Peer-reviewed veterinary case report
Fluorescent dye helps guide soft tissue sarcoma surgery in dogs
By Beer, Patricia et al.·Published in European journal of nuclear medicine and molecular imaging·2025·Clinic for Small Animal Surgery·View original on PubMed →
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Original publication title: Evaluation of a targeted anti-αβintegrin near-infrared fluorescent dye for fluorescence-guided resection of naturally occurring soft tissue sarcomas in dogs.
- Species:
- dog
Plain-English summary
A group of 20 dogs with soft tissue sarcomas (STS) underwent surgery to remove their tumors, with half receiving a special fluorescent dye called Angiostamp800 to help surgeons see the cancer better during the procedure. The dye worked well, as it highlighted all tumors in the treated dogs, allowing for more precise removal. In fact, the surgery was more successful in the dye group, with fewer cases of leftover cancer after surgery. While there was one cancer-related death in the dye group, overall, the use of this fluorescent dye improved the chances of complete tumor removal, which is crucial for better survival rates.
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Abstract
PURPOSE: Complete resection is a key prognostic factor for survival in patients with soft tissue sarcoma (STS), in humas and companion animals alike. Fluorescence-guided surgery could improve resection accuracy. As dogs are frequently affected by STS, they serve as a model to test an anti-αβintegrin targeting near-infrared fluorescent (NIRF) dye (Angiostamp800) for fluorescence-guided surgery in STS to evaluate its safety and feasibility in dogs, and if it translates into a clinically relevant benefit compared to the standard of care with regards to completeness of surgery and local recurrence. Furthermore, we aimed to correlate target expression and NIRF-signal intensity. METHODS: Twenty dogs with STS were randomly allocated to either receive Angiostamp™ (NIRF group) or physiologic saline (control group) preoperatively. The researchers were blinded for treatment, and resections were adapted based on the NIRF-signal, if needed. Margin status was histologically determined at the 1 and 3 cm margin. The tumor-to-background ratio was measured in native tissue biopsies and formalin-fixed tissue. The fluorescent area was compared to the corresponding tumor areas as confirmed by histology using the Dice coefficient. Target expression was quantified by immunohistochemistry and correlated to NIRF-signal ratios. RESULTS: A fluorescent signal was detected in all 10 tumors of the NIRF group, with a tumor-to-background ratio of 7.4 ± 5.8 in native biopsies and 13.5 ± 10.9 in formalin-fixed tissue. In the NIRF group, resection margins were adapted in 5/10 cases, leading to complete resection and preventing R1 in four of these cases. In the NIRF and control group 9/10 and 8/10 resections were R0, with one local recurrence in each group and one sarcoma-related death in the NIRF group. The NIRF-signal correlated with the histologically confirmed tumor area (Dice coefficient 0.75 ± 0.17). Target expression was higher in tumor compared to peritumoral tissue (p < 0.0003) and showed a moderate correlation with the NIRF-signal (r = 0.6516, p < 0.0001). CONCLUSION: Fluorescence-guided surgery using Angiostamp™ can pinpoint residual disease in the tumor bed and contributes to an improved resection accuracy in canine STS.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/39436437/