TY - JOUR
T1 - MET-receptor targeted fluorescent imaging and spectroscopy to detect multifocal papillary thyroid cancer
AU - Metman, Madelon J.H.
AU - Jonker, Pascal K.C.
AU - Sondorp, Luc H.J.
AU - van Hemel, Bettien M.
AU - Sywak, Mark S.
AU - Gill, Anthony J.
AU - Jansen, Liesbeth
AU - van Diest, Paul J.
AU - van Ginhoven, Tessa M.
AU - Löwik, Clemens W.G.M.
AU - Nguyen, Anh H.
AU - Robinson, Dominic J.
AU - van Dam, Gooitzen M.
AU - Links, Thera P.
AU - Coppes, Rob P.
AU - Fehrmann, Rudolf S.N.
AU - Kruijff, Schelto
N1 - Publisher Copyright:
© The Author(s) 2023.
PY - 2024/7
Y1 - 2024/7
N2 - Purpose: Multifocal disease in PTC is associated with an increased recurrence rate. Multifocal disease (MD) is underdiagnosed with the current gold standard of pre-operative ultrasound staging. Here, we evaluate the use of EMI-137 targeted molecular fluorescence-guided imaging (MFGI) and spectroscopy as a tool for the intra-operative detection of uni- and multifocal papillary thyroid cancer (PTC) aiming to improve disease staging and treatment selection. Methods: A phase-1 study (NCT03470259) with EMI-137 was conducted to evaluate the possibility of detecting PTC using MFGI and quantitative fiber-optic spectroscopy. Results: Fourteen patients underwent hemi- or total thyroidectomy (TTX) after administration of 0.09 mg/kg (n = 1), 0.13 mg/kg (n = 8), or 0.18 mg/kg (n = 5) EMI-137. Both MFGI and spectroscopy could differentiate PTC from healthy thyroid tissue after administration of EMI-137, which binds selectively to MET in PTC. 0.13 mg/kg was the lowest dosage EMI-137 that allowed for differentiation between PTC and healthy thyroid tissue. The smallest PTC focus detected by MFGI was 1.4 mm. MFGI restaged 80% of patients from unifocal to multifocal PTC compared to ultrasound. Conclusion: EMI-137-guided MFGI and spectroscopy can be used to detect multifocal PTC. This may improve disease staging and treatment selection between hemi- and total thyroidectomy by better differentiation between unifocal and multifocal disease.
AB - Purpose: Multifocal disease in PTC is associated with an increased recurrence rate. Multifocal disease (MD) is underdiagnosed with the current gold standard of pre-operative ultrasound staging. Here, we evaluate the use of EMI-137 targeted molecular fluorescence-guided imaging (MFGI) and spectroscopy as a tool for the intra-operative detection of uni- and multifocal papillary thyroid cancer (PTC) aiming to improve disease staging and treatment selection. Methods: A phase-1 study (NCT03470259) with EMI-137 was conducted to evaluate the possibility of detecting PTC using MFGI and quantitative fiber-optic spectroscopy. Results: Fourteen patients underwent hemi- or total thyroidectomy (TTX) after administration of 0.09 mg/kg (n = 1), 0.13 mg/kg (n = 8), or 0.18 mg/kg (n = 5) EMI-137. Both MFGI and spectroscopy could differentiate PTC from healthy thyroid tissue after administration of EMI-137, which binds selectively to MET in PTC. 0.13 mg/kg was the lowest dosage EMI-137 that allowed for differentiation between PTC and healthy thyroid tissue. The smallest PTC focus detected by MFGI was 1.4 mm. MFGI restaged 80% of patients from unifocal to multifocal PTC compared to ultrasound. Conclusion: EMI-137-guided MFGI and spectroscopy can be used to detect multifocal PTC. This may improve disease staging and treatment selection between hemi- and total thyroidectomy by better differentiation between unifocal and multifocal disease.
KW - Molecular fluorescence–guided imaging
KW - Multifocality
KW - Papillary thyroid cancer
KW - Spectroscopy
UR - https://www.scopus.com/pages/publications/85177792878
U2 - 10.1007/s00259-023-06525-5
DO - 10.1007/s00259-023-06525-5
M3 - Article
C2 - 38017325
AN - SCOPUS:85177792878
SN - 1619-7070
VL - 51
SP - 2384
EP - 2394
JO - European Journal of Nuclear Medicine and Molecular Imaging
JF - European Journal of Nuclear Medicine and Molecular Imaging
IS - 8
ER -