Magnetic sentinel lymph node biopsy in a murine tumour model

Ahmed, Muneer; Woo, Taeseong; Ohashi, Kunihide; Suzuki, Toshiki; Kaneko, Akiko; Hoshino, Atushi; Zada, Ali; Baker, Rose; Douek, Michael; Kusakabe, Moriaki; Sekino, Masaki

doi:10.1016/j.nano.2015.12.366

Cited by 5 publications

(3 citation statements)

References 17 publications

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“…Although we did not detail the data analysis, we found that there was an increase in the amount of iron in SLNs with increasing times between ferucarbotran injection and surgery. Similar findings were found in a mouse study with Resovist [30] and a porcine study [18] with another SPIO nanoparticle. In this study, a biopsy was possible with the administration one day before.…”

Section: Discussionsupporting

confidence: 87%

Exploratory Study of Superparamagnetic Iron Oxide Dose Optimization in Breast Cancer Sentinel Lymph Node Identification Using a Handheld Magnetic Probe and Iron Quantitation

Taruno

Kuwahata

Sekino

et al. 2022

Cancers

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This exploratory study compared doses of ferucarbotran, a superparamagnetic iron oxide nanoparticle, in sentinel lymph nodes (SLNs) and quantified the SLN iron load by dose and localization. Eighteen females aged ≥20 years scheduled for an SLN biopsy with node-negative breast cancer were divided into two equal groups and administered either 1 mL or 0.5 mL ferucarbotran. Iron content was evaluated with a handheld magnetometer and quantification device. The average iron content was 42.8 µg (range, 1.3–95.0; 0.15% of the injected dose) and 21.9 µg (1.1–71.0; 0.16%) in the 1-mL and 0.5-mL groups, respectively (p = 0.131). The iron content of the closest SLN compared to the second SLN was 53.0 vs. 10.0 µg (19% of the injected dose) and 34.8 vs. 4.1 µg (11.1%) for the 1-mL and 0.5-mL groups, respectively (p = 0.001 for both). The magnetic field was high in both groups (average 7.30 µT and 6.00 µT in the 1-mL and 0.5-mL groups, respectively) but was not statistically significant (p = 0.918). The magnetic field and iron content were correlated (overall SLNs, p = 0.02; 1-mL, p = 0.014; 0.5-mL, p = 0.010). A 0.5-mL dose was sufficient for SLN identification. Primary and secondary SLNs could be differentiated based on iron content. Handheld magnetometers could be used to assess the SLN iron content.

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Section: Discussionsupporting

confidence: 87%

Exploratory Study of Superparamagnetic Iron Oxide Dose Optimization in Breast Cancer Sentinel Lymph Node Identification Using a Handheld Magnetic Probe and Iron Quantitation

Taruno

Kuwahata

Sekino

et al. 2022

Cancers

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“…The total number of excised SLNs showed a significant positive correlation with increasing magnetic nanoparticle volumes ( p < 0.001), and iron content in SLNs with increasing concentration ( p = 0.006). In addition, Ahmed et al [ 28 ] evaluated the impact of site and timing of magnetic nanoparticle injection in a murine model, showing a rapid uptake on MRI, smaller “void artifacts” ( p < 0.001) and a significant increase in iron content with time in the group receiving subcutaneous injection ( r = 0.94; p < 0.001). Previous clinical studies also evaluated different protocols of the SPIO injection.…”

Section: Discussionmentioning

confidence: 99%

Optimization of SPIO Injection for Sentinel Lymph Node Dissection in a Rat Model

Peek

Saeki

Ohashi

et al. 2021

Cancers

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The magnetic technique, consisting of a magnetic tracer and a handheld magnetometer, is a promising alternative technique for sentinel lymph node dissection (SLND) and was shown to be non-inferior to the standard technique in terms of identification rates. In this study, injection characteristics (iron dose, dilution, time course and massaging) were evaluated to optimize magnetic tracer uptake in the sentinel lymph nodes (SLN) in a rat hindleg model. 202 successful SLNDs were performed. Iron uptake in the SLN is proportional (10% utilization rate) to the injection dose between 20 and 200 μg, showing a plateau uptake of 80 μg in the SLN around 1000 μg injection. Linear regression showed that time had a higher impact than dilution, on the SLN iron uptake. Massaging showed no significant change in iron uptake. The amount of residual iron at the injection site was also proportional to the injection dose without any plateau. Time was a significant factor for wash-out of residual iron. From these results, preoperative injection may be advantageous for SLN detection as well as reduction in residual iron at the injection site by potential decrease in required injection dose.

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“…This study has been able to demonstrate that uptake of both tracers was limited to the primary draining lymph node of the murine lower limb (popliteal node) 12 and did not spread to other locations. This is highly suggestive of an adequate dose of tracer being administered to prevent saturation of the primary draining node and passage to higher echelon nodes.…”

Section: Discussionmentioning

confidence: 76%

Combined use of fluorescence with a magnetic tracer and dilution effect upon sentinel node localization in a murine model

Kuwahata¹,

Ahmed²,

Saeki³

et al. 2018

IJN

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BackgroundSentinel node biopsy using radioisotope and blue dye remains a gold standard for axillary staging in breast cancer patients with low axillary burden. However, limitations in the use of radioisotopes have resulted in emergence of novel techniques. This is the first in vivo study to assess the feasibility of combining the two most common novel techniques of using a magnetic tracer and indocyanine green (ICG) fluorescence.Materials and methodsA total of 48 mice were divided into eight groups. Groups 1 and 2, the co-localization groups, received an injection of magnetic tracers (Resovist® and Sienna+®, respectively) and ICG fluorescence; distilled water was used as the solvent of ICG. Groups 3 and 4, the diluted injection groups, received an injection of magnetic tracers (Resovist and Sienna+, respectively) and saline for dilution. Groups 5, 6, and 7, the control groups, received magnetic tracer (Resovist, Sienna+) and ICG alone, respectively. Fluorescent intensity assessment and iron quantification of excised popliteal lymph nodes were performed. Group 1′, a co-localization group, received an injection of magnetic tracers (Resovist) and ICG′ fluorescence: saline was used as the solvent for ICG.ResultsLymphatic uptake of all tracers was confined to the popliteal nodes only, with co-localization confirmed in all cases and no significant difference in fluorescent intensity or iron content of ex vivo nodes between the groups (except for Group 1′). There was no impact of dilution on the iron content in the diluted Sienna+ group, but it significantly enhanced Resovist uptake (P=0.005). In addition, there was a significant difference in iron content (P=0.003) in Group 1′.ConclusionThe combination of a magnetic tracer (Resovist or Sienna+) and ICG fluorescence is feasible for sentinel node biopsy and will potentially allow for precise transcutaneous node identification, in addition to accurate intraoperative assessment. This radioisotope-free “combined technique” warrants further assessment within a clinical trial.

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Magnetic sentinel lymph node biopsy in a murine tumour model

Cited by 5 publications

References 17 publications

Exploratory Study of Superparamagnetic Iron Oxide Dose Optimization in Breast Cancer Sentinel Lymph Node Identification Using a Handheld Magnetic Probe and Iron Quantitation

Exploratory Study of Superparamagnetic Iron Oxide Dose Optimization in Breast Cancer Sentinel Lymph Node Identification Using a Handheld Magnetic Probe and Iron Quantitation

Optimization of SPIO Injection for Sentinel Lymph Node Dissection in a Rat Model

Combined use of fluorescence with a magnetic tracer and dilution effect upon sentinel node localization in a murine model

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