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Experimental study on fluorescent microspheres as a tracer for sentinel node detection.
Hideaki Ueno1, Jun Hihara, Katsuhiko Shimizu
1Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan. hihara@hiroshima-u.ac.jp
Anticancer Research
|May 5, 2005
Summary
Fluorescent microspheres offer a novel, feasible method for sentinel lymph node detection in cancer surgery, overcoming limitations of traditional tracers like blue dye and technetium-99m colloids. This technique shows promise for improved navigation, particularly in challenging cases like esophageal and lung cancer.
Area of Science:
- Oncology
- Surgical Navigation
- Biomedical Imaging
Background:
- Traditional sentinel node tracers (blue dye, Tc-99m colloids) have limitations in specific cancers like esophageal and lung due to anthracotic pigmentation and injection site artifacts.
- Blue dye is ineffective for mediastinal nodes in esophageal/lung cancer patients.
- Tc-99m colloids require specialized facilities and can obscure nearby sentinel nodes.
Purpose of the Study:
- To investigate the efficacy and safety of fluorescent microspheres as novel tracers for sentinel node navigation surgery.
- To overcome the limitations of current tracers in detecting sentinel nodes, especially in the mediastinum.
Main Methods:
- Fluorescent microspheres (0.1-20 µm) were evaluated in rat models for systemic and local side-effects and lymphatic pathway tracing.
- In pigs, microspheres were injected into various gastrointestinal and esophageal tissues (submucosa, subadventitia, subserosa).
- Detection of fluorescence-positive lymph ducts and nodes was performed using ultraviolet light irradiation.
Main Results:
- No systemic side-effects were observed in rats.
- Mild local edema and inflammation were noted in rats.
- Fluorescent microspheres (0.1, 0.5, 1.0 µm) were successfully detected in pig lymph ducts/nodes within one hour post-injection.
Conclusions:
- Sentinel node navigation surgery using fluorescent microspheres is potentially feasible and advantageous.
- This method shows particular promise for esophageal and lung cancer patients, especially for mediastinal lymph node identification.