Molecular Imaging and Biology

, Volume 18, Issue 2, pp 209–218 | Cite as

Intraoperative Molecular Imaging of Lung Adenocarcinoma Can Identify Residual Tumor Cells at the Surgical Margins

  • Jane J. Keating
  • Olugbenga T. Okusanya
  • Elizabeth De Jesus
  • Ryan Judy
  • Jack Jiang
  • Charuhas Deshpande
  • Shuming Nie
  • Philip Low
  • Sunil SinghalEmail author
Research Article



During lung surgery, identification of surgical margins is challenging. We hypothesized that molecular imaging with a fluorescent probe to pulmonary adenocarcinomas could enhance residual tumor during resection.


Mice with flank tumors received a contrast agent targeting folate receptor alpha. Optimal dose and time of injection was established. Margin detection was compared using traditional methods versus molecular imaging. A pilot study was then performed in three humans with lung adenocarcinoma.


The peak tumor-to-background ratio (TBR) of murine tumors was 3.9. Fluorescence peaked at 2 h and was not improved beyond 0.1 mg/kg. Traditional inspection identified 30 % of mice with positive margins. Molecular imaging identified an additional 50 % of residual tumor deposits (p < 0.05). The fluorescent probe visually enhanced all human tumors with a mean TBR of 3.5.


Molecular imaging is an important adjunct to traditional inspection to identify surgical margins after tumor resection.

Key words

Surgical oncology Molecular imaging Lung cancer Thoracic surgery Folate receptor alpha 



This work was supported by the National Institutes of Health RO1 CA163256.

Conflict of Interest

Dr. Low is a consultant and stakeholder in OnTarget Laboratories LLC. Dr. Nie discloses a relationship as a consultant for Spectropath Inc.


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Copyright information

© World Molecular Imaging Society 2015

Authors and Affiliations

  • Jane J. Keating
    • 1
  • Olugbenga T. Okusanya
    • 1
  • Elizabeth De Jesus
    • 1
  • Ryan Judy
    • 1
  • Jack Jiang
    • 1
  • Charuhas Deshpande
    • 2
  • Shuming Nie
    • 3
  • Philip Low
    • 4
  • Sunil Singhal
    • 1
    • 5
    Email author
  1. 1.Division of Thoracic Surgery, Department of SurgeryUniversity of Pennsylvania and Philadelphia VA Medical CenterPhiladelphiaUSA
  2. 2.Department of Pathology, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaUSA
  3. 3.Departments of Biomedical Engineering and ChemistryEmory UniversityAtlantaUSA
  4. 4.Department of ChemistryPurdue UniversityWest LafayetteUSA
  5. 5.Division of Thoracic SurgeryUniversity of Pennsylvania School of MedicinePhiladelphiaUSA

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