Volume 71, Issue 11 e31293
BRIEF REPORT

Let it glow: Intraoperative visualization of pulmonary metastases using pafolacianine, a next-generation fluorescent agent, for young adults undergoing pulmonary metastasectomy

Alison Lehane

Corresponding Author

Alison Lehane

Northwestern Quality Improvement, Research & Education in Surgery (NQUIRES), Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA

Division of Pediatric Surgery, Department of Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA

Correspondence

Alison Lehane, 225 E. Chicago Ave, Chicago, IL 60611, USA.

Email: [email protected]

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Stephanie F. Polites

Stephanie F. Polites

Division of Pediatric Surgery, Department of Surgery, Mayo Clinic's Children's Center, Mayo Clinic, Rochester, Minnesota, USA

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Ashley Dodd

Ashley Dodd

Division of Pediatric Surgery, Department of Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA

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Seth D. Goldstein

Seth D. Goldstein

Division of Pediatric Surgery, Department of Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA

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Timothy B. Lautz

Timothy B. Lautz

Division of Pediatric Surgery, Department of Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA

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First published: 27 August 2024

Level of Evidence: IV

Abstract

A new generation of disease-specific molecular imaging agents is poised to revolutionize fluorescence-guided surgery. Pafolacianine has been approved for adult lung and ovarian cancers. We demonstrate a proof of concept for pediatric surgeons treating young adults with pulmonary metastatic sarcomas. Five successful fluorescence-guided pulmonary metastasectomy operations were performed in young adult patients with metastatic osteosarcoma or Ewing sarcoma following administration of pafolacianine. All osteosarcoma lesions identified using standard techniques were also markedly fluorescent in patients. Novel fluorescent molecular agents targeted to tumor-specific receptors have promise of increased sensitivity and specificity for detecting metastatic nodules and enhancing surgical clearance of disease.

CONFLICT OF INTEREST STATEMENT

The authors declare no conflicts of interest.

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