Near‐infrared fluorescence sentinel lymph node biopsy in vulvar cancer: a randomised comparison of lymphatic tracers

Schaafsma, B.E.; Verbeek, F A; Peters, A. C. B.; Vorst, Joost R. van der; Kroon, CD de; Poelgeest, M. van; Trimbos, J. Baptist; Velde, Cjh van de; Frangioni, J.V.; Vahrmeijer, A.L.; Gaarenstroom, Katja N.

doi:10.1111/1471-0528.12173

Cited by 71 publications

(45 citation statements)

References 27 publications

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“…However, all these data may be organ-dependent, so it is presently unknown if this is also the case in ovarian cancer. Moreover, newly developed hybrid SN detection agents, combining radioactivity with fluorescence or paramagnetic capabilities; alternative operative techniques such as multiphased injection; and new intraoperative imaging technologies may provide additional advantages (24)(25)(26)(27).…”

Section: Discussionmentioning

confidence: 99%

The Detection of Sentinel Nodes in Ovarian Cancer: A Feasibility Study

et al. 2014

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Few sentinel node (SN) studies in ovarian cancer have been reported, mainly because of the risk of tumor dissemination associated with the injection of tracers into the ovarian cortex. To our knowledge, the injection of tracers into the ovarian ligaments has not been explored. The aim of this study was to determine the feasibility of the SN procedure in ovarian cancer with tracer injection into the ovarian ligaments and to establish whether the procedure is safe for the healthcare workers. Methods: The study included patients who were at high risk of ovarian malignancy. Blue dye and radioactive colloid were injected into the proper ovarian ligament and suspensory ligament of the ovary. To measure professional radiation exposure, ring dose meters were worn by the surgeon, theater nurse, and pathologist during 3 procedures. Results: An SN procedure was performed in 21 patients, and at least 1 SN location was identified in all patients using the γ probe before retroperitoneal exploration. SNs were located in the paraaortic and paracaval regions only in 67% of the patients, in the pelvic region only in 9%, and in both the paraaortic/paracaval and the pelvic regions in 24%. All but 2 SNs were found on the ipsilateral side. In 6 patients who underwent retroperitoneal exploration, 1-4 SNs were identified using the γ probe and resected. Blue-stained SNs were detected in 2 patients. Positive SNs were detected in 1 patient with lymph node metastases. The amount of radiation exposure to the surgeon, theater nurse, and pathologist did not exceed the safe limit. Conclusion: The identification of SNs in all cases suggests that the SN procedure performed by injection of tracers in the ovarian ligaments is feasible and promising. The procedure is safe for the involved personnel. Further investigation is necessary to determine the clinical application of this new technique.

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Section: Discussionmentioning

confidence: 99%

The Detection of Sentinel Nodes in Ovarian Cancer: A Feasibility Study

et al. 2014

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“…166 In 32 women with vulvar cancer, 35 SLNs in 24 patients were intraoperatively detected by NIRF imaging using ICG:HSA and ICG alone, though no significant difference was found between them. 167 In Rossi et al's study, 17 out of 20 patients with cervical or endometrial carcinoma were observed with SLNs by ICG injection in the cervix, demonstrating that it is a reliable method for intraoperative SLNs mapping. 168 Eighteen patients with confirmed neoplasia underwent NIR laparoscopy that could transmit both white light and NIR image.…”

mentioning

confidence: 95%

Near-infrared fluorescent probes in cancer imaging and therapy: an emerging field

Yi¹,

Wang²,

Qin³

et al. 2014

IJN

213

149

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Near-infrared fluorescence (NIRF) imaging is an attractive modality for early cancer detection with high sensitivity and multi-detection capability. Due to convenient modification by conjugating with moieties of interests, NIRF probes are ideal candidates for cancer targeted imaging. Additionally, the combinatory application of NIRF imaging and other imaging modalities that can delineate anatomical structures extends fluorometric determination of biomedical information. Moreover, nanoparticles loaded with NIRF dyes and anticancer agents contribute to the synergistic management of cancer, which integrates the advantage of imaging and therapeutic functions to achieve the ultimate goal of simultaneous diagnosis and treatment. Appropriate probe design with targeting moieties can retain the original properties of NIRF and pharmacokinetics. In recent years, great efforts have been made to develop new NIRF probes with better photostability and strong fluorescence emission, leading to the discovery of numerous novel NIRF probes with fine photophysical properties. Some of these probes exhibit tumoricidal activities upon light radiation, which holds great promise in photothermal therapy, photodynamic therapy, and photoimmunotherapy. This review aims to provide a timely and concise update on emerging NIRF dyes and multifunctional agents. Their potential uses as agents for cancer specific imaging, lymph node mapping, and therapeutics are included. Recent advances of NIRF dyes in clinical use are also summarized.

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“…79 Schaafsma et al compared ICG conjugated with albumin (ICG:HSA) with ICG in 24 vulvar cancer patients; HSA was expected to enhance detection because of increased lymphatic uptake. [80][81][82] All 35 nodes were identified in both groups and ICG:HSA did not appear to confer an advantage over ICG alone.…”

Section: Genitourinary Cancersmentioning

confidence: 90%