Evaluation of the clinical utility of Hsp70-based intraoperative fluorescence imaging of head and neck cancer

Introduction The primary intention of surgical therapy for head and neck carcinomas is the complete resection of tumor cells with a maximum of normal tissue preservation. Hsp70-based real-time fluorescence imaging represents a promising method to support intraoperative decision making by selectively detecting tumor tissue. With the aim of transferring this technology into clinical practice, the TPP-IRDye800 tracer was further evaluated on freshly resected tumor material.

Materials and methods The diagnostic accuracy of fluorescence imaging using the topically applied tracer was compared to visual tissue assessment of the tumor by three head and neck surgeons. For this purpose, "regions of interest"(ROI) (1-12) were selected on the epithelial side of 10 resected HNSCC tumors. The classification of ROIs into cancerous and tumor-free by the two methods was compared with the gold standard of histopathological evaluation. Furthermore, it was investigated whether the fluorescence signal could be detected specifically and with sufficient contrast to healthy tissue using an intraoperative clinical imaging system. The results were compared with the preclinical system used in previous studies.

Results Fluorescence imaging achieved a sensitivity of 93% and specificity of 95%. Surgical assessment reached a sensitivity of 91% and specificity of 82%. Congruent signal enhancements could be detected with both imaging systems. The signal to background ratio was 2.2±0.4 compared to 2.4±0.5 for the preclinical system.

Conclusion  Based on the promising performance of the IRDye800 tracer, further efforts towards clinical approval of the fluorescence probe appear justified.

Fakultät für Medizin, TU München

Publication History

Article published online:
12 May 2023