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K. Orihashi
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P1.02 - Biology/Pathology (ID 614)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Biology/Pathology
- Presentations: 1
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P1.02-034 - Non-Invasive Qualitative Diagnosis of Lung Cancer Enabled by Spectrum Analysis of Ultrasound (ID 9376)
09:30 - 16:00 | Author(s): K. Orihashi
- Abstract
Background:
Ultrasound has been widely utilized in clinical to visualize the internal structure of the objective non-invasively. However ultrasound image can’t distinguish malignant lesion from the normal tissue. Spectrum analysis of ultrasound is a newly developed technology which may reflect on the histological feature. We examine if the spectrum analysis is able to distinguish malignant tissue from normal tissue.
Method:
Spectrum was measured using a prototype ultrasound processor EUME5 given by Olympus Japan. three parameters of spectrum such as Midband-fit(M), Intercept(I), and Slope(S) were measured for the objective tissue. In animal study, human lung cancer Xenograft were created in nude mice for each lung cancer cell line (A549, H460, HCC827, and H3122). In clinical setting, surgically excised lungs including lung cancers were examined spectrum analysis for both lung cancers (n=19, 106 slices) and normal lungs (n=17, 65 slices).
Result:
Four different Xenografts exhibited significant differences of spectrum data. In the clinical study, the mean value of M, I and S of both lung cancers and normal lungs were M: -43.22 ±4.09 vs -39.31±3.87(p<0.01,) I: -55.28±3.19 vs -54.13±2.4 (N.S), S: -1.43±0.35 vs -1.73±0.30 (p<0.01)
Conclusion:
Each lung cancer Xenograft of different histology showed different spectrum value. Spectrum analysis is likely to reflect the histological feature. In clinical, M and S showed statistically different values between lung cancer and normal lung. Based on spectrum value, a malignant tumor can be distinguished from the normal lung in the ultrasound image.
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P1.12 - Pulmonology/Endoscopy (ID 698)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Pulmonology/Endoscopy
- Presentations: 1
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P1.12-003 - Photothermal Ablation of Lung Cancer by Low Power Near-Infrared Laser and Topical Injection of Indocyanine Green; A Preliminary Animal Study (ID 8994)
09:30 - 16:00 | Author(s): K. Orihashi
- Abstract
Background:
Surgical resection by lobectomy with systematic lymph node dissection is the gold standard of treatment for early stage non-small cell lung cancer. However, minimally invasive tumor ablation can be an alternative treatment for patients not eligible for surgery due to comorbidities. The present study was designed to evaluate the efficacy of photothermal ablation therapy for lung cancer by low power near-infrared laser and topical injection of Indocyanine green (ICG).
Method:
6 New Zealand white rabbits were employed for the study. Tumor suspension containing VX2 cancer cells with growth factor reduced Matrigel was inoculated into the lung using an ultrathin bronchoscope. 3 rabbits were treated by laser ablation therapy with topical injection of ICG. Another 3 rabbits were treated by laser ablation alone. All tumors were irradiated with a laser with 500 mW output at 808 nm for 15 min. The tumors were examined histopathologically to assess the ablated areas.
Result:
Figure 1The maximum surface temperature of the tumor in rabbits treated by ICG/laser and laser alone were more than 58°C and less than 40°C, respectively. The ablated areas in the rabbits using ICG/laser were statistically larger than those in the rabbits using laser alone (ICG/laser: 0.49±0.27 cm[2] vs laser alone: 0.02±0.002 cm[2]) (p < 0.05).
Conclusion:
We clarified the efficacy of the photothermal treatment by low power near-infrared laser and topical injection of ICG using a rabbit VX2 orthotopic lung cancer model. This system may be able to be applied for transbronchial laser ablation of peripheral lung cancers.
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P1.16 - Surgery (ID 702)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Surgery
- Presentations: 1
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P1.16-026 - Multimodal Image-Guided VATS Resection of Sub-Centimeter Pulmonary Nodules by Cone Beam CT and Bronchoscopic NIR Fluorescence Marking (ID 9222)
09:30 - 16:00 | Author(s): K. Orihashi
- Abstract
Background:
Small-sized pulmonary nodules such as ground grass nodule and metastatic nodules are difficult to identify the localization during video-assisted thoracic surgery (VATS). The authors have developed the bronchoscopic indocyanine green fluorescence (ICG-FL) marking of small-sized pulmonary nodules to localize them durging VATS. The ICG-FL marking have some advantages. Near infra-red (NIR) light has excellent tissue penetrating property so that the ICG-FL marked in the lung parenchyma can be detected from the surface of lung with ICG-FL detecting thoracoscope. Also, NIR fluorescence spectrum can be isolated from the visible color spectrum so that ICG-FL can be detected with high sensitivity regardless of the color tone of the background lung. In the current study, taking advantage of the hybrid operating room (Hybrid OR), all procedures such as navigation bronchoscopic injection of ICG, real-time image-guidance by cone beam CT, intraoperative detection of ICG-FL and VATS wedge resection were performed all at one time under general anesthesia. The purpose of the current study was the validation of the presenting procedure in terms of the accuracy of localization, the surgical invasiveness, and operation time.
Method:
The patients with sub-centimeter pulmonary nodules which were diagnosed as the indication of video-assisted wedge pulmonary resection were enrolled in the study (n=5). At Hybrid OR under general anesthesia, thin bronchoscope was inserted into the peripheral bronchus which lead to the pulmonary nodule. Virtual bronchoscopy navigation was utilized to increase the accuracy of bronchoscopy. Transbronchial aspiration cytology (TBAC) needle was inserted to peripheral bronchus adjucent to the pulmonary nodule. After confirming the location of TBAC needle by Cone beam CT, the 0.05mL of 0.025mg/mL of ICG mixed with iopamidol was injected into lung parenchyma. During VATS resection, the infra-red fluorescence spot of ICG adjucent to the pulmonary nodules were visualized by ICG-FL thoracoscopy (Pin-point, Novadaq. Canada). The successful pulmonary resection was confirmed with macro- and microscopic examination during surgery.
Result:
ICG-FL marking was successful in all 5 cases 8 lesions without any complication. All tumors were successfully excised with the sufficient surgical safety margin. No adverse events were experienced throughout the entire study.
Conclusion:
Cone-beam CT in Hybrid OR can increase the accuracy of bronchoscopic ICG-FL marking. Multimodal cone-beam CT-guided bronchoscopic ICG-FL marking is a precise method to excise the multiple, small-sized pulmonary noddules by minimally invasive thoracic surgery.
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P2.05 - Early Stage NSCLC (ID 706)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Early Stage NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P2.05-010 - Changes between Pre- and Post-Operative AICS (Lung) in NSCLC Patients: Predictability of High-Risk Cases with Recurrence (ID 7915)
09:30 - 16:00 | Author(s): K. Orihashi
- Abstract
Background:
Plasma free amino acid (PFAA) levels are known to change in patients with malignant diseases. We have developed AminoIndex[TM] Cancer Screening (AICS[TM]) using “AminoIndex Technology”, which is a multivariate analysis of PFAA concentrations in various cancer patients and healthy controls. In Japan, AICS[TM] is now commercially available for simultaneous screening of seven cancer types, including lung cancer. The lung cancer specific AICS [AICS (lung)] are classified as rank A (AICS values: 0.0–4.9), rank B (5.0–7.9), or rank C (8.0–10.0); the closer to rank C, the higher risk of lung cancer. The aim of this study was to evaluate post-operative changes of AICS (lung) in patients who underwent curative surgical resection for lung cancer, as well as the associations of these changes with post-operative cancer recurrence.
Method:
The subjects were lung cancer patients with pre-operative AICS (lung) rank B-C, 44 patients (rank C; 29 cases, B; 15 cases) who underwent surgical curative resection. The pathological stage was 29 stage I, 8 stage II and 7 stage III. AICS (lung) was measured within 1 week prior to surgery and from 1.2 to 5.5 years after surgery, and the relationship between fluctuation before and after surgery and post-operative recurrence was analyzed.
Result:
Post-operative AICS (lung) ranks and values decreased in 52% (23/44) and 82% (36/44), respectively. For the pre-operative AICS (lung) rank C patients, post-operative AICS (lung) ranks and values decreased in 52% (15/29) and 86% (25/29), respectively. All 12 patients who had recurrence had a pre-operative AICS (lung) rank C. Among the 7 patients had recurred at the time of post-operative AICS (lung) measurement, 6 patients remained AICS (lung) rank C after surgery and 1 patient was rank B after surgery. On the other hand, among 5 patients in which recurrence was observed after post-operative AICS (lung) measurement, 4 patients remained post-operative AICS (lung) rank C and only 1 patient was rank B.
Conclusion:
Most patients had a decrease in the AICS (lung) rank and value after curative surgical resection. However, ten of 15 patients who had both pre- and post-operative AICS (lung) rank C had recurrence after surgery, suggesting the association between pre- and post-operative change in AICS (lung) and recurrence after lung cancer surgery. Pre- and Post-operative AICS (lung) measurement may be able to predict high-risk cases with post-operative cancer recurrent.
