IRDye800CW-BBN PET-NIRF Imaging Guiding Surgery in Patients With Lower Grade Glioma

Lower grade gliomas (WHO grades II and III) are currently diffused disease with variability of tumor behaviors and of challenge to distinguish the margins in white-light microscope during the surgery. An integrated dual-modality approach combining preoperative positron emission tomography imaging with intraoperative optical guidance that target the same tumor biomarker would be of grade help to solve this problem. BBN, with the amino acid sequence of Gln-Trp-Ala-Val-Gly-His-Leu-Met-NH2, has been extensively used for the development of molecular probes for the imaging of gastrin-releasing peptide receptor (GRPR), a member of the G protein-coupled receptor family of bombesin receptors that over-expressed in various types of cancer cells including glioma. For interests in clinical translation of GRPR targeting dual modality probe, an open label dual modality imaging PET/ NIRF study was designed to investigate the imaging guiding performance in lower grade glioma patients. To investigate whether the preoperative PET with BBN can predict the success of the fluorescence guided surgery with same peptide intraoperatively. The sensitivity, specificity and accuracy of fluorescence guided sampling intraoperatively according to the final pathology will be assessed as well.

Inclusion criteria

• Must be able to provide a written informed consent
• suspected lower grade gliomas on contrast-enhanced MRI

Exclusion criteria

• Consisted of conditions of mental illness
• Severe liver or kidney disease with serum creatinine > 3.0 mg/dl (270 μΜ)
• Any hepatic enzyme level 5 times or more than normal upper limit
• Severe allergy or hypersensitivity to IV radiographic contrast
• Claustrophobia to accept the PET/CT or PET/MRI scanning
• Pregnancy or breast feeding