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Multispectral Real-time Fluorescence Imaging for Intraoperative Detection of the Sentinel Lymph Node in Gynecologic Oncology

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A tri-modal molecular imaging agent for sentinel lymph node mapping.

Zhengtao Qin¹, Carl K Hoh², David J Hall²

¹Department of Chemistry, University of California, San Diego, La Jolla, California; Moores UCSD Cancer Center, University of California, San Diego, La Jolla, California; Department of Radiology, University of California, San Diego, La Jolla, California; UCSD In Vivo Cancer and Molecular Imaging Center, University of California, San Diego, La Jolla, California.

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Summary

This summary is machine-generated.

An instant kit allows radiolabeling of fluorescent-tilmanocept with Gallium-68 and Technetium-99m for sentinel lymph node imaging. This tri-modal agent enables pre-operative mapping, extended fluorescence imaging, and quantitative analysis.

Keywords:

Fluorescence imaging IRDye800CW-tilmanocept Multimodality imaging PET imaging Sentinel lymph node Tilmanocept

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Area of Science:

Molecular Imaging
Radiochemistry
Biotechnology

Background:

Sentinel lymph node (SLN) identification is crucial for cancer staging.
Current imaging methods have limitations in real-time visualization and quantification.

Purpose of the Study:

To develop an "instant kit" for rapid radiolabeling of fluorescent-tilmanocept with Gallium-68 (68Ga) and Technetium-99m (99mTc).
To evaluate the tri-modal imaging capabilities of the radiolabeled agent for SLN detection.

Main Methods:

Lyophilized 800CW-tilmanocept was successively radiolabeled with 68Ga and 99mTc using a kit.
Radiochemical and fluorescence purity were assessed using HPLC and ITLC.
In vitro and in vivo stability studies were performed.
Tri-modal imaging (PET, fluorescence, radiometric) was conducted in mice.

Main Results:

Radiolabeling achieved >98% purity with high in vitro and in vivo stability.
PET and fluorescence imaging successfully identified popliteal SLNs within 0.5 hours.
Fluorescence signal remained stable for up to 72 hours.

Conclusions:

The "instant kit" provides a rapid and efficient method for preparing a tri-modal imaging agent.
This agent facilitates pre-operative SLN mapping, prolonged intraoperative fluorescence guidance, and post-operative radiometric assessment.
The developed method offers a versatile tool for sentinel lymph node molecular imaging.