Preclinical Evaluation of Robotic-Assisted Sentinel Lymph Node Fluorescence Imaging

Liss, Michael A.; Farshchi-Heydari, Salman; Qin, Zhengtao; Hickey, Sean; Hall, D.; Kane, Christopher J.; Vera, David R.

doi:10.2967/jnumed.114.140871

Cited by 13 publications

(15 citation statements)

References 32 publications

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“…This study, based on examination of 36 LNs, demonstrated that the FireFly fluorescence imaging system is capable of detecting fluorescent-labeled tilmanocept up to 38 h after a submucosal injection into the porcine urinary bladder. This result is consistent with fluorescence imaging of SLNs 36 h after fluorescent tilmanocept injection into the footpad of rabbits (20) and the canine prostate gland (18).…”

Section: Discussionsupporting

confidence: 87%

“…We used injections into the submucosal layer of the bladder wall, which has significantly different lymphatic drainage than the foot-pads of the rabbit. Although the previous study (20) used the same fluorescence imaging system/camera, the pelvic LNs that drain the bladder wall are embedded within a layer of fat that envelopes major blood vessels or nerves, an anatomic setting that differs greatly from rabbit popliteal LNs that reside between muscle layers. As a result, the animal model used in the current work provides a far more realistic and demanding challenge to successful fluorescence imaging.…”

Section: Discussionmentioning

confidence: 99%

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Fluorescence-Based Molecular Imaging of Porcine Urinary Bladder Sentinel Lymph Nodes

et al. 2017

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The primary objective was to test the ability of a laparoscopic camera system to detect the fluorescent signal emanating from sentinel lymph nodes (SLNs) approximately 2 d after injection and imaging of a positron-emitting molecular imaging agent into the submucosa of the porcine urinary bladder. Three female pigs underwent a submucosal injection of the bladder with fluorescent-tagged tilmanocept, radiolabeled with bothGa and Tc. One hour after injection, a pelvic PET/CT scan was acquired for preoperative SLN mapping. Approximately 36 h later, robotic SLN mapping was performed using a fluorescence-capable camera system. After identification of the fluorescent lymph nodes, a pelvic lymph node dissection was completed with robotic assistance. All excised nodal packets ( = 36) were assayed for Tc activity, which established a lymph node as an SLN.Tc activity was also used to calculate the amount of dye within each lymph node. All of the SLNs defined by the ex vivo γ-well assay ofTc activity were detected by fluorescence mode imaging. The time between injection and robotic SLN mapping ranged from 32 to 38 h. A total of 5 fluorescent lymph nodes were detected; 2 pigs had 2 fluorescent lymph nodes and 1 pig exhibited a single lymph node. Four of the 5 SLNs exhibited increased SUVs of 12.4-139.0 obtained from PET/CT. The dye content of the injection sites ranged from 371 to 1,441 pmol, which represented 16.5%-64.1% of the injected dose; the amount of dye within the SLNs ranged from 8.5 to 88 pmol, which was equivalent to 0.38%-3.91% of the administered dose. Fluorescent-labeledGa-tilmanocept allows for PET imaging and real-time intraoperative detection of SLNs during robotic surgery.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Fluorescence-Based Molecular Imaging of Porcine Urinary Bladder Sentinel Lymph Nodes

et al. 2017

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“…There have been a couple of reports on robotic sentinel‐node navigation surgery using fluorescence imaging with indocyanine green (ICG) etc. carried out with near‐infrared fluorescence imaging technology built into the robotic platform optical system (Firefly Fluorescence Imaging Scope; Intuitive Surgical, Inc.) . Laparoscopic and endoscopic cooperative surgery (LECS) may develop into robotic and endoscopic cooperative surgery (RECS) in the near future.…”

Section: Future Perspectives On Robotic Upper Gi Surgerymentioning

confidence: 99%

“…carried out with near-infrared fluorescence imaging technology built into the robotic platform optical system (Firefly Fluorescence Imaging Scope; Intuitive Surgical, Inc.). [94][95][96] Laparoscopic and endoscopic cooperative surgery (LECS) may develop into robotic and endoscopic cooperative surgery (RECS) in the near future.…”

Section: Application Of the Surgical Robot To Function-preserving Surmentioning

confidence: 99%

Robotic surgery for upper gastrointestinal cancer: Current status and future perspectives

Suda

Nakauchi

Inaba

et al. 2016

Digestive Endoscopy

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Robotic surgery with the da Vinci Surgical System has been increasingly applied in a wide range of surgical specialties, especially in urology and gynecology. However, in the field of upper gastrointestinal (GI) tract, the da Vinci Surgical System has yet to be standard as a result of a lack of clear benefits in comparison with conventional minimally invasive surgery. We have been carrying out robotic gastrectomy and esophagectomy for operable patients with resectable upper GI malignancies since 2009, and have demonstrated the potential advantages of the use of the robot in possibly reducing postoperative local complications including pancreatic fistula following gastrectomy and recurrent laryngeal nerve palsy after esophagectomy, even though there have been a couple of problems to be solved including longer duration of operation and higher cost. The present review provides updates on robotic surgery for gastric and esophageal cancer based on our experience and review of the literature.

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“…This agent has shown some promises in preoperative planning by PET/CT and intraoperative guidance via fluorescence. 82,83…”

Section: Highly Probable Slns: This Includes Nodes Appearingmentioning

confidence: 99%

Using lymphoscintigraphy as a prognostic tool in patients with cancer

Vidal-Sicart¹,

Olmos²

2016

RRNM

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Early detection of metastatic involvement of lymph nodes is one of the greatest difficulties faced by the physicians. In the last few centuries, the lymphatic system has become an important field of interest in oncology. The lymphatic system functions in two opposing ways in cancer: defense against circulating tumor cells, and, on the other hand, a route for metastasis and a site of tumor growth when the defense mechanism fails. The significant impact of lymphatic dissemination on the staging, treatment, and outcome of solid cancers has stimulated investigations aimed at gaining more insight into several aspects of the lymphatic system. Its application in oncology has evolved in the last 50 years fostered by the recognition of the relationship of lymph node metastases to prognosis in several types of malignant tumors. Lymphatic mapping also offers the opportunity for repetitive studies undertaken for evaluation of the patient during follow-up, thereby offering early evidence of recurrence of the disease. More recent and widespread applications of lymphoscintigraphy form the basis for biopsy of the sentinel lymph node in patients with solid cancers. This article reviews the applications of lymphoscintigraphy in the current diverse oncologic clinical indications for the assessment of secondary lymphedema related to oncologic treatments and sentinel lymph node lymphatic mapping.

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Preclinical Evaluation of Robotic-Assisted Sentinel Lymph Node Fluorescence Imaging

Cited by 13 publications

References 32 publications

Fluorescence-Based Molecular Imaging of Porcine Urinary Bladder Sentinel Lymph Nodes

Fluorescence-Based Molecular Imaging of Porcine Urinary Bladder Sentinel Lymph Nodes

Robotic surgery for upper gastrointestinal cancer: Current status and future perspectives

Using lymphoscintigraphy as a prognostic tool in patients with cancer

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