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High-grade gliomas (HGG) are the most common and most aggressive primary tumors of the brain. Despite recent advances in neuro-oncology survival of these tumors remains around 12-15 months. The first-line of treatment is surgical resection. However, due to its infiltrative nature maximal safe resection leaves residual invasive cancer cells that lead to disease recurrence. Most recurrences are in or near the resection cavity. Advances in optical imaging techniques might aid better delineation of the invasive margin intraoperatively. However as of yet most of these technologies have failed to do so consistently. Recently, alterations in fatty acid metabolism have been linked to the initiation, progression, and recurrence of gliomas. These alterations might provide a novel target for better differentiation of glioma cells and healthy brain tissue. To exploit this, we introduce and test a novel, near-infrared, fluorescent dye, fatty-acid indocyanine green (FA-ICG) in vitro and in vivo. We hypothesize that the combination of targeting mechanism, and the near-infrared properties make FA-ICG a promising candidate for further clinical translation in fluorescence-guided surgery.
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Rolf Gruetter, Cristina Ramona Cudalbu, Bernard Lanz, Mor-Miri Mishkovsky, Jocelyne Bloch, Arnaud Comment