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Single-Injection Composite Tracer Achieves Intraoperative Dual-Tracing and Precise Localization of Sentinel Lymph

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This study introduces a novel composite tracer for sentinel lymph node (SLN) identification, combining SERS nanotags and methylene blue dye for accurate, single-injection visualization. This advancement simplifies the procedure, reducing patient burden and improving SLN biopsy outcomes.

Keywords:
localizationsentinel lymph nodesingle-injection tracersurface-enhanced Raman scattering tagsvisualization

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Area of Science:

  • Biomedical Engineering
  • Optical Imaging
  • Nanotechnology

Background:

  • Sentinel lymph node (SLN) identification currently requires multiple tracer injections, burdening patients and clinicians.
  • Existing methods for SLN marking involve radioactive tracers and methylene blue (MB) dye, posing logistical and comfort challenges.
  • Surface-enhanced Raman scattering (SERS) nanotags offer high sensitivity and specificity for SLN tracing.

Purpose of the Study:

  • To develop and validate a novel single-injection composite tracer for accurate intraoperative SLN visualization and localization.
  • To integrate SERS nanotags with MB dye, leveraging complementary optical modalities for enhanced SLN navigation.
  • To reduce the physical and psychological burden associated with current dual-tracer SLN identification methods.

Main Methods:

  • A composite tracer was formulated by combining SERS nanotags with methylene blue (MB) dye solution.
  • Laser excitation at the second near-infrared window (1064 nm) was employed to minimize MB fluorescence background interference.
  • The composite tracer's feasibility was demonstrated for SLN navigation in rabbit models and subsequently in rhesus monkeys.

Main Results:

  • The composite tracer enabled accurate intraoperative visualization and localization of SLNs.
  • Successful visualization and localization of multiple SLNs in the axilla of rhesus monkeys were achieved for the first time.
  • The 1064 nm laser excitation effectively mitigated MB fluorescence interference, allowing for dual-modality optical imaging.

Conclusions:

  • The developed composite tracer, integrating SERS nanotags and MB dye, offers a promising advancement for SLN navigation.
  • This single-injection approach significantly simplifies the SLN biopsy procedure, enhancing clinical applicability.
  • The study highlights the potential of combining complementary optical modalities for improved diagnostic accuracy in surgical procedures.