Intraoperative Detection of Micrometastases in Whole Excised Lymph Nodes Using Fluorescent Paired-Agent Imaging Principles: Identification of a Suitable Staining and Rinsing Protocol.
Mol Imaging Biol
; 23(4): 537-549, 2021 08.
Article
en En
| MEDLINE
| ID: mdl-33591478
ABSTRACT
PURPOSE:
Correctly identifying nodal status is recognized as a critical prognostic factor in many cancer types and is essential to guide adjuvant treatment. Currently, surgical removal of lymph nodes followed by pathological examination is commonly performed as a standard-of-care to detect node metastases. However, conventional pathology protocols are time-consuming, yet less than 1 % of lymph node volumes are examined, resulting in a 30-60 % rate of missed micrometastases (0.2-2 mm in size). PROCEDURES This study presents a method to fluorescently stain excised lymph nodes using paired-agent molecular imaging principles, which entail co-administration of a molecular-targeted imaging agent with a suitable control (untargeted) agent, whereby any nonspecific retention of the targeted agent is accounted for by the signal from the control agent. Specifically, it was demonstrated that by dual-needle continuous infusion of either an antibody-based imaging agent pair (epidermal growth factor receptor (EGFR) targeted agent IRDye-800CW labeled Cetuximab; control agent IRDye-700DX-IgG) or an Affibody-based pair (EGFR targeted Affibody® agent ABY-029; control agent IRDYe-700DX carboxylate) at 0.3 ml/min.RESULTS:
The results demonstrated the possibility to achieve >99 % sensitivity and > 95 % specificity for detection of a single micrometastasis (~0.2 mm diameter) in a whole lymph node within 22 min of tissue processing time.CONCLUSION:
The detection capabilities offer substantial improvements over existing intraoperative lymph node biopsy methods (e.g., frozen pathology has a micrometastasis sensitivity <20 %).Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Bencenosulfonatos
/
Neoplasias de la Mama
/
Imagen Óptica
/
Cetuximab
/
Indoles
/
Ganglios Linfáticos
Tipo de estudio:
Diagnostic_studies
/
Guideline
/
Prognostic_studies
Límite:
Female
/
Humans
Idioma:
En
Revista:
Mol Imaging Biol
Asunto de la revista:
BIOLOGIA MOLECULAR
/
DIAGNOSTICO POR IMAGEM
Año:
2021
Tipo del documento:
Article
País de afiliación:
Estados Unidos