Sa1221 ENDOSCOPIC MOLECULAR IMAGING OF EARLY GASTRIC CANCER USING HUMAN HEAVY-CHAIN FERRITIN NANOPROBE UNDER CONFOCAL LASER ENDOMICROSCOPY

e23093 Background: Gastric cancer is primarily managed endoscopically by white light gastroscope with suboptimal diagnostic accuracy. Emerging optical imaging technologies possess great potential for improving diagnostic accuracy but currently lack imaging agents for molecular specificity. In this study, a novel ligand of transferrin receptor 1 (TfR1), human H-ferritin (HFn), was labeled with fluorescent agents to enable in vivo real-time imaging by confocal laser endomicroscopy (CLE). Methods: In vivo fluorescence imaging was performed in tumor-bearing mice from human gastric cancer cell lines using fluorescently labeled HFn nanoprobe. The HFn-FITC as molecular imaging agent was applied to the gastric cancer with confocal laser endomicroscopy (CLE) in fresh endoscopic submucosal dissection (ESD) of early gastric cancer. Results: Intravital imaging of gastric xenograft tumors revealed a specific tumor targeting effects of HFn-IRDye800CW, whereas no specific signal was observed in mice injected with free dye. An ex vivo experiment on human specimens using a rigid confocal probe showed positive fluorescent staining in ESD samples diagnosed as early gastric cancers. Our CLE evaluation correlated well with immunohistochemical findings. Conclusions: CLE can be used for in vivo, molecular analysis of early gastric cancer and to identify TfR1 expression in xenografts and human tissue samples. HFn-targeted molecular imaging could improve early detection of gastric cancer.

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In vivo molecular imaging of gastric cancer by targeting MG7 antigen with confocal laser endomicroscopy

Endoscopy ◽

10.1055/s-0032-1325762 ◽

2013 ◽

Vol 45 (02) ◽

pp. 79-85 ◽

Cited By ~ 26

Author(s):

Z. Li ◽

X. Zuo ◽

C. Li ◽

C. Zhou ◽

J. Liu ◽

...

Keyword(s):

Gastric Cancer ◽

Molecular Imaging ◽

Confocal Laser Endomicroscopy ◽

Confocal Laser

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Confocal laser endomicroscopy under propofol‐based sedation for early gastric cancer and pre‐cancerous lesions is associated with better diagnostic accuracy: a retrospective cohort study in China

BMC Anesthesiology ◽

10.1186/s12871-021-01312-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Lihua Chu ◽

Jialian Zhao ◽

Cheng Sheng ◽

Min Yue ◽

Feifei Wang ◽

...

Keyword(s):

Gastric Cancer ◽

Early Gastric Cancer ◽

Intestinal Metaplasia ◽

Retrospective Cohort ◽

Precancerous Lesions ◽

Characteristic Curve ◽

Intraepithelial Neoplasia ◽

Confocal Laser Endomicroscopy ◽

Confocal Laser ◽

Patient Cooperation

Abstract Background Confocal laser endomicroscopy (CLE) has advantages in detecting gastric neoplastic lesions, meanwhile it requires strict patient cooperation. Sedation could improve patient cooperation and quality of endoscopy. However, sedation is still not very popular in some resource-limited countries and regions. The purpose of this study was to compare propofol-based sedated versus un-sedated CLE in the value of diagnosing early gastric cancer (EGC) and precancerous lesions. Methods A retrospective, cohort, single center study of 226 patients who underwent CLE between January 1, 2015 and December 31, 2017 was performed. Patients enrolled were allocated into the propofol-based sedated group (n = 126) and the un-sedated group (n = 100). The comparison of validity and reliability of CLE for identifying EGC and precancerous lesions between the two groups was performed through analyzing CLE diagnosis and pathological diagnosis. Reporting followed the STROBE guidelines. Results The area under receiver operating characteristic curve (AUROC) of diagnosing EGC in the sedated group was 0.97 (95 % CI: 0.95 to 0.99), which was higher than that in the un-sedated group (0.88 (95 % CI: 0.80 to 0.97), P = 0.0407). CLE with sedation performed better than without sedation in diagnosing intraepithelial neoplasia and intestinal metaplasia (P = 0.0008 and P = 0.0001, respectively). For patients considered as high-grade intraepithelial neoplasia or EGC by endoscopists, they would not get biopsy during CLE but receive endoscopic submucosal dissection (ESD) subsequently, and the misdiagnosis rate of CLE was 0 % in the sedated group and 27.59 % (95 % CI: 10.30–44.91 %) in the un-sedated group (P = 0.006). Conclusions Propofol based sedation was associated with improved diagnostic value of CLE for detecting EGC as well as precancerous lesions (intraepithelial neoplasia OR intestinal metaplasia).

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In vivo molecular imaging of gastric cancer in human-murine xenograft models with confocal laser endomicroscopy using a tumor vascular homing peptide

Cancer Letters ◽

10.1016/j.canlet.2014.10.036 ◽

2015 ◽

Vol 356 (2) ◽

pp. 891-898 ◽

Cited By ~ 11

Author(s):

Lijuan Liu ◽

Jipeng Yin ◽

Changhao Liu ◽

Guofeng Guan ◽

Doufei Shi ◽

...

Keyword(s):

Gastric Cancer ◽

Molecular Imaging ◽

Confocal Laser Endomicroscopy ◽

Confocal Laser ◽

Xenograft Models ◽

Homing Peptide

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Confocal laser endomicroscopy under propofol-based sedation for early gastric cancer and pre-cancerous lesions is associated with better diagnosing accuracy: a retrospective cohort study in China

10.21203/rs.3.rs-41225/v1 ◽

2020 ◽

Author(s):

Lihua Chu ◽

Jialian Zhao ◽

Cheng Sheng ◽

Min Yue ◽

Feifei Wang ◽

...

Keyword(s):

Gastric Cancer ◽

Early Gastric Cancer ◽

Retrospective Cohort ◽

Precancerous Lesions ◽

Characteristic Curve ◽

Intraepithelial Neoplasia ◽

Confocal Laser Endomicroscopy ◽

Confocal Laser ◽

Validity And Reliability ◽

Patient Cooperation

Abstract Background: Confocal laser endomicroscopy (CLE) has advantages in detecting gastric neoplastic lesions, meanwhile it requires strict patient cooperation. Sedation could improve patient cooperation and quality of endoscopy. However, sedation is still not very popular in some resource-limited countries and regions. The purpose of this study was to compare propofol-based sedated versus un-sedated CLE in the value of diagnosing early gastric cancer (EGC) and precancerous lesions.Methods: A retrospective, cohort, single center study of 226 patients who underwent CLE between January 1, 2015 and December 31, 2017 was performed.Patients enrolled were allocated into propofol-based sedated group (n=126) and un-sedated group (n=100). The comparison of validity and reliability of CLE for identifying EGC and precancerous lesions between the two groups was performed through analyzing CLE diagnose and pathological diagnose. Results: The area under receiver operating characteristic curve (AUROC) of diagnosing EGC in sedated group was 0.97 (95% CI: 0.95 to 0.99), which was higher than that in un-sedated group (0.88 (95% CI: 0.80 to 0.97), P =0.0407). CLE with sedation performed better than without sedation in diagnosing intraepithelial neoplasia and intestinal metaplasia (P =0.0008 and P =0.0084, respectively). For patients considered as high-grade intraepithelial neoplasia or EGC by endoscopists, they would not get biopsy during CLE but receive ESD subsequently, and the misdiagnosis rate of CLE was 0 in sedated group and 27.59% in un-sedated group (P =0.006).Conclusion: Propofol based sedation was associated with improved diagnostic value of CLE for detecting EGC as well as precancerous lesions.

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Confocal laser endomicroscopy under propofol-based sedation for early gastric cancer and pre-cancerous lesions is associated with better diagnostic accuracy: a retrospective cohort study in China

10.21203/rs.3.rs-41225/v2 ◽

2020 ◽

Author(s):

Lihua Chu ◽

Jialian Zhao ◽

Cheng Sheng ◽

Min Yue ◽

Feifei Wang ◽

...

Keyword(s):

Gastric Cancer ◽

Early Gastric Cancer ◽

Retrospective Cohort ◽

Precancerous Lesions ◽

Characteristic Curve ◽

Intraepithelial Neoplasia ◽

Confocal Laser Endomicroscopy ◽

Confocal Laser ◽

Validity And Reliability ◽

Patient Cooperation

Abstract Background: Confocal laser endomicroscopy (CLE) has advantages in detecting gastric neoplastic lesions, meanwhile it requires strict patient cooperation. Sedation could improve patient cooperation and quality of endoscopy. However, sedation is still not very popular in some resource-limited countries and regions. The purpose of this study was to compare propofol-based sedated versus un-sedated CLE in the value of diagnosing early gastric cancer (EGC) and precancerous lesions.Methods: A retrospective, cohort, single center study of 226 patients who underwent CLE between January 1, 2015 and December 31, 2017 was performed.Patients enrolled were allocated into the propofol-based sedated group (n=126) and the un-sedated group (n=100). The comparison of validity and reliability of CLE for identifying EGC and precancerous lesions between the two groups was performed through analyzing CLE diagnosis and pathological diagnosis. Reporting followed the STROBE guidelines.Results: The area under receiver operating characteristic curve (AUROC) of diagnosing EGC in the sedated group was 0.97 (95% CI: 0.95 to 0.99), which was higher than that in the un-sedated group (0.88 (95% CI: 0.80 to 0.97), P =0.0407). CLE with sedation performed better than without sedation in diagnosing intraepithelial neoplasia and intestinal metaplasia (P =0.0008 and P =0.0084, respectively). For patients considered as high-grade intraepithelial neoplasia or EGC by endoscopists, they would not get biopsy during CLE but receive endoscopic submucosal dissection (ESD) subsequently, and the misdiagnosis rate of CLE was 0% in the sedated group and 27.59% in the un-sedated group (P =0.006).Conclusion: Propofol based sedation was associated with improved diagnostic value of CLE for detecting EGC as well as precancerous lesions.

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Confocal laser endomicroscopy under propofol-based sedation for early gastric cancer and pre-cancerous lesions is associated with better diagnostic accuracy: a retrospective cohort study in China

10.21203/rs.3.rs-41225/v3 ◽

2020 ◽

Author(s):

Lihua Chu ◽

Jialian Zhao ◽

Cheng Sheng ◽

Min Yue ◽

Feifei Wang ◽

...

Keyword(s):

Gastric Cancer ◽

Early Gastric Cancer ◽

Intestinal Metaplasia ◽

Retrospective Cohort ◽

Precancerous Lesions ◽

Characteristic Curve ◽

Intraepithelial Neoplasia ◽

Confocal Laser Endomicroscopy ◽

Confocal Laser ◽

Patient Cooperation

Abstract Background: Confocal laser endomicroscopy (CLE) has advantages in detecting gastric neoplastic lesions, meanwhile it requires strict patient cooperation. Sedation could improve patient cooperation and quality of endoscopy. However, sedation is still not very popular in some resource-limited countries and regions. The purpose of this study was to compare propofol-based sedated versus un-sedated CLE in the value of diagnosing early gastric cancer (EGC) and precancerous lesions.Methods: A retrospective, cohort, single center study of 226 patients who underwent CLE between January 1, 2015 and December 31, 2017 was performed. Patients enrolled were allocated into the propofol-based sedated group (n=126) and the un-sedated group (n=100). The comparison of validity and reliability of CLE for identifying EGC and precancerous lesions between the two groups was performed through analyzing CLE diagnosis and pathological diagnosis. Reporting followed the STROBE guidelines.Results: The area under receiver operating characteristic curve (AUROC) of diagnosing EGC in the sedated group was 0.97 (95% CI: 0.95 to 0.99), which was higher than that in the un-sedated group (0.88 (95% CI: 0.80 to 0.97), P =0.0407). CLE with sedation performed better than without sedation in diagnosing intraepithelial neoplasia and intestinal metaplasia (P =0.0008 and P =0.0001, respectively). Conclusion: Propofol based sedation was associated with improved diagnostic value of CLE for detecting EGC as well as precancerous lesions (intraepithelial neoplasia OR intestinal metaplasia).

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Probe-based confocal laser endomicroscopy in the margin delineation of early gastric cancer for endoscopic submucosal dissection

Journal of Gastroenterology and Hepatology ◽

10.1111/jgh.13635 ◽

2017 ◽

Vol 32 (5) ◽

pp. 1046-1054 ◽

Cited By ~ 5

Author(s):

Jun Chul Park ◽

Yehyun Park ◽

Hyun Ki Kim ◽

Jeong-Hyeon Jo ◽

Chan Hyuk Park ◽

...

Keyword(s):

Gastric Cancer ◽

Early Gastric Cancer ◽

Endoscopic Submucosal Dissection ◽

Confocal Laser Endomicroscopy ◽

Confocal Laser ◽

Submucosal Dissection

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Sa1704 Molecular Imaging of î‘4î’7 Integrin Expression by Confocal Laser Endomicroscopy With Fluorescent Vedolizumab in Crohn's Disease

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2017.03.555 ◽

2017 ◽

Vol 85 (5) ◽

pp. AB247

Author(s):

Timo Rath ◽

Christian Bojarski ◽

Markus Neurath ◽

Raja Atreya

Keyword(s):

Crohn’S Disease ◽

Molecular Imaging ◽

Crohn's Disease ◽

Confocal Laser Endomicroscopy ◽

Confocal Laser ◽

Integrin Expression

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Innovative Diagnostic Endoscopy in Inflammatory Bowel Diseases: From High-Definition to Molecular Endoscopy

Frontiers in Medicine ◽

10.3389/fmed.2021.655404 ◽

2021 ◽

Vol 8 ◽

Author(s):

Christian Bojarski ◽

Maximilian Waldner ◽

Timo Rath ◽

Sebastian Schürmann ◽

Markus F. Neurath ◽

...

Keyword(s):

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Molecular Imaging ◽

Bowel Disease ◽

Multiphoton Microscopy ◽

Confocal Laser Endomicroscopy ◽

Confocal Laser ◽

High Definition ◽

Surveillance Strategy ◽

Inflammatory Bowel

High-definition endoscopy is one essential step in the initial diagnosis of inflammatory bowel disease (IBD) characterizing the extent and severity of inflammation, as well as discriminating ulcerative colitis (UC) from Crohn's disease (CD). Following general recommendations and national guidelines, individual risk stratification should define the appropriate surveillance strategy, biopsy protocol and frequency of endoscopies. Beside high-definition videoendoscopy the application of dyes applied via a spraying catheter is of additional diagnostic value with a higher detection rate of intraepithelial neoplasia (IEN). Virtual chromoendoscopy techniques (NBI, FICE, I-scan, BLI) should not be recommended as a single surveillance strategy in IBD, although newer data suggest a higher comparability to dye-based chromoendoscopy than previously assumed. First results of oral methylene blue formulation are promising for improving the acceptance rate of classical chromoendoscopy. Confocal laser endomicroscopy (CLE) is still an experimental but highly innovative endoscopic procedure with the potential to contribute to the detection of dysplastic lesions. Molecular endoscopy in IBD has taken application of CLE to a higher level and allows topical application of labeled probes, mainly antibodies, against specific target structures expressed in the tissue to predict response or failure to biological therapies. First pre-clinical and in vivo data from label-free multiphoton microscopy (MPM) are now available to characterize mucosal and submucosal inflammation on endoscopy in more detail. These new techniques now have opened the door to individualized and highly specific molecular imaging in IBD in the future and pave the path to personalized medicine approaches. The quality of evidence was stated according to the Oxford Center of evidence-based medicine (March 2009). For this review a Medline search up to January 2021 was performed using the words “inflammatory bowel disease,” “ulcerative colitis,” “crohn's disease,” “chromoendoscopy,” “high-definition endoscopy,” “confocal laser endomicroscopy,” “confocal laser microscopy,” “molecular imaging,” “multiphoton microscopy.”

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