Clinical feasibility of imaging with indocyanine green combined with carbon nanoparticles for sentinel lymph node identification in papillary thyroid microcarcinoma

Abstract

Background:Although several previous studies demonstrated the feasibility and efficacy of indocyanine green (ICG) for thyroid cancer surgery, ICG was administered through venous injection and focused on parathyroid gland protection. We thus aimed to study the feasibility of imaging using ICG combined with carbon nanoparticles (CNs) in the identification of sentinel lymph nodes (SLNs) in patients diagnosed with papillary thyroid microcarcinoma (PTMC).Methods:Two approaches were applied to detect lymph nodes in PTMC surgery. Patients were randomized into 2 groups. ICG and CNs were injected into the thyroid in Group A. In Group B, only CNs was injected. Black-stained or fluorescent nodes observed using near-infrared fluorescence imaging systems were defined as SLNs. SLN and central lymph node (CLN) dissection was completed in both groups. The pathological and postoperative outcomes were compared between 2 groups.Results:There were 40 patients in Group A and 60 in Group B. A total of 138 SLNs were identified; 72 and 66 SLNs were detected and dissected in Groups A and B, respectively. The number of SLNs identified (per patient) in Group A was higher than that in Group B (P = .027). The number of harvested CLNs was 161 and 192 in Groups A and B, respectively, out of which 45 and 48 lymph nodes with metastasis were confirmed by permanent pathology. The CLN metastatic rate in Group A was higher than that in Group B (P = .048).Conclusion:Imaging using ICG combined CNs is feasible and safe for SLN identification in PTMC patients. Compared with using only CNs, more SLNs can be removed and more metastatic lymph nodes can be confirmed when using the combined method. Although the combined method appears to accurately stage tumors, further research is needed.

Nanoparticle Surface Functionalization: How to Improve Biocompatibility and Cellular Internalization

“…The use of NPs has grown exponentially in the last 15 years especially for cancer treatment, because of their capability to perform high precision tasks, such as the delivery of drugs and imaging contrast agents (CAs) directly to tumor cells (Panebianco et al, 2019;Zhang X. et al, 2019), by using a large number of molecular targets (Yoo et al, 2019). In particular, the accumulation of nanocarriers in cancer cells can occur through two different mechanisms: passive and active targeting.…”

Carbon nanoparticles combined with indocyanine green for sentinel lymph node detection in endometrial carcinoma

“…Carbon nanoparticles (CNPs) are a convenient colorimetric tracer that can detect SLNs with the naked eye and have been used to trace lymph nodes and lymphatic vessels in gastrointestinal tumors, thyroid cancer, breast cancer patients in China. [5][6][7] CNPs consist of ordinary activated carbon transformed through a technical treatment into very small particles. With an average particle size of 150 nm, CNPs can perfectly enter lymphatic vessels and lymphatic capillaries other than blood vessels.…”

Long Non-Coding RNA MAPK8IP1P2 Inhibits Lymphatic Metastasis of Thyroid Cancer by Activating Hippo Signaling via Sponging miR-146b-3p

“…Most PTCs are effectively treated by surgical removal, followed by adjuvant radioactive iodine therapy, and has a favorable 5-year survival rate exceeding 95% ( 4 ). However, the principal issue derived from PTC is its high propensity to metastasize to lymph node, which significantly affects the prognosis of thyroid cancer patients ( 5 ). Therefore, identification of lymph node metastasis-relevant factor will facilitate early detection of lymph node metastasis and development of anti-lymph node metastasis therapeutic strategy in thyroid cancer patients.…”