PDF(Pubmed)
Abstract：
UNASSIGNED: Breast-conserving surgery (BCS) is limited by high rates of positive margins and re-operative interventions. Fluorescence-guided surgery seeks to detect the entire lesion in real time, thus guiding the surgeons to remove all the tumor at the index procedure.
UNASSIGNED: Our aim was to identify the optimal combination of a camera system and fluorophore for fluorescence-guided BCS.
UNASSIGNED: A systematic review of medical databases using the terms \"fluorescence,\" \"breast cancer,\" \"surgery,\" and \"fluorescence imaging\" was performed. Cameras were compared using the ratio between the fluorescent signal from the tumor compared to background fluorescence, as well as diagnostic accuracy measures, such as sensitivity, specificity, and positive predictive value.
UNASSIGNED: Twenty-one studies identified 14 camera systems using nine different fluorophores. Twelve cameras worked in the infrared spectrum. Ten studies reported on the difference in strength of the fluorescence signal between cancer and normal tissue, with results ranging from 1.72 to 4.7. In addition, nine studies reported on whether any tumor remained in the resection cavity (5.4% to 32.5%). To date, only three studies used the fluorescent signal for guidance during real BCS. Diagnostic accuracy ranged from 63% to 98% sensitivity, 32% to 97% specificity, and 75% to 100% positive predictive value.
UNASSIGNED: In this systematic review, all the studies reported a clinically significant difference in signal between the tumor and normal tissue using various camera/fluorophore combinations. However, given the heterogeneity in protocols, including camera setup, fluorophore studied, data acquisition, and reporting structure, it was impossible to determine the optimal camera and fluorophore combination for use in BCS. It would be beneficial to develop a standardized reporting structure using similar metrics to provide necessary data for a comparison between camera systems.
UNASSIGNED: Our aim was to identify the optimal combination of a camera system and fluorophore for fluorescence-guided BCS.
UNASSIGNED: A systematic review of medical databases using the terms \"fluorescence,\" \"breast cancer,\" \"surgery,\" and \"fluorescence imaging\" was performed. Cameras were compared using the ratio between the fluorescent signal from the tumor compared to background fluorescence, as well as diagnostic accuracy measures, such as sensitivity, specificity, and positive predictive value.
UNASSIGNED: Twenty-one studies identified 14 camera systems using nine different fluorophores. Twelve cameras worked in the infrared spectrum. Ten studies reported on the difference in strength of the fluorescence signal between cancer and normal tissue, with results ranging from 1.72 to 4.7. In addition, nine studies reported on whether any tumor remained in the resection cavity (5.4% to 32.5%). To date, only three studies used the fluorescent signal for guidance during real BCS. Diagnostic accuracy ranged from 63% to 98% sensitivity, 32% to 97% specificity, and 75% to 100% positive predictive value.
UNASSIGNED: In this systematic review, all the studies reported a clinically significant difference in signal between the tumor and normal tissue using various camera/fluorophore combinations. However, given the heterogeneity in protocols, including camera setup, fluorophore studied, data acquisition, and reporting structure, it was impossible to determine the optimal camera and fluorophore combination for use in BCS. It would be beneficial to develop a standardized reporting structure using similar metrics to provide necessary data for a comparison between camera systems.
摘要：
■保乳手术（BCS）受到高切缘率和再次手术干预的限制。荧光引导手术旨在实时检测整个病变，从而指导外科医生在索引程序中切除所有肿瘤。
■我们的目的是确定用于荧光引导的BCS的相机系统和荧光团的最佳组合。
■使用术语“荧光，乳腺癌,\"\"手术,进行了\"和\"荧光成像\"。使用来自肿瘤的荧光信号与背景荧光之间的比率来比较相机，以及诊断准确性措施，比如灵敏度，特异性，和阳性预测值。
■21项研究使用9种不同的荧光团确定了14种相机系统。十二台摄像机在红外光谱中工作。十项研究报道了癌症和正常组织之间荧光信号强度的差异，结果从1.72到4.7。此外,9项研究报道了切除腔内是否存在肿瘤(5.4%~32.5%).迄今为止,只有三项研究在真实BCS期间使用荧光信号进行指导。诊断准确率从63%到98%的灵敏度，32%至97%的特异性，和75%至100%的阳性预测值。
■在这篇系统综述中，所有研究均报道了使用各种相机/荧光团组合的肿瘤和正常组织之间的信号存在临床显着差异.然而,考虑到协议的异质性，包括相机设置，研究荧光团，数据采集,和报告结构，无法确定用于BCS的最佳相机和荧光团组合。使用类似度量来开发标准化报告结构以提供用于相机系统之间的比较的必要数据将是有益的。
■我们的目的是确定用于荧光引导的BCS的相机系统和荧光团的最佳组合。
■使用术语“荧光，乳腺癌,\"\"手术,进行了\"和\"荧光成像\"。使用来自肿瘤的荧光信号与背景荧光之间的比率来比较相机，以及诊断准确性措施，比如灵敏度，特异性，和阳性预测值。
■21项研究使用9种不同的荧光团确定了14种相机系统。十二台摄像机在红外光谱中工作。十项研究报道了癌症和正常组织之间荧光信号强度的差异，结果从1.72到4.7。此外,9项研究报道了切除腔内是否存在肿瘤(5.4%~32.5%).迄今为止,只有三项研究在真实BCS期间使用荧光信号进行指导。诊断准确率从63%到98%的灵敏度，32%至97%的特异性，和75%至100%的阳性预测值。
■在这篇系统综述中，所有研究均报道了使用各种相机/荧光团组合的肿瘤和正常组织之间的信号存在临床显着差异.然而,考虑到协议的异质性，包括相机设置，研究荧光团，数据采集,和报告结构，无法确定用于BCS的最佳相机和荧光团组合。使用类似度量来开发标准化报告结构以提供用于相机系统之间的比较的必要数据将是有益的。
