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Multispectral Real-time Fluorescence Imaging for Intraoperative Detection of the Sentinel Lymph Node in Gynecologic Oncology
Published on: October 20, 2010
Image-guided oncologic surgery using invisible light: completed pre-clinical development for sentinel lymph node
Eiichi Tanaka1, Hak Soo Choi, Hirofumi Fujii
1Division of Hematology/Oncology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
Annals of Surgical Oncology
|September 30, 2006
Summary
Near-infrared (NIR) fluorescence imaging enables real-time surgical guidance for sentinel lymph node (SLN) mapping in melanoma. This pre-clinical study shows promising results with novel tracers, potentially replacing radioactive methods in future human trials.
Area of Science:
- Oncology
- Medical Imaging
- Nanotechnology
Background:
- Near-infrared (NIR) fluorescence imaging offers high-sensitivity, real-time guidance in oncologic surgery without altering the surgical field's appearance.
- Pre-clinical development of NIR fluorescence technology for sentinel lymph node (SLN) mapping was conducted using a large animal model of spontaneous melanoma.
Purpose of the Study:
- To complete pre-clinical development of NIR fluorescence-guided SLN mapping.
- To evaluate different NIR tracers for their efficacy in SLN identification.
- To provide insights for optimizing imaging systems and tracer selection for future clinical applications.
Main Methods:
- Sinclair swine with spontaneous melanoma and regional lymph node metastasis were utilized.
- Tested tracers included indocyanine green-HSA, CW800-HSA, and NIR quantum dots.
- Peri-tumoral injections of tracers were administered, followed by real-time SLN mapping and image-guided resection.
Main Results:
- All 12 injections successfully identified SLNs and lymphatic channels within 1 minute (100% success rate).
- Effective SLN mapping was achieved despite highly pigmented skin and black fur.
- Tracer hydrodynamic diameter significantly influenced in vivo behavior.
Conclusions:
- Pre-clinical development of NIR fluorescence-guided SLN mapping is complete.
- The technology shows potential to replace radioactive and colored tracers.
- This approach offers real-time guidance and aids pathologist in tissue analysis.
