Intraoperative Molecular Diagnostic Imaging Can XXXX .

@entity1 @entity8 @entity66 @entity5 @entity19 @entity1358
PURPOSE: Margin status can often be difficult to assess intraoperatively, particularly during partial nephrectomy given the time constraints related to @entity8 . We hypothesized that a targeted molecular imaging approach could be used during surgery to identify @entity5 margins and confirm disease clearance. MATERIALS AND METHODS: EC17, a novel tracer targeting FRa, was used in @entity19 models of @entity1358 to identify positive margins after surgery. Positive margins were detected due to elevated @entity5 -to-background ratios of the @entity5 compared to surrounding normal tissues. We performed a pilot study in 4  @entity1 using EC17 preoperatively with intraoperative imaging during the operation. RESULTS: FRa was highly expressed in 65% of @entity1358 harvested from the operating room. In the @entity19 model intraoperative imaging of @entity1358 revealed a mean    SD @entity5 -to-background ratio of 8.2      1.1 in the RCC10, 11.2    1.1 in the 786-0 and 4.3    1.1 in the UMRC2 cell line. Compared to visual inspection intraoperative imaging of the surgical resection bed identified @entity66 in 24% more animals. In the @entity1 pilot study targeted molecular imaging identified 2 of 4 @entity1358 and had no false-positive results. In these 2 cases the @entity5 -to-background ratio was 3.7 and 4.6, respectively. In each case we confirmed disease clearance and @entity5 fluorescence did not correlate with nodule size or @entity5 grade. CONCLUSIONS: To our knowledge this is the first demonstration in @entity1 of identifying @entity1358 during surgery using a targeted molecular contrast agent. This approach may lead to a superior method of identifying @entity5 and @entity5 borders in the intraoperative setting.
