TRAMP mouse model, where prostate cancer that had invaded beyond the capsule of the prostate was identified intra-operatively.
Methods: Studies were performed in vivo in a tumor mouse model. PET imaging was performed with a Siemens Inveon scanner; Cerenkov images were collected with a commercial optical imaging system (Perkin-Elmer). A transgenic adenocarcinoma of the mouse prostate (TRAMP) mouse model was used to investigate the feasibility of imaging local invasion of the cancer beyond the prostate capsule. Four mice with ~1cm prostate tumors with questionable invasion as determined by T2-W MRI were injected with ~1 mCi of FDG. The injection was followed by PET/CT after 75 minutes, and subsequent sacrifice; surgery commenced immediately after. PET/CT was used to identify tissues pre-operatively. Resected tissues were analyzed with histology to identify tissues that contained tumor cells for correlation to Cerenkov imaging.
Results: All four TRAMP mice exhibited extensive tumor invasion in the prostate with subsequent invasion into the seminal vesicles. No tumor tissue was identified in the other tissues, as confirmed by pathology. Cerenkov imaging was able to significantly differentiate between tissues involved with tumor and those with no tumor (P<0.01).
Conclusion: The multiscale strategy, where PET helped to guide surgical resection of Cerenkov-enhancing tissues, proved to significantly delineate tumor from non-tumor tissue. This study demonstrates a potentially powerful technique to surgical resection of tumors.
Funding Support, Disclosures, and Conflict of Interest: We acknowledge the NCI R01 CA128908, NIH ICMIC P50CA114747, DOD Breast Cancer Fellowship W81XWH-10-1-0506, and the Center for Biomedical Imaging at Stanford (CBIS).