ABSTRACT OF THE WEEK

Veterinary surgery : VS : the official journal of the American College of Veterinary Surgeons
Volume 45 | Issue 6 (August 2016)

A Novel Imaging System Distinguishes Neoplastic from Normal Tissue During Resection of Soft Tissue Sarcomas and Mast Cell Tumors in Dogs.

Vet Surg. August 2016;45(6):715-22.

Suzanne Bartholf DeWitt¹, William C Eward², Cindy A Eward³, Alexander L Lazarides⁴, Melodi Javid Whitley⁵, Jorge M Ferrer⁶, Brian E Brigman⁷, David G Kirsch⁸, John Berg⁹

¹ Duke University Medical Center, Durham, North Carolina.; ² Duke University Medical Center, Durham, North Carolina.; ³ Veterinary Specialty Hospital of the Carolinas, Cary, North Carolina.; ⁴ Duke University Medical Center, Durham, North Carolina.; ⁵ Duke University Medical Center, Durham, North Carolina.; ⁶ Lumicell, Inc., Wellesley, Massachusetts.; ⁷ Duke University Medical Center, Durham, North Carolina.; ⁸ Duke University Medical Center, Durham, North Carolina.; ⁹ Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts.

Abstract

OBJECTIVE:To assess the ability of a novel imaging system designed for intraoperative detection of residual cancer in tumor beds to distinguish neoplastic from normal tissue in dogs undergoing resection of soft tissue sarcoma (STS) and mast cell tumor (MCT).

STUDY DESIGN:Non-randomized prospective clinical trial.

ANIMALS:12 dogs with STS and 7 dogs with MCT.

METHODS:A fluorescent imaging agent that is activated by proteases in vivo was administered to the dogs 4-6 or 24-26 hours before tumor resection. During surgery, a handheld imaging device was used to measure fluorescence intensity within the cancerous portion of the resected specimen and determine an intensity threshold for subsequent identification of cancer. Selected areas within the resected specimen and tumor bed were then imaged, and biopsies (n=101) were obtained from areas that did or did not have a fluorescence intensity exceeding the threshold. Results of intraoperative fluorescence and histology were compared.

RESULTS:The imaging system correctly distinguished cancer from normal tissue in 93/101 biopsies (92%). Using histology as the reference, the sensitivity and specificity of the imaging system for identification of cancer in biopsies were 92% and 92%, respectively. There were 10/19 (53%) dogs which exhibited transient facial erythema soon after injection of the imaging agent which responded to but was not consistently prevented by intravenous diphenhydramine.

CONCLUSION:A fluorescence-based imaging system designed for intraoperative use can distinguish canine soft tissue sarcoma (STS) and mast cell tumor (MCT) tissue from normal tissue with a high degree of accuracy. The system has potential to assist surgeons in assessing the adequacy of tumor resections during surgery, potentially reducing the risk of local tumor recurrence. Although responsive to antihistamines, the risk of hypersensitivity needs to be considered in light of the potential benefits of this imaging system in dogs.

Article Tools:

Medline

Email to me

Grants:

T32 GM007171 GM NIGMS NIH HHS
U43 CA165024 CA NCI NIH HHS

Archives Highlights:

Left hind limb lameness in a 13-month-old spayed female German Shepherd Dog.
This case report discusses medial epiphyseal artery occlusion that resulted in osteonecrosis and collapse of the femoral head.

Acute onset of circling and dull mentation in a 1-year-old male neutered domestic shorthair cat.
CNS cuterebriasis represents a neurologic disease more common in cats than dogs, resulting in presentation during summer months with acute onset and often asymmetric, focal or multifocal, intracranial signs preceded by upper respiratory disease.

Head and dental injuries among farriers and hoof care practitioners: A nationwide survey in Switzerland.
Head/face injuries were more frequently reported by farriers than hoof care practitioners (60.6% and 20.7%, respectively). The rate of dental injuries, mainly related to a horse kick, was 11.1% and 1.9% among farriers and hoof care practitioners, respectively. Negligence in wearing mandatory eye protection was reported by 37.5% of respondents.

Delayed embryonic development or a long sperm survival in two mares-A registration conundrum.
Donor mares were inseminated with semen from one stallion during one oestrous cycle and semen from a different stallion on the subsequent oestrous cycle. Embryo(s) were collected 8?days after ovulation during the second oestrous cycle and transferred into synchronised recipient mares. Genetic testing was performed to determine parentage of the two foals. For both foals, DNA parentage testing excluded the second stallion as the genetic sire and confirmed that the first stallion, whose semen was inseminated on the previous oestrous cycle, was the actual genetic sire.

'Brave Enough': A Qualitative Study of Veterinary Decisions to Withhold or Delay Antimicrobial Treatment in Pets.
The use of antimicrobials by companion animal veterinarians in the absence of a clear indication is often powerfully driven by behavioural beliefs, chiefly, fears of clinical deterioration and of failing to meet client expectations.