A self-assembled multimodal complex for combined pre- and intraoperative imaging of the sentinel lymph node

Buckle, Tessa; Leeuwen, Anne C. van; Chin, P.; Janssen, Hans; Müller, Sara; Jonkers, Jos; Leeuwen, F.W.B. van

doi:10.1088/0957-4484/21/35/355101

Cited by 91 publications

(75 citation statements)

References 37 publications

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“…The ICG-99m Tc-nanocolloid solution was prepared by adding 0.050 mL (0.250 mg ICG) of the ICGPulsion solution to 1 mL of 99m Tc-nanocolloid solution (pH 6-7). ICG-99m Tc-nanocolloid was formed via noncovalent interactions between ICG and albumin molecules (13)(14)(15). All procedures were performed under Kern Energie Wet (Nuclear Energy Law) using Dutch guidelines for good manufacturing practices and with the approval of the local pharmacist.…”

Section: Tracer Preparationmentioning

confidence: 99%

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Relationship Between Intraprostatic Tracer Deposits and Sentinel Lymph Node Mapping in Prostate Cancer Patients

et al. 2012

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Intraprostatic injection of the hybrid tracer indocyanine green (ICG)-99m Tc-nanocolloid enables both preoperative sentinel node (SN) identification and intraoperative visualization of the SN. Relating the fluorescence deposits in embedded prostate tissue specimens to the preoperatively detected SNs also provides the opportunity to study the influence of their placement on lymphatic drainage pattern. Methods: Nineteen patients with prostate carcinoma scheduled for robot-assisted laparoscopic prostatectomy and lymph node (LN) dissection were included. ICG-99m Tc-nanocolloid was injected intraprostatically, guided by ultrasound. SN biopsy was performed using a combination of radioguidance and fluorescence guidance. Tracer distribution was visualized in paraffin-embedded prostate samples using ex vivo fluorescence imaging. This distribution was correlated to the number and location of the SNs identified on preoperative lymphoscintigraphy and SPECT/CT. Results: ICG-99m Tc-nanocolloid helped guide surgical excision of the SNs. Ex vivo fluorescence imaging revealed a large variation in the locations of intraprostatic tracer deposits among patients. Tracer deposits in the peripheral zone correlated with a higher number of visualized LNs than deposits in the central zone (on average, 4.7 vs. 2.4 LNs per patient). Furthermore, tracer deposits in the mid gland correlated with a higher number of visualized LNs than deposits near the base or apex of the prostate (on average, 6 vs. 3.5 LNs per patient). Conclusion: The hybrid nature of the tracer not only enables surgical guidance but also provides an opportunity to study the correlation between the location of tracer deposits within the prostate and the number and location of preoperatively visualized SNs. These data suggest that the location at which a tracer deposit is placed influences the lymphatic drainage pattern.

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Section: Tracer Preparationmentioning

confidence: 99%

“…To achieve this, we developed a hybrid radiocolloid that can be visualized with a g-camera, SPECT/CT imaging, and near-infrared fluorescence imaging (13,14). This hybrid radiocolloid enabled us to link preoperative SN identification to intraoperative visualization of the SNs in patients with prostate carcinoma (15).…”

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Relationship Between Intraprostatic Tracer Deposits and Sentinel Lymph Node Mapping in Prostate Cancer Patients

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“…22,23 We have previously demonstrated in SLN imaging using a mouse model for metastatic breast cancer (one tumor draining lymph node) that the specificity of ICG99m Tc-NanoColl complexes is similar to conventional lymphoscintigraphy. 24 Therefore, we reasoned that a cocktail injection of albumin (radiocolloids) and ICG could have potential.…”

Section: Introductionmentioning

confidence: 99%

Tracer-cocktail injections for combined pre- and intraoperative multimodal imaging of lymph nodes in a spontaneous mouse prostate tumor model

et al. 2011

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Abstract. To improve surgical guidance toward prostate draining lymph nodes, we investigate the potential of intraoperative fluorescence imaging and combined pre-and intraoperative multimodality imaging approaches. Transgenic adenocarcinoma mouse prostate mice with spontaneous prostate tumors are injected intratumorally with: 1. a cocktail of patent blue (Pb) and indocyanine green (ICG); 2. a cocktail of albumin radiocolloids ( 99m TcNanoColl), Pb, and ICG; or 3. a cocktail of radiolabeled albumin ( 99m Tc-Vasculosis), Pb, and ICG. The distribution of these imaging agents over the lymph nodes (LNs) are studied at different time points after injection. We find that at 60-min postinjection, ICG significantly improves the detection of the LNs compared to Pb, 53 versus 7%, respectively. Moreover, a cocktail of ICG and 99m Tc-NanoColl improves the fluorescent detection rate to 86%, equalling that of the clinically applied 99m Tc-NanoColl. A similar overlap is observed in our initial clinical pilot data. Fluorescent detection of the LNs using a ICG with 99m Tc-Vasculosis gives similar results as "free" ICG (58%; 60 min). A 99m Tc-NanoColl, Pb, and cocktail ICG enriches the standard 99m Tc-NanoColl approach by adding optical detection of the sentinel lymph nodes. Furthermore, this approach improves fluorescent-based guidance and enables both accurate surgical planning and intraoperative detection, based on a single injection. C 2011 Society of Photo-Optical Instrumentation Engineers (SPIE).

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“…Yet, because the signal penetration of fluorescent probes is limited by tissue attenuation, radioguidance to the general area of interest is still indispensable (23). To combine the beneficial properties of both modalities, a hybrid tracer comprising the fluorescent dye indocyanine green (ICG) and the human serum albumin-based radiocolloid 99m Tc-nanocolloid was developed (24,25). Recently, hybrid ICG-99m Tc-nanocolloid was introduced for laparoscopic and open sentinel node biopsies in patients with prostate cancer or head and neck melanoma (23,26,27).…”

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Comparing the Hybrid Fluorescent–Radioactive Tracer Indocyanine Green–^99mTc-Nanocolloid with ^99mTc-Nanocolloid for Sentinel Node Identification: A Validation Study Using Lymphoscintigraphy and SPECT/CT

Brouwer¹,

Buckle²,

Vermeeren³

et al. 2012

J Nucl Med

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The purpose of this study was to compare the lymphoscintigraphic drainage patterns of a hybrid sentinel node tracer consisting of the fluorescent dye indocyanine green (ICG) and 99m Tc-nanocolloid with the drainage pattern of 99m Tc-nanocolloid alone, the current standard tracer in many European countries. Methods: Twenty-five patients with a melanoma in the head and neck region (n 5 10), a melanoma on the trunk (n 5 6), or penile carcinoma (n 5 9) who were scheduled for sentinel node biopsy were prospectively included. First, the standard 99m Tc-nanocolloid procedure was performed. After injection at the lesion site, lymphoscintigraphy was performed with a 10-min dynamic study and static planar images at 10 min and 2 h after injection, followed by SPECT/CT. The same scintigraphic procedure was repeated after injection of hybrid ICG-99m Tcnanocolloid the same afternoon in 10 patients or the next morning in 15 patients. The paired images of both injections were evaluated, and count rates in the sentinel nodes were calculated and compared. Sentinel nodes were surgically localized using blue dye, a g-ray detection probe, a portable g-camera, and a fluorescence camera. Results: Lymphatic drainage was visualized in all 25 patients using 99m Tc-nanocolloid, leading to the identification of 66 sentinel nodes in total. These same sentinel nodes were also identified during the second scintigraphic procedure with ICG-99m Tc-nanocolloid. Moreover, a high correlation between the radioactive counting rates in the sentinel nodes of both scintigraphic studies was observed (mean R 2 5 0.83). Intraoperatively (4-23 h after the second injection), all preoperatively identified sentinel nodes could be localized using radio-and fluorescence guidance combined. In total, 95% of the sentinel nodes could be intraoperatively visualized by means of fluorescence imaging, whereas merely 54% stained blue. Ex vivo, all radioactive sentinel nodes were fluorescent and vice versa. No adverse reactions were observed. Conclusion: The lymphatic drainage pattern of ICG-99m Tc-nanocolloid is identical to that of 99m Tc-nanocolloid. This observation, together with the added value of intraoperative fluorescence guidance, warrants wider evaluation of hybrid ICG-99m Tc-nanocolloid as a tracer for sentinel node procedures.

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A self-assembled multimodal complex for combined pre- and intraoperative imaging of the sentinel lymph node

Cited by 91 publications

References 37 publications

Relationship Between Intraprostatic Tracer Deposits and Sentinel Lymph Node Mapping in Prostate Cancer Patients

Relationship Between Intraprostatic Tracer Deposits and Sentinel Lymph Node Mapping in Prostate Cancer Patients

Tracer-cocktail injections for combined pre- and intraoperative multimodal imaging of lymph nodes in a spontaneous mouse prostate tumor model

Comparing the Hybrid Fluorescent–Radioactive Tracer Indocyanine Green–^99mTc-Nanocolloid with ^99mTc-Nanocolloid for Sentinel Node Identification: A Validation Study Using Lymphoscintigraphy and SPECT/CT

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A self-assembled multimodal complex for combined pre- and intraoperative imaging of the sentinel lymph node

Cited by 91 publications

References 37 publications

Relationship Between Intraprostatic Tracer Deposits and Sentinel Lymph Node Mapping in Prostate Cancer Patients

Relationship Between Intraprostatic Tracer Deposits and Sentinel Lymph Node Mapping in Prostate Cancer Patients

Tracer-cocktail injections for combined pre- and intraoperative multimodal imaging of lymph nodes in a spontaneous mouse prostate tumor model

Comparing the Hybrid Fluorescent–Radioactive Tracer Indocyanine Green–99mTc-Nanocolloid with 99mTc-Nanocolloid for Sentinel Node Identification: A Validation Study Using Lymphoscintigraphy and SPECT/CT

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Comparing the Hybrid Fluorescent–Radioactive Tracer Indocyanine Green–^99mTc-Nanocolloid with ^99mTc-Nanocolloid for Sentinel Node Identification: A Validation Study Using Lymphoscintigraphy and SPECT/CT