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Updated: Jan 13, 2026
An In Vivo Murine Sciatic Nerve Model of Perineural Invasion
Published on: April 23, 2018
Intraoperative Molecular Imaging Can Detect Large Nerve Perineural Invasion: A Case Report
Carleigh R Burns1, Aviva S Mattingly1, Kim Ely2
1Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Background:
Perineural invasion (PNI) in head and neck squamous cell carcinoma (SCC) results in worse overall survival. Diagnosis requires resection and microscopic evaluation.
Methods:
A 63-year-old male with persistent cT4aN0 p16-positive SCC of the left base of tongue following chemoradiotherapy underwent salvage total glossectomy. Fluorescence-guided imaging of the wound bed was performed with PDE-GEN3 near-infrared (NIR) imaging following infusion of an optically EGFR-targeted antibody, Panitumumab-IRDye800 (pan800).
Results:
The proximal resected hypoglossal nerve was imaged intraoperatively and demonstrated a strong green fluorescence signal, raising concern for subclinical PNI. Biopsy of the nerve revealed SCC on frozen section analysis. This was re-resected with subsequent proximal margin negative for carcinoma. Postoperatively, ex vivo imaging of the nerve using PDE-GEN3 NIR imaging again demonstrated the presence of pan800 within the initial positive nerve margin, confirming subclinical PNI.
Conclusions:
This case shows the feasibility of intraoperative fluorescence as a method to help identify subclinical PNI.
Trial Registration:
ClinicalTrials.gov identifier: NCT05945875.
