Intraoperative molecular imaging can identify XXXX during pulmonary resection.

@entity1 @entity1501 @entity5 @entity2 @entity420 @entity2220 @entity8983
BACKGROUND: More than 80,000 @entity1 undergo resection of a @entity2 each year, and the only method to determine if the @entity5 is malignant is histologic analysis. We propose that a targeted molecular contrast agent could bind @entity2220 , which could be identified using real-time optical imaging at the time of surgery. METHODS: Fifty @entity1 with a biopsy-proven @entity2220 were enrolled. Before surgery, @entity1 were systemically administered 0.1 mg/kg of a fluorescent @entity1501 receptor alpha (FRa)-targeted molecular contrast agent by intravenous infusion. During surgery, @entity5 were imaged in situ and ex  vivo, after the lung parenchyma was dissected to directly expose the @entity5 to the imaging system. RESULTS: @entity5 ranged from 0.3 to 7.5 cm (mean: 2.6 cm), and 46 of 50 (92%) @entity2220 were fluorescent. No false uptake occurred, and in 2 cases, intraoperative imaging revealed @entity5 metastases (3 mm and 6 mm) that were not recognized preoperatively. Four @entity420 were not fluorescent, and immunohistochemistry showed that these @entity420 did not express FRa. @entity5 fluorescence was independent of nodule size, uptake of @entity8983 , histology, and @entity5 differentiation. Molecular imaging could identify only 7 of the 50 @entity420 in situ in the @entity1 without bisection. The most important predictor of the success of molecular imaging in locating the @entity5 in situ was the distance of the nodule from the pleural surface. CONCLUSIONS: Intraoperative molecular imaging with a targeted contrast agent can identify @entity2220 , and this technology is currently useful in @entity1 with @entity5 , irrespective of size. With further refinements, this tool may prove useful in locating @entity420 that are deeper in the lung parenchyma, in lymph nodes, and at pleural and resection margins.
