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Patent blue V and indocyanine green for fluorescence microimaging of human peritoneal carcinomatosis using probe-based confocal laser endomicroscopy

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Abstract

Background

Peritoneal carcinomatosis is a metastatic stage aggravating abdominal and pelvic cancer dissemination. The preoperative evaluation of lesions remains difficult today. Probe-based confocal laser endomicroscopy (pCLE) provides dynamic images of tissue architecture and cellular details. This technology allows in vivo histological interpretation of tissue. The main limitation of pCLE for adoption in the clinic is the unavailability of fluorescent contrast agents. The aim of our study was to evaluate the staining performance of indocyanine green and patent blue V for histological diagnosis of pCLE images of pathological and non-pathological peritoneal tissue.

Methods

We performed a correlative study with the histological gold standard on ex vivo human specimens from 25 patients operated for peritoneal carcinomatosis; 70 specimens were stained by topical application with ICG or patent blue V and then imaged with a probe-based confocal laser endomicroscope. A total of 350 pCLE images and 70 corresponding histological sections were randomly and blindly interpreted by two pathologists (PT1 and PT2). The images were first classified into two categories, tumoral versus non-tumoral, and a refined histological diagnosis was then given.

Results

All presented images were interpreted by PT1 (who received prior training on PCLE image reading) and PT2 (no training). 100 % sensitivity for PT1 and PT2 was noticed with tissues stained with ICG to differentiate tumoral and non-tumoral tissue. Global scores were always better for PT1 (major concordance between 86 and 94 %) than for PT2 (major concordance between 77 and 89 %) independently of the fluorescent dye when histological diagnosis was done on pCLE images.

Conclusion

In conclusion, the pair ICG-pCLE offers the best combination for a non-trained pathologist for the interpretation of pCLE images from peritoneum.

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Acknowledgments

The authors wish to thank the Centre de Ressources Biologiques, Irene Villa, and the technicians of the Biopathology Department of Gustave Roussy for the preparation, staining, and scanning of histological samples. The authors thank Maunakea Tech (Paris, France) for the loan of the 785-nm Cellvizio instrument and S. Randall Thomas for his suggestions and corrections to improve the manuscript.

Funding

This work was supported by OSEO-Bpi France (PERSEE Project- Grant I0911038W).

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Authors and Affiliations

  1. Gustave Roussy, Imaging and Cytometry Platform, UMS AMMICa, Université Paris-Saclay, 114, Rue Edouard Vaillant, 94805, Villejuif, France

    Muriel Abbaci, Frederic De Leeuw & Corinne Laplace-Builhé

  2. IR4M, CNRS, Univ. Paris Sud, Université Paris-Saclay, 94805, Villejuif, France

    Muriel Abbaci, Frederic De Leeuw & Corinne Laplace-Builhé

  3. Gustave Roussy, Department of Pathology, Université Paris-Saclay, Villejuif, France

    Peggy Dartigues, Ranya Soufan & Monique Fabre

Authors
  1. Muriel Abbaci
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  2. Peggy Dartigues
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  3. Frederic De Leeuw
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  4. Ranya Soufan
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  6. Corinne Laplace-Builhé
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Corresponding authors

Correspondence to Muriel Abbaci or Corinne Laplace-Builhé.

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Disclosures

Muriel Abbaci, Peggy Dartigues, Frederic De Leeuw, Ranya Soufan, Monique Fabre and Corinne Laplace-Builhé have no conflicts of interest or financial ties to disclose.

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Abbaci, M., Dartigues, P., De Leeuw, F. et al. Patent blue V and indocyanine green for fluorescence microimaging of human peritoneal carcinomatosis using probe-based confocal laser endomicroscopy. Surg Endosc 30, 5255–5265 (2016). https://doi.org/10.1007/s00464-016-4873-2

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