Hisashi Hara1,2, Tsuyoshi Takahashi1,2, Rie Nakatsuka1,2, Shigeyoshi Higashi1,3, Tetsuji Naka2, Kazuki Sumiyama4, Yasuhiro Miyazaki1, Tomoki Makino1, Yukinori Kurokawa1, Makoto Yamasaki1, Shuji Takiguchi1, Masaki Mori1, Yuichiro Doki1, Kiyokazu Nakajima5,6. 1. Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Japan. 2. Laboratory for Immune Signal, National Institute of Biomedical Innovation, Health and Nutrition, Ibaraki, Japan. 3. Division of Next Generation Endoscopic Intervention, Osaka University, Suite 0912, Center of Medical Innovation and Translational Research, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan. 4. Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan. 5. Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Japan. knakajima@gesurg.med.osaka-u.ac.jp. 6. Division of Next Generation Endoscopic Intervention, Osaka University, Suite 0912, Center of Medical Innovation and Translational Research, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan. knakajima@gesurg.med.osaka-u.ac.jp.
Abstract
BACKGROUND: In digestive cancers, it is mandatory to diagnose peritoneal metastasis prior to selecting therapy. Therefore, exploratory laparoscopy has gained wider clinical acceptance. In laparoscopy, the peritoneal metastasis is pathologically confirmed by excisional biopsy; however, there remain technical difficulties in performing precise diagnosis and adequate biopsy on small peritoneal lesions without damaging organs. We have focused on "optical biopsy" using probe-based confocal laser endomicroscopy (pCLE). The aims of this study were (1) to optimize current CLE system for real-time observation of peritoneal metastases and (2) to assess its potential usefulness as diagnostic modality in preclinical settings. METHODS: To optimize condition and evaluate feasibility, we prepared peritoneal metastasis mice model with gastric cancer cell line (MKN-45). On Day 10 after seeding, the mice were laparotomized and performed pCLE observations with CellvizioLAB (LSU-F 400/488 nm, Mauna Kea Technologies, Paris, France). We evaluated two different CLE probes, three different dyes, and optimal interval time. The detected sites were excised and pathologically evaluated on its morphology. Next, the feasibility and safety were validated in porcine model for clinical usage. After injection of fluorescein, pCLE was applied for the observation of intra-abdominal organs. RESULT: A miniature probe-type pCLE system with 60 μm focal depth (UltraMini O) and 1 % fluorescein dye was chosen for good visualization in mice model. The irregular microarchitecture images suspected to malignancy were obtained from the metastases. In the porcine model, observation of abdominal organs was feasible without any organ injury in the laparoscopic procedures. The dosage of 1 % fluorescein (3 ml/body) was appropriate in observing intra-abdominal organs, and each intra-abdominal organ was clearly observed with the same imaging quality we obtained in mice model. CONCLUSION: The pCLE was feasible and safe and potentially useful for the diagnosis of the peritoneal metastasis in in vivo animal models.
BACKGROUND: In digestive cancers, it is mandatory to diagnose peritoneal metastasis prior to selecting therapy. Therefore, exploratory laparoscopy has gained wider clinical acceptance. In laparoscopy, the peritoneal metastasis is pathologically confirmed by excisional biopsy; however, there remain technical difficulties in performing precise diagnosis and adequate biopsy on small peritoneal lesions without damaging organs. We have focused on "optical biopsy" using probe-based confocal laser endomicroscopy (pCLE). The aims of this study were (1) to optimize current CLE system for real-time observation of peritoneal metastases and (2) to assess its potential usefulness as diagnostic modality in preclinical settings. METHODS: To optimize condition and evaluate feasibility, we prepared peritoneal metastasis mice model with gastric cancer cell line (MKN-45). On Day 10 after seeding, the mice were laparotomized and performed pCLE observations with CellvizioLAB (LSU-F 400/488 nm, Mauna Kea Technologies, Paris, France). We evaluated two different CLE probes, three different dyes, and optimal interval time. The detected sites were excised and pathologically evaluated on its morphology. Next, the feasibility and safety were validated in porcine model for clinical usage. After injection of fluorescein, pCLE was applied for the observation of intra-abdominal organs. RESULT: A miniature probe-type pCLE system with 60 μm focal depth (UltraMini O) and 1 % fluorescein dye was chosen for good visualization in mice model. The irregular microarchitecture images suspected to malignancy were obtained from the metastases. In the porcine model, observation of abdominal organs was feasible without any organ injury in the laparoscopic procedures. The dosage of 1 % fluorescein (3 ml/body) was appropriate in observing intra-abdominal organs, and each intra-abdominal organ was clearly observed with the same imaging quality we obtained in mice model. CONCLUSION: The pCLE was feasible and safe and potentially useful for the diagnosis of the peritoneal metastasis in in vivo animal models.
Authors: Prateek Sharma; Alexander R Meining; Emmanuel Coron; Charles J Lightdale; Herbert C Wolfsen; Ajay Bansal; Monther Bajbouj; Jean-Paul Galmiche; Julian A Abrams; Amit Rastogi; Neil Gupta; Joel E Michalek; Gregory Y Lauwers; Michael B Wallace Journal: Gastrointest Endosc Date: 2011-07-13 Impact factor: 9.427
Authors: Marcia Irene Canto; Sharmila Anandasabapathy; William Brugge; Gary W Falk; Kerry B Dunbar; Zhe Zhang; Kevin Woods; Jose Antonio Almario; Ursula Schell; John Goldblum; Anirban Maitra; Elizabeth Montgomery; Ralf Kiesslich Journal: Gastrointest Endosc Date: 2013-11-09 Impact factor: 9.427