New whole-body multimodality imaging of gastric cancer peritoneal metastasis combining fluorescence imaging with ICG-labeled antibody and MRI in mice

• Published in: Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association Vol. 17; no. 3; pp. 497 - 507
• Main Authors: Ito, Akihiro, Ito, Yuichi, Matsushima, Shigeru, Tsuchida, Daisuke, Ogasawara, Mai, Hasegawa, Junichi, Misawa, Kazunari, Kondo, Eisaku, Kaneda, Norio, Nakanishi, Hayao
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 2014; Springer Nature B.V
• Subjects: Abdominal Surgery; Animals; Antibodies, Monoclonal; Cancer Research; Carcinoembryonic Antigen - immunology; Gastric cancer; Gastroenterology; Humans; Imaging, Three-Dimensional - methods; Indocyanine Green; Magnetic Resonance Imaging - methods; Male; Medicine; Medicine & Public Health; Mice; Mice, Nude; Neoplasm Staging; Oncology; Optical Imaging - methods; Original Article; Peritoneal Neoplasms - diagnosis; Peritoneal Neoplasms - secondary; Receptor, Epidermal Growth Factor - immunology; Sensitivity and Specificity; Stomach Neoplasms - pathology; Surgical Oncology; Molecular imaging; Fluorescence imaging; Multimodality imaging; MRI; Peritoneal metastasis; ICG; Cetuximab; NIR-fluorophore; Gastric cancer; CEA
• ISSN: 1436-3291; 1436-3305
• DOI: 10.1007/s10120-013-0316-0

Background Peritoneal metastasis is the most frequent pattern of recurrence after curative surgery for gastric cancer. However, such a recurrence is difficult to detect by conventional computed tomography (CT) and magnetic resonance imaging (MRI) at an early stage. To improve the sensitivity and specificity of diagnostic imaging for peritoneal metastasis, we developed a new type of multimodality imaging combining fluorescence imaging with near-infrared fluorophore (NIR)-labeled antibodies and MRI. Methods Dual optical imaging of peritoneal metastasis was carried out using luciferase-tagged gastric cancer cell lines and XenoLight CF750 or indocyanine green (ICG)-labeled anti-human epidermal growth factor receptor (EGFR) or CEA antibody as a probe in mice with Ivis in vivo imaging system. Results This whole-body fluorescent imaging system sensitively detected metastatic foci <1 mm in diameter in the peritoneal cavity noninvasively. Fluorescence imaging proved to be specific because the fluorescence signal was abolished by blocking with excess unlabeled antibody. Although this fluorescence imaging had higher sensitivity for detection of small-sized peritoneal metastases than MRI, it proved difficult to accurately determine organ distribution of the metastasis. We thus developed a multimodality imaging system by the fusion of the three-dimensional fluorescence image with the MRI image and demonstrated its improved diagnostic accuracy over either method alone. Conclusion The present results suggest that multimodality imaging consisting of fluorescence imaging with NIR-labeled EGFR or CEA antibody and MRI allows sensitive, specific, and anatomically accurate detection of peritoneal metastasis noninvasively at an early stage.