Charlotte Benoit1, Aurélie Rodrigues1,2, Julien Calderaro3,4, Cécile Charpy4, Sylvie Simonin5, Jean-Charles Deybach5,6, Laurent Gouya5,6, Hervé Puy5,6, Caroline Schmitt5,6, René Farcy7, Valérie Vilgrain8, Valérie Paradis9, Nicolas Pote9, Fouad Lafdil2,3,10, Sébastien Mule2,3,11, Emmanuel Itti3,12, Alain Luciani13,14,15. 1. Nodea Medical, 1 mail du Pr Georges Mathé, 94800, Villejuif, France. 2. INSERM IMRB U955, Equipe 18, Créteil, France. 3. Faculté de Santé de Créteil, UPEC, Créteil, France. 4. Département de Pathologie, Hôpitaux Universitaires Henri Mondor, AP-HP, 51 Avenue du Marechal de Lattre de Tassigny, 94010, Créteil Cedex, France. 5. Centre Français Des Porphyries, Hôpital Louis Mourier, Assistance Publique-Hôpitaux de Paris, Colombes, France. 6. UMR1149 INSERM, Centre de Recherche Sur L'Inflammation (CRI), Université Paris Diderot, Site Bichat, Laboratory of Excellence, GR-Ex, Paris, France. 7. Laboratoire Aimé Cotton, Université Paris-Sud, ENS Cachan, CNRS, Université Paris-Saclay, 91405, Orsay Cedex, France. 8. Radiologie, Hôpital Beaujon, APHP, Clichy, France. 9. Anatomopathologie, Hôpital Beaujon, APHP, Clichy, France. 10. Institut Universitaire de France (IUF), Cedex 05 75231, Paris, France. 11. Service d'Imagerie Médicale, Hôpitaux Universitaires Henri Mondor, AP-HP, Créteil, France. 12. Service de Médecine Nucléaire, Hôpitaux Universitaires Henri Mondor, AP-HP, 51 Avenue du Marechal de Lattre de Tassigny, 94010, Créteil Cedex, France. 13. INSERM IMRB U955, Equipe 18, Créteil, France. alain.luciani@aphp.fr. 14. Faculté de Santé de Créteil, UPEC, Créteil, France. alain.luciani@aphp.fr. 15. Service d'Imagerie Médicale, Hôpitaux Universitaires Henri Mondor, AP-HP, Créteil, France. alain.luciani@aphp.fr.
Abstract
OBJECTIVES: To assess the performance of 405 nm-induced autofluorescence for the characterization of primary liver nodules on ex vivo resected specimens. MATERIALS AND METHODS: Forty resected liver specimens bearing 53 primary liver nodules were included in this IRB-approved prospective study. Intratissular spectroscopic measurements were performed using a 25-G fibered-needle on all ex vivo specimens: 5 autofluorescence measurements were performed in both nodules and adjacent parenchyma. The spectra derivatives of the 635 and 670 nm autofluorescence peaks observed in nodules and in adjacent liver parenchyma were compared (Kruskal-Wallis and Mann-Whitney when appropriate). RESULTS: A total of 42 potentially evolutive primary liver nodules-34 hepatocellular carcinomas, 4 intrahepatic cholangiocarcinomas, 4 hepatocellular adenomas-and 11 benign nodules-5 focal nodular hyperplasias, 6 regenerative nodules-were included. Both 635 and 670 nm Δderivatives were significantly higher in benign as compared to potentially evolutive (PEV) nodules (respectively 32.9 ± 4.5 vs 15.3 ± 1.4; p < 0.0001 and 5.7 ± 0.6 vs 2.5 ± 0.1; p < 0.0001) with respective sensitivity and specificity of 78% and 91% for distinguishing PEV from benign nodules. CONCLUSION: 405 nm-induced autofluorescence enables the discrimination of benign from PEV primary liver nodules, suggesting that autofluorescence imaging could be used to optimize US targeted liver biopsies. KEY POINTS: • 405 nm-induced autofluorescence can distinguish liver tumors from the adjacent liver parenchyma. • The analysis of autofluorescence imaging observed within primary liver tumors can discriminate benign tumors from those requiring follow-up or targeted liver biopsy. • In current practice, autofluorescence imaging could be embedded within biopsy needle, to enable, in addition to ultrasound guidance, optimal targeting of liver nodules which could optimize tissue sampling.
OBJECTIVES: To assess the performance of 405 nm-induced autofluorescence for the characterization of primary liver nodules on ex vivo resected specimens. MATERIALS AND METHODS: Forty resected liver specimens bearing 53 primary liver nodules were included in this IRB-approved prospective study. Intratissular spectroscopic measurements were performed using a 25-G fibered-needle on all ex vivo specimens: 5 autofluorescence measurements were performed in both nodules and adjacent parenchyma. The spectra derivatives of the 635 and 670 nm autofluorescence peaks observed in nodules and in adjacent liver parenchyma were compared (Kruskal-Wallis and Mann-Whitney when appropriate). RESULTS: A total of 42 potentially evolutive primary liver nodules-34 hepatocellular carcinomas, 4 intrahepatic cholangiocarcinomas, 4 hepatocellular adenomas-and 11 benign nodules-5 focal nodular hyperplasias, 6 regenerative nodules-were included. Both 635 and 670 nm Δderivatives were significantly higher in benign as compared to potentially evolutive (PEV) nodules (respectively 32.9 ± 4.5 vs 15.3 ± 1.4; p < 0.0001 and 5.7 ± 0.6 vs 2.5 ± 0.1; p < 0.0001) with respective sensitivity and specificity of 78% and 91% for distinguishing PEV from benign nodules. CONCLUSION: 405 nm-induced autofluorescence enables the discrimination of benign from PEV primary liver nodules, suggesting that autofluorescence imaging could be used to optimize US targeted liver biopsies. KEY POINTS: • 405 nm-induced autofluorescence can distinguish liver tumors from the adjacent liver parenchyma. • The analysis of autofluorescence imaging observed within primary liver tumors can discriminate benign tumors from those requiring follow-up or targeted liver biopsy. • In current practice, autofluorescence imaging could be embedded within biopsy needle, to enable, in addition to ultrasound guidance, optimal targeting of liver nodules which could optimize tissue sampling.
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