PET:The Merging of Biology and Imaging into Molecular Imaging
Molecular Imaging for Cancer Visualization
Transcript of Molecular Imaging for Cancer Visualization
Molecular Imaging for Cancer Visualization
American College of Surgeons
Surgical Simulation Summit Chicago, IL
March 16-17, 2018
Michael Bouvet, MD Professor of Surgery
University of California San Diego San Diego VA Medical Center
MolecularImagingforCancerVisualization-Outline
• Preclinicalmousemodels• Optionsformolecularimagingoftumors• Currenttechnologyforfluorescenceguidedsurgerythatisavailableintheclinic
• Futuredirections
Primary Pancreatic Tumor
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40 46 50 57 64
Spleen Metastasis
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40 46 50 57 64
Bowel Metastasis
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40 46 50 57 64
Omental Metastasis
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40 46 50 57 64
- Bouvet M, Wang J, Nardin SR, Nassirpour R, Yang M, Baranov E, Jiang P, Moossa AR, Hoffman RM. Real-time optical imaging of primary tumor growth and multiple metastatic events in a pancreatic cancer orthotopic model. Cancer Research 62(5):1534-1540, 2002.
HumanizationofAnti-CEAAntibody(M5A)
Yazaki et al. PEDS 2004
CDR grafting onto Herceptin framework
Dr Paul Yazaki City of Hope,
Beckman Research Institute
PET Imaging Using 64Cu-M5A Anti-CEA mAb
55 yo M T3N1 rectal cancer with small lung mets and circulating CEA levels of 142. FDG-PET uptake in large primary tumor and peri-rectal nodes.
FOLFOX x 8 with reduction of primary, no change in lung mets (felt benign), and CEA normal.
Neoadjuvant chemo-radiotherapy: 54 Gy + capecitabine.
64Cu-M5A scan at 7 weeks post RT – primary and nodal uptake at 24 and 48 hours Surgical resection of primary planned
Cetuximab-IRDye800formultimodalityopticalimaging:Potentialforguidingsurgical
therapyandpathologicalanalysis
EbenRosenthal,MD
From: Bouvet M, Hoffman RM. Laparoscopic fluorescence imaging for identification and resection of pancreatic and hepatobiliary cancer. In: Kokudo N, Ishizawa T (eds.), Fluorescence Imaging: Treatment of Hepatobiliary and Pancreatic Diseases. Front Gastrointest Res. Basel, Karger, 2013, vol 31, pp. 92-99.
ParathyroidectomywithICG
• 17yofemale• Calcium11.9• PTH113• Kidneystones• Bonepain• Sestamibiscanandultrasoundwerenegative
ParathyroidectomywithICG
• 17yofemale• Calcium11.9• PTH113• Kidneystones• Bonepain• Sestamibiscanandultrasoundwerenegative
Conclusions
• Curativesurgeryisdependentonremovingallprimaryandmetastaticcancercells
• Techniquesinfluorescenceguidedsurgery(FGS)areemergingthatselectivelyilluminatecancercells
• FGSenhancestumordetection,surgicalnavigation,marginconfirmation,andinsomecasescanbecombinedwiththerapeutictechniquestoeliminatemicroscopicdisease
Acknowledgements • Bouvet lab
– John DeLong – Thinzar Helmi Lwin – Jeong Youp Park – Ho Kyoung Hwang – Siamak Amirfahkri
• Funding – NIH/NCI – American Cancer Society – VA Merit Review – Leo and Anne Albert Trust – Intuitive Surgical Research Grant
• City of Hope – John C. Williamson – Gagandeep “Gaugs” Singh – Paul Yazaki
• AntiCancer, Inc – Robert M Hoffman – Takashi Murakami – Yukihiko Hiroshima – Sang Nam Yoon
• University of Nebraska – Surinder Batra