A Hybrid Radioactive and Fluorescent Tracer for Sentinel Node Biopsy in Penile Carcinoma as a Potential Replacement for Blue Dye

Brouwer, Oscar R.; Berg, Nynke S. van den; Mathéron, Hanna M.; Poel, Henk G. van der; Rhijn, Bas W. van; Bex, Axel; Tinteren, Harm van; Olmos, Renato A. Valdés; Leeuwen, Fijs W. B. van; Horenblas, Simon

doi:10.1016/j.eururo.2013.11.014

Cited by 139 publications

(137 citation statements)

References 22 publications

Supporting

Mentioning

125

Contrasting

Unclassified

Order By: Relevance

“…These findings clearly underline the strengths and weaknesses of the 2 individual imaging signatures. Moreover, the reported detection percentages show that the find rates with the hybrid modality are highly similar to those previously reported for combined use of the individual modalities (13). The current prototype setup was not optimized from an efficacy point of view, and its use influenced operating room logistics and the operation time.…”

Section: Discussionsupporting

confidence: 67%

“…Hybrid tracer injection and preoperative SN mapping were performed 1 d before surgery or on the morning of the day of surgery as previously described (13). In brief, 4 deposits of 0.1 mL of hybrid tracer ICG-99m Tc-nanocolloid was injected per patient around the primary lesion.…”

Section: Injection Procedures and Preoperative Imagingmentioning

confidence: 99%

“…The current study was performed by experienced surgical personnel that regularly uses intraoperative fluorescence-and g-tracing modalities, even in combination with the hybrid tracer (13).…”

Section: System Evaluationmentioning

confidence: 99%

“…Such shortcomings can be overcome using a hybrid tracer, for example, ICG-99m Tcnanocolloid, a tracer that contains both a radioisotope and an optical fluorescent dye. The clinical value of ICG-99m Tc-nanocolloid has already been extensively demonstrated by us (12)(13)(14) and others (11,15) whereby it was shown that using the hybrid tracer allows for direct translation of (in-depth) preoperative imaging findings into the operation theater. The radiolabel of the hybrid tracer allows preoperative SN mapping in a fashion similar to the conventional radioguided approach (12), meaning it also provides directional information for the placement of the incisions.…”

mentioning

confidence: 99%

“…The radiolabel of the hybrid tracer allows preoperative SN mapping in a fashion similar to the conventional radioguided approach (12), meaning it also provides directional information for the placement of the incisions. During the operation, the combination of radio-and fluorescence guidance can be used to refine this even further by confirming the actual location and removal of the SNs defined at preoperative imaging (12)(13)(14). This combined approach significantly outperformed blue dye-based SN identification (12)(13)(14).…”

mentioning

confidence: 99%

See 4 more Smart Citations

Hybrid Surgical Guidance: Does Hardware Integration of γ- and Fluorescence Imaging Modalities Make Sense?

KleinJan¹,

Hellingman²,

Berg³

et al. 2016

J Nucl Med

Self Cite

View full text Add to dashboard Cite

The clinically applied hybrid tracer indocyanine green-99m Tc-nanocolloid enables combined radio-and fluorescence image guidance during sentinel node (SN) biopsy procedures. To provide optimal surgical guidance, this tracer requires the presence of both g-and fluorescence modalities in the operating room. We reasoned that the combination or integration of these modalities could further evolve the hybrid surgical guidance concept. To study this potential, we clinically applied 2 setups that included the combination of g-detection modalities and an open surgery fluorescence camera. Methods: To attach the fluorescence camera (VITOM) to either a g-ray detection probe (GP; VITOM-GP) or a portable g-camera (GC; Vitom GC), clipon brackets were designed and printed in 3-dimensional sterilizable RC31. Both combined modalities were evaluated in, respectively, 5 and 6 patients with penile cancer during an SN biopsy procedure using indocyanine green-99m Tc-nanocolloid. Intraoperatively, radioand fluorescence-guided SN detection rates were scored at working distances of 0, 10, 20, and 30 cm for both combinations. Results: Using the VITOM-GP combination, we evaluated 9 SNs. g-tracing rates were shown to be 100%, 88.9%, 55.6%, and 55.6% at a respective working distance of 0, 10, 20, and 30 cm. Detection rates for the fluorescence imaging-based detection were found to be 100%, 77.8%, and 77.8%, at respective working distances of 10, 20, and 30 cm. When the VITOM-GC setup was used, all 10 intraoperatively evaluated SNs could be visualized with the g-camera independent of the working distance. Fluorescence detection rates were 90%, 80%, and 80% at 10-, 20-, and 30-cm working distances. The integrated detection modalities were shown to work synergistically; overall the, GC was most valuable for rough localization (10-to 30-cm range) of the SNs, the GP for providing convenient realtime acoustic feedback, whereas fluorescence guidance allowed detailed real-time SN visualization. Conclusion: Our findings suggest that full integration of a fluorescence camera with g-detector (GP or GC) can be of value when a hybrid, radioactive and fluorescent tracer is used.

show abstract

Section: Discussionsupporting

confidence: 67%

Section: Injection Procedures and Preoperative Imagingmentioning

confidence: 99%

Section: System Evaluationmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Hybrid Surgical Guidance: Does Hardware Integration of γ- and Fluorescence Imaging Modalities Make Sense?

KleinJan¹,

Hellingman²,

Berg³

et al. 2016

J Nucl Med

Self Cite

View full text Add to dashboard Cite

show abstract

Advanced Nanotechnology Leading the Way to Multimodal Imaging‐Guided Precision Surgical Therapy

et al. 2019

View full text Add to dashboard Cite

Surgical resection is the primary and most effective treatment for most patients with solid tumors. However, patients suffer from postoperative recurrence and metastasis. In the past years, emerging nanotechnology has led the way to minimally invasive, precision and intelligent oncological surgery after the rapid development of minimally invasive surgical technology. Advanced nanotechnology in the construction of nanomaterials (NMs) for precision imaging-guided surgery (IGS) as well as surgery-assisted synergistic therapy is summarized, thereby unlocking the advantages of nanotechnology in multimodal IGS-assisted precision synergistic cancer therapy. First, mechanisms and principles of NMs to surgical targets are briefly introduced. Multimodal imaging based on molecular imaging technologies provides a practical method to achieve intraoperative visualization with high resolution and deep tissue penetration. Moreover, multifunctional NMs synergize surgery with adjuvant therapy (e.g., chemotherapy, immunotherapy, phototherapy) to eliminate residual lesions. Finally, key issues in the development of ideal theranostic NMs associated with surgical applications and challenges of clinical transformation are discussed to push forward further development of NMs for multimodal IGS-assisted precision synergistic cancer therapy.

show abstract

Image‐guided surgery using multimodality strategy and molecular probes

Jiang

2015

WIREs Nanomed Nanobiotechnol

View full text Add to dashboard Cite

The ultimate goal of cancer surgery is to maximize the excision of tumorous tissue with minimal damage to the collateral normal tissues, reduce the postoperative recurrence, and improve the survival rate of patients. In order to locate tumor lesions, highlight tumor margins, visualize residual disease in the surgical wound, and map potential lymph node metastasis, various imaging techniques and molecular probes have been investigated to assist surgeons to perform more complete tumor resection. Combining imaging techniques with molecular probes is particularly promising as a new approach for image-guided surgery. Considering inherent limitations of different imaging techniques and insufficient sensitivity of nonspecific molecular probes, image-guided surgery with multimodality strategy and specific molecular probes appears to be an optimal choice. In this article, we briefly describe typical imaging techniques and molecular probes followed by a focused review on the current progress of multimodal image-guided surgery with specific molecular navigation. We also discuss optimal strategy that covers all stages of image-guided surgery including preoperative scanning of tumors, intraoperative inspection of surgical bed and postoperative care of patients.

show abstract

A Hybrid Radioactive and Fluorescent Tracer for Sentinel Node Biopsy in Penile Carcinoma as a Potential Replacement for Blue Dye

Cited by 139 publications

References 22 publications

Hybrid Surgical Guidance: Does Hardware Integration of γ- and Fluorescence Imaging Modalities Make Sense?

Hybrid Surgical Guidance: Does Hardware Integration of γ- and Fluorescence Imaging Modalities Make Sense?

Advanced Nanotechnology Leading the Way to Multimodal Imaging‐Guided Precision Surgical Therapy

Image‐guided surgery using multimodality strategy and molecular probes

Contact Info

Product

Resources

About