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However, identification of tumor cells in the resection margins is difficult, resulting in nonradical resections, increased cancer recurrence and subsequent decreased patient survival. Novel imaging techniques that aid in demarcating tumor margins during surgery are needed. Overexpression of carcinoembryonic antigen (CEA) is found in the majority of gastrointestinal carcinomas, including colorectal and pancreas. We developed ssSM3E\/800CW, a novel CEA\u2010targeted near\u2010infrared fluorescent (NIRF) tracer, based on a disulfide\u2010stabilized single\u2010chain antibody fragment (ssScFv), to visualize colorectal and pancreatic tumors in a clinically translatable setting. The applicability of the tracer was tested for cell and tissue binding characteristics and dosing using immunohistochemistry, flow cytometry, cell\u2010based plate assays and orthotopic colorectal (HT\u201029, well differentiated) and pancreatic (BXPC\u20103, poorly differentiated) xenogeneic human\u2013mouse models. NIRF signals were visualized using the clinically compatible FLARE\u2122 imaging system. Calculated clinically relevant doses of ssSM3E\/800CW selectively accumulated in colorectal and pancreatic tumors\/cells, with highest tumor\u2010to\u2010background ratios of 5.1\u2009\u00b1\u20090.6 at 72 hr postinjection, which proved suitable for intraoperative detection and delineation of tumor boarders and small (residual) tumor nodules in mice, between 8 and 96 hr postinjection. <jats:italic>Ex vivo<\/jats:italic> fluorescence imaging and pathologic examination confirmed tumor specificity and the distribution of the tracer. Our results indicate that ssSM3E\/800CW shows promise as a diagnostic tool to recognize colorectal and pancreatic cancers for fluorescent\u2010guided surgery applications. If successfully translated clinically, this tracer could help improve the completeness of surgery and thus survival.<\/jats:p>","DOI":"10.1002\/ijc.29571","type":"journal-article","created":{"date-parts":[[2015,4,20]],"date-time":"2015-04-20T12:38:56Z","timestamp":1429533536000},"page":"1910-1920","source":"Crossref","is-referenced-by-count":58,"title":["Preclinical evaluation of a novel <scp>CEA<\/scp>\u2010targeting near\u2010infrared fluorescent tracer delineating colorectal and pancreatic tumors"],"prefix":"10.1002","volume":"137","author":[{"given":"Martin C.","family":"Boonstra","sequence":"first","affiliation":[{"name":"Department of Surgery Leiden University Medical Center Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berend","family":"Tolner","sequence":"additional","affiliation":[{"name":"Department of Oncology Royal Free &amp; University College Medical School London United 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