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Molecular fluorescence-guided surgery of peritoneal carcinomatosis of colorectal origin: a single-centre feasibility study Niels J Harlaar, MD, Marjory Koller, MD, Steven J de Jongh, MD, Barbara L van Leeuwen, MD, Patrick H Hemmer, MD, Schelto Kruijff, MD, Robert J van Ginkel, MD, Lukas B Been, MD, Johannes S de Jong, MD, Gursah Kats-Ugurlu, MD, Matthijs D Linssen, PharmD, Annelies Jorritsma-Smit, PharmD, Marleen van Oosten, MD, Wouter B Nagengast, MD, Prof Vasilis Ntziachristos, PhD, Prof Gooitzen M van Dam, MD The Lancet Gastroenterology & Hepatology Volume 1, Issue 4, Pages (December 2016) DOI: /S (16) Copyright © 2016 Elsevier Ltd Terms and Conditions
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Figure 1 Intraoperative imaging by white light imaging, molecular fluorescence-guided surgery, and overlay images Intraoperative detection of a peritoneal metastasis detected by visual inspection and palpation (A; arrow) and fluorescence-guided surgery (B and C; arrow). In the same patient, fluorescence detection of a tumour-positive resection surface of a recurrent sigmoid carcinoma (E, F; arrow) that was initially missed by visual inspection and palpation alone (D); the fluorescent dye excreted by the kidney within the ureter (triangle) is also depicted. (G–I) After resection of a para-aortal lymph node, three small fluorescent spots were detected in adjacent metastatic lymph nodes. (J–L) A clinically suspicious but non-fluorescent benign lesion (arrow), which was confirmed by histopathology. A video of the procedure is available online (see web video). The Lancet Gastroenterology & Hepatology 2016 1, DOI: ( /S (16) ) Copyright © 2016 Elsevier Ltd Terms and Conditions
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Figure 2 Mean fluorescent intensity of tissue slides
The cutoff mean fluorescent intensity value for the tumour versus non-tumour was set at 1298 (dotted line). Lesions indicated as false positives (n=8) were due to foreign body material such as previous suturing material or highly fibrotic and vascularised lesions. Patient samples of peritoneal metastases taken before tracer injection were included as control specimen for tumour (n=4) and non-tumour lesions (n=3). The Lancet Gastroenterology & Hepatology 2016 1, DOI: ( /S (16) ) Copyright © 2016 Elsevier Ltd Terms and Conditions
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