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Noji T, Narasaki H, Ebihara Y, Tanaka K, Nakanishi Y, Asano T, Nakamura T, Tsuchikawa T, Okamura K, Hirano S. Near infrared fluorescence light imaging for lymphatic flow toward para-aortic lymph node from the Calot's triangle: A prospective exploratory study. Photodiagnosis Photodyn Ther 2018; 24:274-279. [PMID: 30268862 DOI: 10.1016/j.pdpdt.2018.09.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 09/13/2018] [Accepted: 09/24/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Metastasis to para-aortic lymph nodes (PAN) in hilar malignancies is considered distant metastasis. Fluorescence imaging using near infrared fluorescence light and indocyanine green (ICG-NIR imaging) are widely employed for identifying the sentinel lymph node, which might be an ideal alternative procedure for whole excisional biopsy of PAN. However, there has been no report about ICG-NIR imaging in hilar malignancies. The purpose of this study was to determine the optimal dose for indocyanine green to detect PAN and to reveal the detection rate of ICG-NIR imaging for lymphatic flow toward regional lymph nodes (RLN) or PAN from the Calot's triangle. PATIENTS AND METHODS We enrolled 62 patients with hepato-pancreatic-biliary malignancies in this study. The dose of ICG was optimized in the first 15 patients and the detection rate for RLN and PAN was evaluated in the remaining 47. We observed that the optimal administered dose of ICG for detecting fluorescent signals in PAN was 5 mg/mL. RESULTS Using this dose, RLN and PAN fluorescence were detected in 29 of 42 patients. Fluorescent signals were recorded in the lymph nodes (LN) along the bile duct and the posterior surface of the head of the pancreas. We also detected PAN fluorescent signals on the right side of the aorta around the left renal vein. We recommend 5 mg/ml of ICG to visualize lymphatic flow from the hepatoduodenal ligament to PAN using ICG-NIR imaging. However, because detection rate of RLN and PAN were 69%, respectively, further improvement for this procedure will be necessary for clinical application.
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Affiliation(s)
- Takehiro Noji
- Hokkaido University Faculty of Medicine, Gastroenterological Surgery II, Hokkaido, Kita 15 Nishi 7, Kita-ku, 060-8638, Sapporo, Japan.
| | - Hajime Narasaki
- Hokkaido University Faculty of Medicine, Gastroenterological Surgery II, Hokkaido, Kita 15 Nishi 7, Kita-ku, 060-8638, Sapporo, Japan
| | - Yuma Ebihara
- Hokkaido University Faculty of Medicine, Gastroenterological Surgery II, Hokkaido, Kita 15 Nishi 7, Kita-ku, 060-8638, Sapporo, Japan
| | - Kimitaka Tanaka
- Hokkaido University Faculty of Medicine, Gastroenterological Surgery II, Hokkaido, Kita 15 Nishi 7, Kita-ku, 060-8638, Sapporo, Japan
| | - Yoshitsugu Nakanishi
- Hokkaido University Faculty of Medicine, Gastroenterological Surgery II, Hokkaido, Kita 15 Nishi 7, Kita-ku, 060-8638, Sapporo, Japan
| | - Toshimichi Asano
- Hokkaido University Faculty of Medicine, Gastroenterological Surgery II, Hokkaido, Kita 15 Nishi 7, Kita-ku, 060-8638, Sapporo, Japan
| | - Toru Nakamura
- Hokkaido University Faculty of Medicine, Gastroenterological Surgery II, Hokkaido, Kita 15 Nishi 7, Kita-ku, 060-8638, Sapporo, Japan
| | - Takahiro Tsuchikawa
- Hokkaido University Faculty of Medicine, Gastroenterological Surgery II, Hokkaido, Kita 15 Nishi 7, Kita-ku, 060-8638, Sapporo, Japan
| | - Keisuke Okamura
- Hokkaido University Faculty of Medicine, Gastroenterological Surgery II, Hokkaido, Kita 15 Nishi 7, Kita-ku, 060-8638, Sapporo, Japan
| | - Satoshi Hirano
- Hokkaido University Faculty of Medicine, Gastroenterological Surgery II, Hokkaido, Kita 15 Nishi 7, Kita-ku, 060-8638, Sapporo, Japan
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Shirata C, Kawaguchi Y, Kobayashi K, Kobayashi Y, Arita J, Akamatsu N, Kaneko J, Sakamoto Y, Kokudo N, Hasegawa K. Usefulness of indocyanine green-fluorescence imaging for real-time visualization of pancreas neuroendocrine tumor and cystic neoplasm. J Surg Oncol 2018; 118:1012-1020. [DOI: 10.1002/jso.25231] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 08/20/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Chikara Shirata
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery; Graduate School of Medicine, The University of Tokyo; Tokyo Japan
| | - Yoshikuni Kawaguchi
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery; Graduate School of Medicine, The University of Tokyo; Tokyo Japan
| | - Kosuke Kobayashi
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery; Graduate School of Medicine, The University of Tokyo; Tokyo Japan
| | - Yuta Kobayashi
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery; Graduate School of Medicine, The University of Tokyo; Tokyo Japan
| | - Junichi Arita
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery; Graduate School of Medicine, The University of Tokyo; Tokyo Japan
| | - Nobuhisa Akamatsu
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery; Graduate School of Medicine, The University of Tokyo; Tokyo Japan
| | - Junichi Kaneko
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery; Graduate School of Medicine, The University of Tokyo; Tokyo Japan
| | - Yoshihiro Sakamoto
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery; Graduate School of Medicine, The University of Tokyo; Tokyo Japan
| | - Norihiro Kokudo
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery; Graduate School of Medicine, The University of Tokyo; Tokyo Japan
| | - Kiyoshi Hasegawa
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery; Graduate School of Medicine, The University of Tokyo; Tokyo Japan
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Favril S, Abma E, Blasi F, Stock E, Devriendt N, Vanderperren K, de Rooster H. Clinical use of organic near-infrared fluorescent contrast agents in image-guided oncologic procedures and its potential in veterinary oncology. Vet Rec 2018; 183:354. [DOI: 10.1136/vr.104851] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 04/11/2018] [Accepted: 04/17/2018] [Indexed: 12/15/2022]
Affiliation(s)
- Sophie Favril
- Small Animal Department, Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
- Cancer Research Institute Ghent (CRIG); Ghent Belgium
| | - Eline Abma
- Small Animal Department, Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
- Cancer Research Institute Ghent (CRIG); Ghent Belgium
| | - Francesco Blasi
- Ephoran Multi-Imaging Solutions s.r.l.; Colleretto Giacosa Italy
| | - Emmelie Stock
- Department of Medical Imaging of Domestic Animals, Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
| | - Nausikaa Devriendt
- Small Animal Department, Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
| | - Katrien Vanderperren
- Department of Medical Imaging of Domestic Animals, Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
| | - Hilde de Rooster
- Small Animal Department, Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
- Cancer Research Institute Ghent (CRIG); Ghent Belgium
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154
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Takemoto N, Koyanagi A, Yasuda M, Yamamoto H. Comparison of the indocyanine green dye method versus the combined method of indigo carmine blue dye with indocyanine green fluorescence imaging for sentinel lymph node biopsy in breast conservative therapy for stage ≤IIA breast cancer. BMC WOMENS HEALTH 2018; 18:151. [PMID: 30227837 PMCID: PMC6145193 DOI: 10.1186/s12905-018-0646-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 09/12/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Fluorescence imaging (FI) is one of the methods to identify sentinel lymph nodes (SLNs). However, the procedure is technically complicated and requires procedural skills, as SLN biopsy must be conducted in dim light conditions. As an improved version of this method, we introduced a combined method (Combined mixed dye and fluorescence; CMF) consisting of indigo carmine blue dye and FI. The direct visualization of SLNs under shadowless surgical light conditions is facilitated by the addition of the blue dye. We compared the SLN detection rates of CMF with that of the indocyanine green (ICG) dye method (ICG-D). METHODS A total of 202 patients with stage ≤IIA breast cancer who underwent breast conservative therapy with separate incision from January 2004 to February 2017 were reviewed. Details of the two methods are as follows: (1) ICG-D: 10 mg of ICG was used and the green-stained SLNs were resected via a 3-4 cm axillary incision; (2) CMF: A combination of 5 mg of ICG and 4-8 mg of indigo carmine was used. After a 1.5-2 cm incision was made near the point of disappearance of the fluorescence using Photodynamic Eye (PDE), the blue-stained SLNs were resected under shadowless surgical light conditions. RESULTS There were 92 ICG-D and 110 CMF cases. CMF resulted in a significantly higher SLN detection rate than ICG-D (96.4% vs. 83.7%; p = 0.003). This difference was particularly notable in those aged ≥60 years (98.3% vs. 74.3%) and individuals with body mass index (BMI) ≥25 kg/m2 (90.3% vs. 58.3%). CONCLUSION CMF is an effective method to identify SLNs which is safe and efficient. CMF achieves a high SLN identification rate and most of this procedure is feasible under shadowless surgical light conditions. CMF can reliably perform SLN biopsy even in those aged ≥60 years and individuals with BMI ≥ 25 kg/m2.
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Affiliation(s)
- Nobuyuki Takemoto
- Department of Breast & Endocrine Surgery, Japan Medical Alliance East Saitama General Hospital, 5-517, Yoshino, Satte, Saitama, 0153-340, Japan.
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain
| | - Masanori Yasuda
- Department of Pathology, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Hiroshi Yamamoto
- Geriatric Health Service Facility (COSMOS), Japan Medical Alliance Yokohama Stroke and Brain Center, Yokohama city, Japan
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155
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Li C, Torres VC, Tichauer KM. Noninvasive detection of cancer spread to lymph nodes: A review of molecular imaging principles and protocols. J Surg Oncol 2018; 118:301-314. [PMID: 30196532 DOI: 10.1002/jso.25124] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 05/06/2018] [Indexed: 12/20/2022]
Abstract
Identification of cancer spread to tumor-draining lymph nodes offers critical information for guiding treatment in many cancer types. Current clinical methods of nodal staging are invasive and can have substantial negative side effects. Molecular imaging protocols have long been proposed as a less invasive means of nodal staging, having the potential to enable highly sensitive and specific evaluations. This review article summarizes the current status and future perspectives for molecular targeted nodal staging.
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Affiliation(s)
- Chengyue Li
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, Illinois
| | - Veronica C Torres
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, Illinois
| | - Kenneth M Tichauer
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, Illinois
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156
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New Techniques for Diagnosis and Treatment of Musculoskeletal Tumors: Methods of Intraoperative Margin Detection. Tech Orthop 2018. [DOI: 10.1097/bto.0000000000000290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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157
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Townsend KL, Milovancev M, Bracha S. Feasibility of near-infrared fluorescence imaging for sentinel lymph node evaluation of the oral cavity in healthy dogs. Am J Vet Res 2018; 79:995-1000. [DOI: 10.2460/ajvr.79.9.995] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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158
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Liberale G, Bohlok A, Bormans A, Bouazza F, Galdon MG, El Nakadi I, Bourgeois P, Donckier V. Indocyanine green fluorescence imaging for sentinel lymph node detection in colorectal cancer: A systematic review. Eur J Surg Oncol 2018; 44:1301-1306. [DOI: 10.1016/j.ejso.2018.05.034] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 03/26/2018] [Accepted: 05/30/2018] [Indexed: 01/09/2023] Open
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159
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Nakaseko Y, Ishizawa T, Saiura A. Fluorescence-guided surgery for liver tumors. J Surg Oncol 2018; 118:324-331. [DOI: 10.1002/jso.25128] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 05/20/2018] [Indexed: 01/01/2023]
Affiliation(s)
- Yuichi Nakaseko
- Department of Gastroenterological Surgery, Cancer Institute Hospital; Japanese Foundation for Cancer Research; Tokyo Japan
| | - Takeaki Ishizawa
- Department of Gastroenterological Surgery, Cancer Institute Hospital; Japanese Foundation for Cancer Research; Tokyo Japan
| | - Akio Saiura
- Department of Gastroenterological Surgery, Cancer Institute Hospital; Japanese Foundation for Cancer Research; Tokyo Japan
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160
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Ersoy YE, Kadioglu H. Review of Novel Sentinel Lymph Node Biopsy Techniques in Breast Cancer Patients Treated With Neoadjuvant Chemotherapy. Clin Breast Cancer 2018; 18:e555-e559. [DOI: 10.1016/j.clbc.2018.01.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 01/16/2018] [Indexed: 01/05/2023]
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161
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Shirotsuki R, Uchida H, Tanaka Y, Shirota C, Yokota K, Murase N, Hinoki A, Oshima K, Chiba K, Sumida W, Hayakawa M, Tainaka T. Novel thoracoscopic navigation surgery for neonatal chylothorax using indocyanine-green fluorescent lymphography. J Pediatr Surg 2018; 53:1246-1249. [PMID: 29486888 DOI: 10.1016/j.jpedsurg.2018.01.019] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 12/31/2017] [Accepted: 01/24/2018] [Indexed: 01/30/2023]
Abstract
BACKGROUND Postoperative chylothorax after surgery for esophageal atresia/tracheoesophageal fistula (TEF) is a rare but serious complication, especially in neonates. This study aimed to identify the thoracic duct and ligate chylous leakage sites, using thoracoscopic navigation of an indocyanine-green (ICG)-based near-infrared (NIR) fluorescence imaging system. METHODS From November 2014 to April 2017, thoracoscopic intraoperative ICG-NIR imaging was performed in 10 newborns (11 surgeries) with first TEF operation or with persistent postoperative chylothorax after TEF operation. NIR imaging was performed 1h after an inter-toe injection of ICG. Thoracoscopic ligations against the NIR-detected leakage sites were performed with sutures. RESULTS The thoracic duct or lymphatic leakage was directly visualized in each patient. In 8 surgeries with first thoracoscopic TEF operation, one case had suspected minor chylous leakage without postoperative chylothorax. Another case with no chylous leakage at the first operation resulted in chylothorax at postoperative day 11. In three neonates with postoperative chylothorax, leakage points were detected near the ablation site of the azygos vein during the first operation. These points were properly ligated, and postoperative chylous leakage ceased with no adverse events. CONCLUSIONS Thoracoscopic ICG-NIR imaging encourages the repair of refractory chylothorax and seems reliable. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Ryo Shirotsuki
- Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa, Nagoya 466-8550, Japan
| | - Hiroo Uchida
- Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa, Nagoya 466-8550, Japan.
| | - Yujiro Tanaka
- Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa, Nagoya 466-8550, Japan
| | - Chiyoe Shirota
- Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa, Nagoya 466-8550, Japan
| | - Kazuki Yokota
- Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa, Nagoya 466-8550, Japan
| | - Naruhiko Murase
- Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa, Nagoya 466-8550, Japan
| | - Akinari Hinoki
- Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa, Nagoya 466-8550, Japan
| | - Kazuo Oshima
- Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa, Nagoya 466-8550, Japan
| | - Kosuke Chiba
- Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa, Nagoya 466-8550, Japan
| | - Wataru Sumida
- Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa, Nagoya 466-8550, Japan
| | - Masahiro Hayakawa
- Division of Neonatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, Nagoya, Japan
| | - Takahisa Tainaka
- Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa, Nagoya 466-8550, Japan
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Shen S, Xu Q, Zhou Y, Mao F, Guan J, Sun Q. Comparison of sentinel lymph node biopsy guided by blue dye with or without indocyanine green in early breast cancer. J Surg Oncol 2018; 117:1841-1847. [PMID: 29790178 DOI: 10.1002/jso.25058] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 03/08/2018] [Indexed: 11/11/2022]
Abstract
BACKGROUND There were limited data available for a head-to-head comparison of the identification rate and survival between the combined method of indocyanine green fluorescence and blue dye versus the traditional blue dye alone method for sentinel lymph node (SLN) biopsy. METHODS From January 2013 to December 2015, 523 eligible breast cancer patients were included in this nonrandomized prospective analysis. The identification rates, the number of SLNs identified, and the disease-free survival (DFS) between the two mapping methods were compared. RESULTS The identification rate of SLNs was significantly higher with the combined method than that with the blue dye alone method (99.2% vs 93.3%, respectively; P < 0.001). The average number of SLNs identified per patient in the combined method group was 3.7 ± 2.4, which was more than that in the blue dye alone group (3.2 ± 1.6; P = 0.004). With a median follow-up of 29 months, 0.5% patients in the combined group, and 1.3% patients in the blue dye group had axillary recurrences. The DFS between the two groups showed no significant difference (P = 0.161). CONCLUSION The combined method achieved a higher identification rate and lower rate of axillary recurrence compared to the blue dye alone method.
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Affiliation(s)
- Songjie Shen
- Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Dongcheng District, Beijing, China
| | - Qianqian Xu
- Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Dongcheng District, Beijing, China
| | - Yidong Zhou
- Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Dongcheng District, Beijing, China
| | - Feng Mao
- Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Dongcheng District, Beijing, China
| | - Jinghong Guan
- Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Dongcheng District, Beijing, China
| | - Qiang Sun
- Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Dongcheng District, Beijing, China
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163
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Takada M, Takeuchi M, Suzuki E, Sato F, Matsumoto Y, Torii M, Kawaguchi-Sakita N, Nishino H, Seo S, Hatano E, Toi M. Real-time navigation system for sentinel lymph node biopsy in breast cancer patients using projection mapping with indocyanine green fluorescence. Breast Cancer 2018; 25:650-655. [PMID: 29744670 DOI: 10.1007/s12282-018-0868-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 05/02/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Inability to visualize indocyanine green fluorescence images in the surgical field limits the application of current near-infrared fluorescence imaging (NIR) systems for real-time navigation during sentinel lymph node (SLN) biopsy in breast cancer patients. The aim of this study was to evaluate the usefulness of the Medical Imaging Projection System (MIPS), which uses active projection mapping, for SLN biopsy. METHODS A total of 56 patients (59 procedures) underwent SLN biopsy using the MIPS between March 2016 and November 2017. After SLN biopsy using the MIPS, residual SLNs were removed using a conventional NIR camera and/or radioisotope method. The primary endpoint of this study was identification rate of SLNs using the MIPS. RESULTS In all procedures, at least one SLN was detected by the MIPS, giving an SLN identification rate of 100% [95% confidence interval (CI) 94-100%]. SLN biopsy was successfully performed without operating lights in all procedures. In total, 3 positive SLNs were excised using MIPS, but were not included in the additional SLNs excised by other methods. The median number of SLNs excised using the MIPS was 3 (range 1-7). Of procedures performed after preoperative systemic therapy, the median number of SLNs excised using the MIPS was 3 (range 2-6). CONCLUSIONS The MIPS is effective in detecting SLNs in patients with breast cancer, providing continuous and accurate projection of fluorescence signals in the surgical field, without need for operating lights, and could be useful in real-time navigation surgery for SLN biopsy.
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Affiliation(s)
- Masahiro Takada
- Department of Surgery (Breast Surgery), Kyoto University Hospital, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Megumi Takeuchi
- Department of Breast Surgery, Mitsubishi Kyoto Hospital, 1, Katsura Goshocho, Nishikyo-ku, Kyoto, 615-8087, Japan
| | - Eiji Suzuki
- Department of Surgery (Breast Surgery), Kyoto University Hospital, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Fumiaki Sato
- Department of Surgery (Breast Surgery), Kyoto University Hospital, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Yoshiaki Matsumoto
- Department of Surgery (Breast Surgery), Kyoto University Hospital, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Masae Torii
- Department of Surgery (Breast Surgery), Kyoto University Hospital, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Nobuko Kawaguchi-Sakita
- Department of Surgery (Breast Surgery), Kyoto University Hospital, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Hiroto Nishino
- Department of Surgery (Hepato-Biliary-Pancreatic Surgery and Transplantation), Kyoto University Hospital, 54, Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Satoru Seo
- Department of Surgery (Hepato-Biliary-Pancreatic Surgery and Transplantation), Kyoto University Hospital, 54, Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Etsuro Hatano
- Department of Surgery (Hepato-Biliary-Pancreatic Surgery and Transplantation), Kyoto University Hospital, 54, Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
- Department of Surgery, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, 663-8501, Japan
| | - Masakazu Toi
- Department of Surgery (Breast Surgery), Kyoto University Hospital, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
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165
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Takemiya K, Ning X, Seo W, Wang X, Mohammad R, Joseph G, Titterington JS, Kraft CS, Nye JA, Murthy N, Goodman MM, Taylor WR. Novel PET and Near Infrared Imaging Probes for the Specific Detection of Bacterial Infections Associated With Cardiac Devices. JACC Cardiovasc Imaging 2018; 12:875-886. [PMID: 29680350 DOI: 10.1016/j.jcmg.2018.02.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 02/04/2018] [Accepted: 02/08/2018] [Indexed: 12/18/2022]
Abstract
OBJECTIVES The aim of this study was to develop imaging agents to detect early stage infections in implantable cardiac devices. BACKGROUND Bacteria ingest maltodextrins through the specific maltodextrin transporter. We developed probes conjugated with either a fluorescent dye (maltohexaose fluorescent dye probe [MDP]) or a F-18 (F18 fluoromaltohexaose) and determined their usefulness in a model of infections associated with implanted cardiac devices. METHODS Stainless steel mock-ups of medical devices were implanted subcutaneously in rats. On post-operative day 4, animals were injected with either Staphylococcus aureus around the mock-ups to induce a relatively mild infection or oil of turpentine to induce noninfectious inflammation. Animals with a sterile implant were used as control subjects. On post-operative day 6, either the MDP or F18 fluoromaltohexaose was injected intravenously, and the animals were scanned with the appropriate imaging device. Additional positron emission tomography imaging studies were performed with F18-fluorodeoxyglucose as a comparison of the specificity of our probes (n = 5 to 9 per group). RESULTS The accumulation of the MDP in the infected rats was significantly increased at 1 h after injection when compared with the control and noninfectious inflammation groups (intensity ratio 1.54 ± 0.07 vs. 1.26 ± 0.04 and 1.20 ± 0.05, respectively; p < 0.05) and persisted for more than 24 h. In positron emission tomography imaging, both F18 fluoromaltohexaose and F18 fluorodeoxyglucose significantly accumulated in the infected area 30 min after the injection (maximum standard uptake value ratio 4.43 ± 0.30 and 4.87 ± 0.28, respectively). In control rats, there was no accumulation of imaging probes near the device. In the noninfectious inflammation rats, no significant accumulation was observed with F18 fluoromaltohexaose, but F18 fluorodeoxyglucose accumulated in the mock-up area (maximum standard uptake value 2.53 ± 0.39 vs. 4.74 ± 0.46, respectively; p < 0.05). CONCLUSIONS Our results indicate that maltohexaose-based imaging probes are potentially useful for the specific and sensitive diagnosis of infections associated with implantable cardiac devices.
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Affiliation(s)
- Kiyoko Takemiya
- Emory University School of Medicine, Department of Medicine, Division of Cardiology, Atlanta, Georgia
| | - Xinghai Ning
- University of California at Berkeley, Department of Bioengineering, Berkeley, California
| | - Wonewoo Seo
- Emory University School of Medicine, Department of Radiology and Imaging Sciences, Emory Center for Systems Imaging, Atlanta, Georgia
| | - Xiaojian Wang
- University of California at Berkeley, Department of Bioengineering, Berkeley, California
| | - Rafi Mohammad
- University of California at Berkeley, Department of Bioengineering, Berkeley, California
| | - Giji Joseph
- Emory University School of Medicine, Department of Medicine, Division of Cardiology, Atlanta, Georgia
| | - Jane S Titterington
- Emory University School of Medicine, Department of Medicine, Division of Cardiology, Atlanta, Georgia
| | - Colleen S Kraft
- Emory University School of Medicine, Department of Pathology and Laboratory Medicine, Atlanta, Georgia
| | - Jonathan A Nye
- Emory University School of Medicine, Department of Radiology and Imaging Sciences, Emory Center for Systems Imaging, Atlanta, Georgia
| | - Niren Murthy
- University of California at Berkeley, Department of Bioengineering, Berkeley, California.
| | - Mark M Goodman
- Emory University School of Medicine, Department of Radiology and Imaging Sciences, Emory Center for Systems Imaging, Atlanta, Georgia.
| | - W Robert Taylor
- Emory University School of Medicine, Department of Medicine, Division of Cardiology, Atlanta, Georgia; Atlanta Veterans Affairs Medical Center, Cardiology Division, Atlanta, Georgia; Emory University School of Medicine and Georgia Institute of Technology, Department of Biomedical Engineering, Atlanta, Georgia.
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The inhibitory effect of gadoxetate disodium on hepatic transporters: a study using indocyanine green. Eur Radiol 2018; 28:4128-4133. [PMID: 29651770 DOI: 10.1007/s00330-018-5403-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 02/20/2018] [Accepted: 02/22/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVES To assess the inhibitory effect of gadoxetate disodium on the transporter system using indocyanine green (ICG). MATERIALS AND METHODS Groups of six female B6 Albino mice were injected with the test agent (0.62 mmol/kg gadoxetate disodium) or phosphate-buffered saline (control) 10 min before injection of ICG. Identical fluorescence images were subsequently obtained to create time-efficiency curves of liver parenchymal uptake. The study was performed on hypothermic and normothermic mice. The logarithms of the absorption rate constants (logKa values) and of the elimination rate constants (logKe values) were calculated for each experimental condition, and between-group differences were compared using Student's t-test. RESULTS The logKe values of the test group were lower than those of the control group at both temperatures (-6.52 vs. -5.87 under hypothermic conditions and -4.54 vs. -4.14 under normothermic conditions), and both differences were statistically significant (p = 0.037, 0.015 respectively). In terms of the logKa values, although the difference did not reach statistical significance (p = 0.052), the test group had lower values than the control group under hypothermic conditions (-0.771 vs. -0.376). In normothermic mice, the logKa values for the test and control groups were 0.037 and 0.277 respectively, thus not significantly different (p = 0.404). CONCLUSIONS Gadoxetate disodium inhibited ICG excretion. Thus, gadoxetate disodium inhibited the ATP-binding cassette sub-family C member 2 transporter. KEY POINTS • Gadoxetate disodium inhibited ICG excretion. • Gadoxetate disodium tended to inhibit hepatic ICG uptake. • Drug-drug interactions of gadoxetate disodium need further investigation.
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Maeda T, Yamamoto Y, Iwasaki D, Hayashi T, Funayama E, Oyama A, Murao N, Furukawa H. Lymphatic Reconnection and Restoration of Lymphatic Flow by Nonvascularized Lymph Node Transplantation: Real-Time Fluorescence Imaging Using Indocyanine Green and Fluorescein Isothiocyanate–Dextran. Lymphat Res Biol 2018; 16:165-173. [DOI: 10.1089/lrb.2016.0070] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Taku Maeda
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Hokkaido at Sapporo (UHS), Sapporo City, Hokkaido, Japan
| | - Yuhei Yamamoto
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Hokkaido at Sapporo (UHS), Sapporo City, Hokkaido, Japan
| | - Daisuke Iwasaki
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Hokkaido at Sapporo (UHS), Sapporo City, Hokkaido, Japan
| | - Toshihiko Hayashi
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Hokkaido at Sapporo (UHS), Sapporo City, Hokkaido, Japan
| | - Emi Funayama
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Hokkaido at Sapporo (UHS), Sapporo City, Hokkaido, Japan
| | - Akihiko Oyama
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Hokkaido at Sapporo (UHS), Sapporo City, Hokkaido, Japan
| | - Naoki Murao
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Hokkaido at Sapporo (UHS), Sapporo City, Hokkaido, Japan
| | - Hiroshi Furukawa
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Hokkaido at Sapporo (UHS), Sapporo City, Hokkaido, Japan
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168
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Furukawa N, Oi H, Yoshida S, Shigetomi H, Kanayama S, Kobayashi H. The Usefulness of Photodynamic Eye for Sentinel Lymph Node Identification in Patients with Cervical Cancer. TUMORI JOURNAL 2018. [DOI: 10.1177/548.6512] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims and background We studied the potential use of sentinel lymph node identification using a near-infrared fluorescence imaging technique in the treatment of cervical cancer. Methods and study design Directly before the start of the operation, 0.2 ml of 5 mg/ml indocyanine green was prepared and injected into 4 sites in the cervix using a 26-gauge standard needle, at 3, 6, 9 and 12 o'clock positions. When the operation was advanced to the pelvis, near-infrared fluorescence imaging was performed using photodynamic eye (Hamamatsu Photonics Co., Japan). The sentinel lymph nodes and other dissected lymph nodes were histologically examined to find any metastases. Results Twelve patients were examined. Their ages ranged from 36 to 68 years (median, 58). Sentinel lymph nodes were identified in 10 patients (83%), and all were bi-laterally identified. The median maximum tumor diameter of dissected cervical tumors was 35 mm (22–65); histology was squamous cell carcinoma in 8 patients and adenocarcinoma in 2 patients. Capillary lymphatic space involvement was found in 8 of the 10 patients. The site of the sentinel lymph node was the right external iliac node in 8 patients, the right obturator node in 8, the left external iliac node in 9, and the left obturator node in 8. Lymph node metastasis was found in 2 of the 12 patients, and all were sentinel lymph nodes. No metastasis from lymph nodes other than sentinel lymph nodes was observed. Conclusions Photodynamic eye achieved a detection rate similar to that obtained with the blue dye and radioisotope method. It is also easier to use than the other two methods. Free full text available at www.tumorionline.it
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Affiliation(s)
- Naoto Furukawa
- Department of Obstetrics and Gynecology, Nara Medical University 840 Shijo-cho, Kashihara, Nara 634–8522, Japan
| | - Hidekazu Oi
- Department of Obstetrics and Gynecology, Nara Medical University 840 Shijo-cho, Kashihara, Nara 634–8522, Japan
| | - Shozo Yoshida
- Department of Obstetrics and Gynecology, Nara Medical University 840 Shijo-cho, Kashihara, Nara 634–8522, Japan
| | - Hiroshi Shigetomi
- Department of Obstetrics and Gynecology, Nara Medical University 840 Shijo-cho, Kashihara, Nara 634–8522, Japan
| | - Seiji Kanayama
- Department of Obstetrics and Gynecology, Nara Medical University 840 Shijo-cho, Kashihara, Nara 634–8522, Japan
| | - Hiroshi Kobayashi
- Department of Obstetrics and Gynecology, Nara Medical University 840 Shijo-cho, Kashihara, Nara 634–8522, Japan
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Kim H, Beack S, Han S, Shin M, Lee T, Park Y, Kim KS, Yetisen AK, Yun SH, Kwon W, Hahn SK. Multifunctional Photonic Nanomaterials for Diagnostic, Therapeutic, and Theranostic Applications. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2018; 30. [PMID: 29363198 DOI: 10.1002/adma.201701460] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 10/20/2017] [Indexed: 05/08/2023]
Abstract
The last decade has seen dramatic progress in the principle, design, and fabrication of photonic nanomaterials with various optical properties and functionalities. Light-emitting and light-responsive nanomaterials, such as semiconductor quantum dots, plasmonic metal nanoparticles, organic carbon, and polymeric nanomaterials, offer promising approaches to low-cost and effective diagnostic, therapeutic, and theranostic applications. Reasonable endeavors have begun to translate some of the promising photonic nanomaterials to the clinic. Here, current research on the state-of-the-art and emerging photonic nanomaterials for diverse biomedical applications is reviewed, and the remaining challenges and future perspectives are discussed.
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Affiliation(s)
- Hyemin Kim
- PHI BIOMED Co., #613, 12 Gangnam-daero 65-gil, Seocho-gu, Seoul, 06612, South Korea
| | - Songeun Beack
- Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk, 37673, South Korea
| | - Seulgi Han
- Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk, 37673, South Korea
| | - Myeonghwan Shin
- Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk, 37673, South Korea
| | - Taehyung Lee
- Department of Chemical Engineering, POSTECH, 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk, 37673, South Korea
| | - Yoonsang Park
- Department of Chemical Engineering, POSTECH, 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk, 37673, South Korea
| | - Ki Su Kim
- Wellman Center for Photomedicine, Massachusetts General Hospital, 65 Landsdowne St., UP-5, Cambridge, MA, 02139, USA
| | - Ali K Yetisen
- Wellman Center for Photomedicine, Massachusetts General Hospital, 65 Landsdowne St., UP-5, Cambridge, MA, 02139, USA
| | - Seok Hyun Yun
- Wellman Center for Photomedicine, Massachusetts General Hospital, 65 Landsdowne St., UP-5, Cambridge, MA, 02139, USA
| | - Woosung Kwon
- Department of Chemical and Biological Engineering, Sookmyung Women's University, 100 Cheongpa-ro 47-gil, Seoul, 04310, South Korea
| | - Sei Kwang Hahn
- Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk, 37673, South Korea
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Qiu SQ, Zhang GJ, Jansen L, de Vries J, Schröder CP, de Vries EGE, van Dam GM. Evolution in sentinel lymph node biopsy in breast cancer. Crit Rev Oncol Hematol 2018; 123:83-94. [PMID: 29482783 DOI: 10.1016/j.critrevonc.2017.09.010] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 06/12/2017] [Accepted: 09/19/2017] [Indexed: 02/05/2023] Open
Abstract
Sentinel lymph node biopsy (SLNB) is the standard of care for axillary staging in clinically node-negative (cN0) breast cancer patients without neoadjuvant chemotherapy (NAC). The application of SLNB in patients receiving NAC has also been explored. Evidence supports its use after NAC in pretreatment cN0 patients. Nonetheless, its routine use in all the pretreatment node-positive patients who become cN0 after NAC is unjustified due to the unacceptably high false-negative rate, which can be improved in a subset of patients. Axillary surgery omission in selected patients with a low risk of ALN metastasis has gained more and more research interest because the SLNs are tumor-free in more than 70% of all patients. To avoid drawbacks of conventional mapping methods, novel techniques for SLN detection have been developed and shown to be highly accurate in patients with early breast cancer. This article reviews the progress in SLNB in patients with breast cancer.
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Affiliation(s)
- Si-Qi Qiu
- Department of Medical Oncology, University Medical Center Groningen, Groningen, The Netherlands; Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands; The Breast Center, Cancer Hospital of Shantou University Medical College, Guangdong, China
| | - Guo-Jun Zhang
- The Breast Center, Cancer Hospital of Shantou University Medical College, Guangdong, China; Changjiang Scholar's Laboratory of Shantou University Medical College, Guangdong, China
| | - Liesbeth Jansen
- Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands
| | - Jakob de Vries
- Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands
| | - Carolien P Schröder
- Department of Medical Oncology, University Medical Center Groningen, Groningen, The Netherlands
| | - Elisabeth G E de Vries
- Department of Medical Oncology, University Medical Center Groningen, Groningen, The Netherlands
| | - Gooitzen M van Dam
- Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands; Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands.
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Bao Z, Zhang Y, Tan Z, Yin X, Di W, Ye J. Gap-enhanced Raman tags for high-contrast sentinel lymph node imaging. Biomaterials 2018; 163:105-115. [PMID: 29455067 DOI: 10.1016/j.biomaterials.2018.02.020] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 01/29/2018] [Accepted: 02/08/2018] [Indexed: 12/13/2022]
Abstract
The sentinel lymph node (SLN) biopsy is gaining in popularity as a procedure to investigate the lymphatic metastasis of malignant tumors. The commonly used techniques to identify the SLNs in clinical practice are blue dyes-guided visualization, radioisotope-based detection and near-infrared fluorescence imaging. However, all these methods have not been found to perfectly fit the clinical criteria with issues such as short retention time in SLN, poor spatial resolution, autofluorescence, low photostability and high cost. In this study, we have reported a new type of nanoprobes, named, gap-enhanced Raman tags (GERTs) for the SLN Raman imaging. With the advantageous features including unique "fingerprint" Raman signal, strong Raman enhancement, high photostability, good biocompatibility and extra-long retention time, we have demonstrated that GERTs are greatly favorable for high-contrast and deep SLN Raman imaging, which meanwhile reveals the dynamic migration behavior of the probes entering the SLN. In addition, a quantitative volumetric Raman imaging (qVRI) data-processing method is employed to acquire a high-resolution 3-dimensional (3D) margin of SLN as well as the content variation of GERTs in the SLN. Moreover, SLN detection could be realized via a cost-effective commercial portable Raman scanner. Therefore, GERTs hold the great potential to be translated in clinical application for accurate and intraoperative location of the SLN.
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Affiliation(s)
- Zhouzhou Bao
- Department of Obstetrics and Gynecology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, PR China; Shanghai Key Laboratory of Gynecologic Oncology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, PR China; State Key Laboratory of Oncogenes and Related Genes, Shanghai Cancer Institute, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, PR China
| | - Yuqing Zhang
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, PR China; Shanghai Med-X Engineering Research Center, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, PR China
| | - Ziyang Tan
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, PR China; Shanghai Med-X Engineering Research Center, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, PR China
| | - Xia Yin
- Department of Obstetrics and Gynecology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, PR China; Shanghai Key Laboratory of Gynecologic Oncology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, PR China; State Key Laboratory of Oncogenes and Related Genes, Shanghai Cancer Institute, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, PR China
| | - Wen Di
- Department of Obstetrics and Gynecology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, PR China; Shanghai Key Laboratory of Gynecologic Oncology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, PR China; State Key Laboratory of Oncogenes and Related Genes, Shanghai Cancer Institute, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, PR China.
| | - Jian Ye
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, PR China; Shanghai Key Laboratory of Gynecologic Oncology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, PR China; State Key Laboratory of Oncogenes and Related Genes, Shanghai Cancer Institute, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, PR China; Shanghai Med-X Engineering Research Center, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, PR China.
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172
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Detection of alternative subpleural lymph flow pathways using indocyanine green fluorescence. Surg Today 2018; 48:640-648. [DOI: 10.1007/s00595-018-1631-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 01/05/2018] [Indexed: 12/31/2022]
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173
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Yuan L, Qi X, Zhang Y, Yang X, Zhang F, Fan L, Chen L, Zhang K, Zhong L, Li Y, Gan S, Fu W, Jiang J. Comparison of sentinel lymph node detection performances using blue dye in conjunction with indocyanine green or radioisotope in breast cancer patients: a prospective single-center randomized study. Cancer Biol Med 2018; 15:452-460. [PMID: 30766755 PMCID: PMC6372915 DOI: 10.20892/j.issn.2095-3941.2018.0270] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Objective: This randomized study aimed to compare the clinical efficacy between the novel dual tracer composed of indocyanine green (ICG) and blue dye (BD) and the conventional dual tracer composed of radioisotope and BD for sentinel lymph node (SLN) mapping in patients with breast cancer. Methods: This study enrolled 471 clinically lymph node-negative patients with primary breast cancer. All patients underwent mastectomy, and those undergoing sentinel lymph node biopsy (SLNB) were randomized to receive blue dye plus radioisotope (RB group) or BD plus ICG (IB group). The detection performances on SLN identification rate, positive SLN counts, detection sensitivity, and false-negative rate were compared between the two groups. Results: In the IB group, 97% (194/200) of the patients who underwent the ICG and BD dual tracer injection showed fluorescent-positive lymphatic vessels within 2–5 min. The identification rate of SLNs was comparable between the IB group (99.0%, 198/200) and the RB group (99.6%, 270/271) (P = 0.79). No significant differences were observed in the identification rate of metastatic SLNs (22.5% vs. 22.9%, P > 0.05, RB group vs. IB group, the same below), positive SLN counts (3.72 ± 2.28 vs. 3.91 ± 2.13, P > 0.05), positive metastatic SLN counts (0.38 ± 0.84 vs. 0.34 ± 0.78, P > 0.05), SLNB detection sensitivity (94.4% vs. 92.5%, P > 0.05), or false-negative rate (5.6% vs. 7.5%, P > 0.05) between the two groups.
Conclusions: ICG can be used as a promising alternative tracer for radioisotope in SLN mapping, and when it is combined with BD in lymphangiography, it offers comparable detection sensitivity compared to the conventional lymphatic mapping strategies that are widely used in clinical practice.
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Affiliation(s)
- Long Yuan
- Department of Breast Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China
| | - Xiaowei Qi
- Department of Breast Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China
| | - Yi Zhang
- Department of Breast Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China
| | - Xinhua Yang
- Department of Breast Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China
| | - Fan Zhang
- Department of Breast Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China
| | - Linjun Fan
- Department of Breast Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China
| | - Li Chen
- Department of Breast Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China
| | - Kongyong Zhang
- Department of Breast Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China
| | - Ling Zhong
- Department of Breast Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China
| | - Yanling Li
- Department of Breast Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China
| | - Sijie Gan
- Department of Breast Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China
| | - Wenying Fu
- Department of Breast Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China
| | - Jun Jiang
- Department of Breast Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China
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Hackethal A, Hirschburger M, Eicker SO, Mücke T, Lindner C, Buchweitz O. Role of Indocyanine Green in Fluorescence Imaging with Near-Infrared Light to Identify Sentinel Lymph Nodes, Lymphatic Vessels and Pathways Prior to Surgery - A Critical Evaluation of Options. Geburtshilfe Frauenheilkd 2018; 78:54-62. [PMID: 29375146 PMCID: PMC5778195 DOI: 10.1055/s-0043-123937] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Revised: 11/29/2017] [Accepted: 11/30/2017] [Indexed: 02/07/2023] Open
Abstract
Modern surgical strategies aim to reduce trauma by using functional imaging to improve surgical outcomes. This reviews considers and evaluates the importance of the fluorescent dye indocyanine green (ICG) to visualize lymph nodes, lymphatic pathways and vessels and tissue borders in an interdisciplinary setting. The work is based on a selective search of the literature in PubMed, Scopus, and Google Scholar and the authors' own clinical experience. Because of its simple, radiation-free and uncomplicated application, ICG has become an important clinical indicator in recent years. In oncologic surgery ICG is used extensively to identify sentinel lymph nodes with promising results. In some studies, the detection rates with ICG have been better than the rates obtained with established procedures. When ICG is used for visualization and the quantification of tissue perfusion, it can lead to fewer cases of anastomotic insufficiency or transplant necrosis. The use of ICG for the imaging of organ borders, flap plasty borders and postoperative vascularization has also been scientifically evaluated. Combining the easily applied ICG dye with technical options for intraoperative and interventional visualization has the potential to create new functional imaging procedures which, in future, could expand or even replace existing established surgical techniques, particularly the techniques used for sentinel lymph node and anastomosis imaging.
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Affiliation(s)
- Andreas Hackethal
- Tagesklinik Altonaer Straße, Frauenklinik an der Elbe, Hamburg, Germany
| | | | - Sven Oliver Eicker
- Neurochirurgie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Thomas Mücke
- Mund-Kiefer-Gesichtschirurgie, St. Josefshospital, Krefeld-Uerdingen, Germany
| | - Christoph Lindner
- Gynäkologie und Geburtshilfe, Agaplesion Diakonieklinikum Hamburg, Hamburg, Germany
| | - Olaf Buchweitz
- Tagesklinik Altonaer Straße, Frauenklinik an der Elbe, Hamburg, Germany
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176
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Nagaya T, Nakamura YA, Choyke PL, Kobayashi H. Fluorescence-Guided Surgery. Front Oncol 2017; 7:314. [PMID: 29312886 PMCID: PMC5743791 DOI: 10.3389/fonc.2017.00314] [Citation(s) in RCA: 222] [Impact Index Per Article: 31.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 12/05/2017] [Indexed: 01/02/2023] Open
Abstract
Surgical resection of cancer remains an important treatment modality. Despite advances in preoperative imaging, surgery itself is primarily guided by the surgeon’s ability to locate pathology with conventional white light imaging. Fluorescence-guided surgery (FGS) can be used to define tumor location and margins during the procedure. Intraoperative visualization of tumors may not only allow more complete resections but also improve safety by avoiding unnecessary damage to normal tissue which can also reduce operative time and decrease the need for second-look surgeries. A number of new FGS imaging probes have recently been developed, complementing a small but useful number of existing probes. In this review, we describe current and new fluorescent probes that may assist FGS.
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Affiliation(s)
- Tadanobu Nagaya
- Molecular Imaging Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
| | - Yu A Nakamura
- Molecular Imaging Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
| | - Peter L Choyke
- Molecular Imaging Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
| | - Hisataka Kobayashi
- Molecular Imaging Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
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Beer P, Pozzi A, Rohrer Bley C, Bacon N, Pfammatter NS, Venzin C. The role of sentinel lymph node mapping in small animal veterinary medicine: A comparison with current approaches in human medicine. Vet Comp Oncol 2017; 16:178-187. [DOI: 10.1111/vco.12372] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 10/17/2017] [Indexed: 12/20/2022]
Affiliation(s)
- P. Beer
- Clinic for Small Animal Surgery, Vetsuisse Faculty; University of Zurich; Zurich Switzerland
| | - A. Pozzi
- Clinic for Small Animal Surgery, Vetsuisse Faculty; University of Zurich; Zurich Switzerland
| | - C. Rohrer Bley
- Division of Radiation Oncology, Vetsuisse Faculty; University of Zurich; Zurich Switzerland
| | - N. Bacon
- Fitzpatrick Referrals Oncology and Soft Tissue; Guildford Hospital; Guildford UK
| | - N. S. Pfammatter
- Clinic for Diagnostic Imaging, Vetsuisse Faculty; University of Zurich; Zurich Switzerland
| | - C. Venzin
- Clinic for Small Animal Surgery, Vetsuisse Faculty; University of Zurich; Zurich Switzerland
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178
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Lymphatic Territories (Lymphosomes) in the Rat: An Anatomical Study for Future Lymphatic Research. Plast Reconstr Surg 2017; 140:945-951. [PMID: 29068930 DOI: 10.1097/prs.0000000000003776] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Understanding the precise anatomy in experimental animals is crucial for correct design of research projects. Rats are commonly used for scientific research in plastic surgery because of their availability in academic institutions, moderate cost, and sizable vessels for microsurgical procedures. In past publications about rat anatomy, lymphatic mapping has been limited and incomplete. The aim of this study was to comprehensively map the superficial lymphatic system in the rat. METHODS Twenty-seven Sprague-Dawley rats were used for this study. Indocyanine green fluorescence lymphography was used to identify the lymphatic vessels and lymph nodes. Under general anaesthesia, indocyanine green was injected intradermally at multiple spots along the dorsal and medial midlines, front and hind paws, ears, and tail. The course of the lymphatic vessels was traced on the skin with a marker pen and photographed. The superficial lymphatic vessels in each rat were sketched on a graphic template and all of the templates were superimposed using graphics software to define the relationship between the lymphatic vessel and sentinel node. RESULTS Indocyanine green fluorescence lymphography was able to demonstrate the superficial lymphatic vessels in the rat. Six groups of regional lymph node/s were identified and lymphatic pathways to those nodes delineated. The authors' lymphosome concept was successfully applied to the rat, with six lymphosomes identified. CONCLUSIONS The authors succeeded in performing superficial lymphatic mapping in the rat. The authors' anatomical findings can provide further information about the lymphatic system in the normal state and promote understanding of pathologic changes generated by surgical manipulation for future studies.
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Guo J, Yang H, Wang S, Cao Y, Liu M, Xie F, Liu P, Zhou B, Tong F, Cheng L, Liu H, Wang S. Comparison of sentinel lymph node biopsy guided by indocyanine green, blue dye, and their combination in breast cancer patients: a prospective cohort study. World J Surg Oncol 2017; 15:196. [PMID: 29096643 PMCID: PMC5667473 DOI: 10.1186/s12957-017-1264-7] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 10/23/2017] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Recent studies show that near-infrared (NIR) fluorescence imaging using indocyanine green (ICG) has the potential to improve the performance of sentinel lymph node (SLN) mapping. The current cohort study was designed to assess the value of the combination of ICG and methylene blue (MB) dye in patients undergoing SLN biopsy. METHODS A prospective self-controlled trial was designed to detect the difference in the detection efficacies of ICG, MB, and combined ICG and MB (ICG + MB) navigation methods. Between 2010 and 2013, 198 consecutive early breast cancer patients eligible for sentinel lymph node biopsy were enrolled and 200 biopsy procedures were performed by injection of both ICG and MB. SLNs were searched and removed under the guidance of fluorescence and/or blue dye. The mapping characteristics, the detection rate of SLNs and positive SLNs, and the number of SLNs of ICG, MB, and ICG + MB were compared. Injection safety of ICG and MB was evaluated. RESULTS Fluorescence imaging of lymphatic flow, which is helpful to locate the incision site, could be seen in 184 of 200 procedures. The nodal detection rate of ICG, MB, and ICG + MB samples was 97, 89, and 99.5% (χ 2 = 26.2, p < 0.001), respectively, with the combination method yielding a superior identification result. The addition of ICG to the MB method resulted in the identification of more lymph nodes (median 3 versus 2) and more positive axillas (22.7% involved axillas were discovered by fluorescence only) than either method alone. No acute or chronic allergic reaction was observed in this study. However, 23 patients (23/82) who received breast-conserving therapy reported temporary skin staining, and 5 patients had permanent tattooing. Palpable subcutaneous nodules at the injection sites were reported in nine patients. There were no reports of skin necrosis. CONCLUSIONS The lymphatic navigation by ICG fluorescence detects SLNs at a high detection rate and improves the mapping performance when added to the MB method. The novel ICG + MB dual tracing modality, without involvement of radioactive isotopes, exhibits great potential as an alternative to traditional standard mapping methods. TRIAL REGISTRATION ACTRN12612000109808 . Retrospectively registered on 23 January 2012.
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Affiliation(s)
- Jiajia Guo
- Peking University People's Hospital Breast Center, NO 11, Xizhimen South Street, Xicheng District, Beijing, 10044, People's Republic of China
| | - Houpu Yang
- Peking University People's Hospital Breast Center, NO 11, Xizhimen South Street, Xicheng District, Beijing, 10044, People's Republic of China
| | - Shu Wang
- Peking University People's Hospital Breast Center, NO 11, Xizhimen South Street, Xicheng District, Beijing, 10044, People's Republic of China.
| | - Yingming Cao
- Peking University People's Hospital Breast Center, NO 11, Xizhimen South Street, Xicheng District, Beijing, 10044, People's Republic of China
| | - Miao Liu
- Peking University People's Hospital Breast Center, NO 11, Xizhimen South Street, Xicheng District, Beijing, 10044, People's Republic of China
| | - Fei Xie
- Peking University People's Hospital Breast Center, NO 11, Xizhimen South Street, Xicheng District, Beijing, 10044, People's Republic of China
| | - Peng Liu
- Peking University People's Hospital Breast Center, NO 11, Xizhimen South Street, Xicheng District, Beijing, 10044, People's Republic of China
| | - Bo Zhou
- Peking University People's Hospital Breast Center, NO 11, Xizhimen South Street, Xicheng District, Beijing, 10044, People's Republic of China
| | - Fuzhong Tong
- Peking University People's Hospital Breast Center, NO 11, Xizhimen South Street, Xicheng District, Beijing, 10044, People's Republic of China
| | - Lin Cheng
- Peking University People's Hospital Breast Center, NO 11, Xizhimen South Street, Xicheng District, Beijing, 10044, People's Republic of China
| | - Hongjun Liu
- Peking University People's Hospital Breast Center, NO 11, Xizhimen South Street, Xicheng District, Beijing, 10044, People's Republic of China
| | - Siyuan Wang
- Peking University People's Hospital Breast Center, NO 11, Xizhimen South Street, Xicheng District, Beijing, 10044, People's Republic of China
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Sugie T, Toi M. Comparison of the Indocyanine Green Fluorescence and Blue Dye Methods for the Detection of Sentinel Lymph Nodes in Early-stage Breast Cancer: A Reply. Ann Surg Oncol 2017; 24:583-584. [DOI: 10.1245/s10434-017-6187-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Indexed: 11/18/2022]
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181
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Gvetadze SR, Lv M, Ilkaev KD, Xiong P, Li J, Yang X, Sun J. [Imaging diagnostic methods for identification of sentinel lymph nodes in patients with early squamous cell carcinoma of the oral cavity mucosa: a literature review]. STOMATOLOGII︠A︡ 2017; 96:69-73. [PMID: 29072651 DOI: 10.17116/stomat201796569-73] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The paper describes properties of clinical visualization approaches which are applied for detection of sentinel lymph nodes in patients suffering from oral cavity squamous cell cancer. Diagnostic efficiency results and technological features of different imaging techniques are discussed.
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Affiliation(s)
- S R Gvetadze
- Department of Oral Maxillofacial - Head Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China; Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - M Lv
- Department of Oral Maxillofacial - Head Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - K D Ilkaev
- Department of head and neck tumors, upper gastro-respiratory tract tumors, N.N. Blokhin Russian Cancer Research Center, Moscow, Russia
| | - P Xiong
- Department of Ultrasound, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - J Li
- Department of Oral Maxillofacial - Head Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - X Yang
- Department of Oral Maxillofacial - Head Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - J Sun
- Department of Oral Maxillofacial - Head Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China
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182
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Kawaguchi Y, Hasegawa K, Makuuchi M. Overview of fluorescence imaging focusing on fusion-image for laparoscopic hepatectomy. Transl Gastroenterol Hepatol 2017; 2:65. [PMID: 28905006 DOI: 10.21037/tgh.2017.08.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 08/10/2017] [Indexed: 11/06/2022] Open
Affiliation(s)
- Yoshikuni Kawaguchi
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Kiyoshi Hasegawa
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
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183
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Jones A, Wilton J. Can intra-operative fluorescence play a significant role in hepatobiliary surgery? Eur J Surg Oncol 2017; 43:1622-1627. [DOI: 10.1016/j.ejso.2017.02.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 02/17/2017] [Accepted: 02/24/2017] [Indexed: 01/02/2023] Open
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184
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Miranda D, Carter K, Luo D, Shao S, Geng J, Li C, Chitgupi U, Turowski SG, Li N, Atilla-Gokcumen GE, Spernyak JA, Lovell JF. Multifunctional Liposomes for Image-Guided Intratumoral Chemo-Phototherapy. Adv Healthc Mater 2017; 6:10.1002/adhm.201700253. [PMID: 28504409 PMCID: PMC5568974 DOI: 10.1002/adhm.201700253] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 04/07/2017] [Indexed: 12/11/2022]
Abstract
Intratumoral (IT) drug injections reduce systemic toxicity, but delivered volumes and distribution can be inconsistent. To improve IT delivery paradigms, porphyrin-phospholipid (PoP) liposomes are passively loaded with three hydrophilic cargos: sulforhodamine B, a fluorophore; gadolinium-gadopentetic acid, a magnetic resonance (MR) agent; and oxaliplatin, a colorectal cancer chemotherapeutic. Liposome composition is optimized so that cargo is retained in serum and storage, but is released in less than 1 min with exposure to near infrared light. Light-triggered release occurs with PoP-induced photooxidation of unsaturated lipids and all cargos release concurrently. In subcutaneous murine colorectal tumors, drainage of released cargo is delayed when laser treatment occurs 24 h after IT injection, at doses orders of magnitude lower than systemic ones. Delayed light-triggering results in substantial tumor shrinkage relative to controls a week following treatment, although regrowth occurs subsequently. MR imaging reveals that over this time frame, pools of liposomes within the tumor migrate to adjacent regions, possibly leading to altered spatial distribution during triggered drug release. Although further characterization of cargo loading and release is required, this proof-of-principle study suggests that multimodal theranostic IT delivery approaches hold potential to both guide injections and interpret outcomes, in particular when combined with chemo-phototherapy.
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Affiliation(s)
- Dyego Miranda
- Department of Biomedical Engineering, University at Buffalo, State University of New York, Buffalo, NY 14260, USA
| | - Kevin Carter
- Department of Biomedical Engineering, University at Buffalo, State University of New York, Buffalo, NY 14260, USA
| | - Dandan Luo
- Department of Biomedical Engineering, University at Buffalo, State University of New York, Buffalo, NY 14260, USA
| | - Shuai Shao
- Department of Biomedical Engineering, University at Buffalo, State University of New York, Buffalo, NY 14260, USA
| | - Jumin Geng
- Department of Biomedical Engineering, University at Buffalo, State University of New York, Buffalo, NY 14260, USA
| | - Changning Li
- Department of Biomedical Engineering, University at Buffalo, State University of New York, Buffalo, NY 14260, USA
| | - Upendra Chitgupi
- Department of Biomedical Engineering, University at Buffalo, State University of New York, Buffalo, NY 14260, USA
| | - Steven G Turowski
- Department of Pharmacology and Therapeutics, Roswell Park Cancer Institute, Buffalo NY 14263, USA
| | - Nasi Li
- Department of Chemistry, University at Buffalo, State University of New York, Buffalo, NY 14260, USA
| | - G. Ekin Atilla-Gokcumen
- Department of Chemistry, University at Buffalo, State University of New York, Buffalo, NY 14260, USA
| | - Joseph A Spernyak
- Department of Department of Cell Stress Biology, Roswell Park Cancer Institute, Buffalo, NY 14263, USA
| | - Jonathan F Lovell
- Department of Biomedical Engineering, University at Buffalo, State University of New York, Buffalo, NY 14260, USA
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185
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Tomita K, Kageyama S, Hanada E, Yoshida T, Okinaka Y, Kubota S, Nagasawa M, Johnin K, Narita M, Kawauchi A. Indocyanine Green Angiography-assisted Laparoendoscopic Single-site Varicocelectomy. Urology 2017; 106:221-225. [DOI: 10.1016/j.urology.2017.04.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 04/17/2017] [Accepted: 04/04/2017] [Indexed: 12/01/2022]
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186
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Guerrero Y, Singh SP, Mai T, Murali RK, Tanikella L, Zahedi A, Kundra V, Anvari B. Optical Characteristics and Tumor Imaging Capabilities of Near Infrared Dyes in Free and Nano-Encapsulated Formulations Comprised of Viral Capsids. ACS APPLIED MATERIALS & INTERFACES 2017; 9:19601-19611. [PMID: 28524652 DOI: 10.1021/acsami.7b03373] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Near infrared (NIR) fluorescent molecules and nanosized structures can serve as potential optical probes for image-guided removal of small tumor nodules (≲ 1 mm diameter). Although indocyanine green (ICG) remains as the only FDA-approved NIR dye, other organic dyes are under extensive development for enhanced imaging capabilities. One such dye is BrCy106-NHS where bromine is substituted for aromatic structures in cyanine dyes. Herein, we investigate the absorption and fluorescence characteristics of ICG and BrCy106-NHS, and quantitatively assess their tumor imaging capabilities in free (non-encapsulated) and a nano-encapsulated form that utilizes the capsid protein (CP) from genome-depleted plant-infecting brome mosaic virus as the encapsulating shell. We refer to these nanoconstructs as optical viral ghosts (OVGs). For example, when fabricated at CP to dye concentration ratio of 200, value of the spectrally integrated fluorescence emission for BrCy106-NHS-doped OVGs is ∼60 times higher than that of ICG-doped OVGs. Our analysis of homogenized mice intraperitoneal tumors indicate that the averaged total fluorescence emission associated with the use of BrCy106-NHS-doped can be at least about 44 times greater than that of ICG-doped OVGs. Our results suggest that OVGs containing BrCy106-NHS may potentially serve as effective optical probes for tumor imaging.
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Affiliation(s)
- Yadir Guerrero
- Department of Bioengineering, University of California , Riverside, California 92521, United States
| | | | - Turong Mai
- Department of Bioengineering, University of California , Riverside, California 92521, United States
| | | | - Leela Tanikella
- Department of Bioengineering, University of California , Riverside, California 92521, United States
| | - Atta Zahedi
- Department of Bioengineering, University of California , Riverside, California 92521, United States
| | | | - Bahman Anvari
- Department of Bioengineering, University of California , Riverside, California 92521, United States
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187
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Rauch S, Haid A, Jasarevic Z, Saely CH, Becherer A, Wenzl E. Does BMI affect the detection of sentinel lymph nodes with indocyanine green in early breast cancer patients? Eur Surg 2017. [DOI: 10.1007/s10353-017-0480-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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188
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A Conjugate of Pentamethine Cyanine and 18F as a Positron Emission Tomography/Near-Infrared Fluorescence Probe for Multimodality Tumor Imaging. Int J Mol Sci 2017; 18:ijms18061214. [PMID: 28590411 PMCID: PMC5486037 DOI: 10.3390/ijms18061214] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 05/30/2017] [Accepted: 06/03/2017] [Indexed: 12/22/2022] Open
Abstract
The novel synthesis of a dual-modality, pentamethine cyanine (Cy5) fluorescent, 18F positron emission tomography (PET) imaging probe is reported. The probe shows a large extinction coefficient and large quantum yield in the biologically transparent, near-infrared window (650–900 nm) for in vivo fluorescent imaging. This fluorophore bears the isotope, 18F, giving a 18F-PET/near-infrared fluorescent (NIRF), bi-modal imaging probe, that combines the long-term stability of NIRF and the unlimited penetration depth of PET imaging. The bi-modal probe is labeled with 18F in a quick, one-step reaction, which is important in working with the rapid decay of 18F. The bi-modal probe bears a free carboxyl group, highlighting a PET/NIRF synthon that can be conjugated onto many advanced biomolecules for biomarker-specific in vivo dual-modal PET/NIR tumor imaging, confocal histology, and utility in multi-fluorophore, fluorescence-guided surgery. Its potential in vivo biocompatibility is explored in a quick proof-of-principal in vivo study. The dye is delivered to A549 xenograft flank-tumors to generate PET and NIRF signals at the tumor site. The tumor distribution is confirmed in ex vivo gamma counting and imaging. Pentamethine cyanine (Cy5) has the ability to preferentially accumulate in tumor xenografts. We substitute the PET/NIRF probe for Cy5, and explore this phenomenon.
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189
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Liberale G, Bourgeois P, Larsimont D, Moreau M, Donckier V, Ishizawa T. Indocyanine green fluorescence-guided surgery after IV injection in metastatic colorectal cancer: A systematic review. Eur J Surg Oncol 2017; 43:1656-1667. [PMID: 28579357 DOI: 10.1016/j.ejso.2017.04.015] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 03/14/2017] [Accepted: 04/26/2017] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE Indocyanine green fluorescence-guided surgery (ICG-FGS) has emerged as a potential new imaging modality for improving the detection of hepatic, lymph node (LN), and peritoneal metastases in colorectal cancer (CRC) patients. The aim of this paper is to review the available literature in the clinical setting of ICG-FGS for tumoral detection in various fields of metastatic colorectal disease. METHODS PubMed and Medline literature databases were searched for original articles on the use of ICG in the setting of clinical studies on colorectal cancer. The search terms used were "near-infrared fluorescence", "intraoperative imaging", "indocyanine green", "human" and "colorectal cancer". RESULTS ICG fluorescence imaging (ICG-FI) is clearly supported as an intraoperative technique that allows the detection of additional superficial hepatic metastases of CRC. Data on the role of ICG-FI in the intraoperative detection of peritoneal metastases and LN metastases are scarce but encouraging and ICG-FI could potentially improve the staging and treatment of these patients. CONCLUSION ICG-FI is a promising imaging technique in the detection of small infraclinic LN, hepatic, and peritoneal metastatic deposits that may allow better staging and more complete surgical resection with a potential prognostic benefit for patients.
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Affiliation(s)
- G Liberale
- Department of Surgical Oncology, Belgium.
| | - P Bourgeois
- Department of Nuclear Medicine and Clinic-Unit of Lymphology, R&D Group for the Clinical Application of Fluorescence Imaging at the Jules Bordet Institute, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
| | | | - M Moreau
- Department of Statistics, Belgium.
| | - V Donckier
- Department of Surgical Oncology, Belgium.
| | - T Ishizawa
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
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190
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Terasawa M, Ishizawa T, Mise Y, Inoue Y, Ito H, Takahashi Y, Saiura A. Applications of fusion-fluorescence imaging using indocyanine green in laparoscopic hepatectomy. Surg Endosc 2017; 31:5111-5118. [PMID: 28455774 DOI: 10.1007/s00464-017-5576-z] [Citation(s) in RCA: 104] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 04/19/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND Indocyanine green (ICG)-fluorescence imaging has been developed for real-time identification of hepatic tumors and segmental boundaries during hepatectomy. Fusion ICG-fluorescence imaging (real-time visualization of pseudocolor-fluorescence signals on white-light color images) may serve as a reliable navigation tool especially in laparoscopic hepatectomy, in which gross inspection and palpation are limited. METHODS The study population consisted of 41 patients undergoing laparoscopic hepatectomy. Hepatic tumors were identified by fluorescence imaging following the preoperative intravenous administration of ICG (0.5 mg/kg body weight). To visualize hepatic perfusion and segmental boundaries, ICG (1.25 mg) was injected intravenously during surgery, following closure of the proximal portal pedicle. A laparoscopic imaging system, which enabled superimposition of the pseudocolor-fluorescence images on white color images, was used for the fusion ICG-fluorescence imaging. RESULTS Among the 53 malignant tumors resected, fusion ICG-fluorescence imaging revealed 45 nodules (85%), including three nodules of colorectal liver metastasis unidentifiable by white-light color images or intraoperative ultrasonography. It also delineated the segmental boundaries on the hepatic raw surfaces as well as on the phrenic/visceral surfaces in all 12 patients evaluated using this technique. CONCLUSIONS Fusion imaging enhances the feasibility of intraoperative ICG-fluorescence imaging in the identification of hepatic tumors and segmental boundaries. It may therefore help surgeons in the safe and accurate completion of laparoscopic hepatectomies.
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Affiliation(s)
- Muga Terasawa
- Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Takeaki Ishizawa
- Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
| | - Yoshihiro Mise
- Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Yosuke Inoue
- Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Hiromichi Ito
- Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Yu Takahashi
- Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Akio Saiura
- Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
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191
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Ji Y, Luo N, Jiang Y, Li Q, Wei W, Yang H, Liu J. Clinical utility of the additional use of blue dye for indocyanine green for sentinel node biopsy in breast cancer. J Surg Res 2017; 215:88-92. [PMID: 28688667 DOI: 10.1016/j.jss.2017.03.038] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 03/04/2017] [Accepted: 03/24/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND Indocyanine green (ICG) is widely used as a tracer in sentinel lymph node biopsy (SLNB) of patients with breast cancer. Whether SLNB performance can be improved by supplementing ICG with methylene blue dye remains controversial. This study compared the performance of SLNB when ICG was used alone or with blue dye. MATERIALS AND METHODS Consecutive patients with T1-3 primary breast cancer at our hospital were recruited into our study and randomized to undergo SLNB with ICG alone (n = 62) or with the combination of ICG and blue dye (n = 65). We compared the two methods in terms of identification rate, number and detection time of sentinel lymph nodes (SLNs) removed. RESULTS SLN identification rate were similar in the absence (95.2%) or presence of blue dye (98.5%, P = 0.578) but significantly, more average nodes were removed when blue dye was used (3.8 ± 1.5 versus 2.7 ± 1.2, P = 0.000), and the average time for detecting each SLN was significantly shorter (3.91 ± 1.87 versus 5.65 ± 2.95 min; P = 0.000). No patient in the study experienced severe adverse reactions or complications. Recurrence of axillary node was detected in one patient (1.6%) using ICG alone but not in any patients using ICG and blue dye. CONCLUSIONS The efficiency and sensitivity of SLNB can be improved by combining ICG with blue dye.
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Affiliation(s)
- Yinan Ji
- Department of Breast Surgery, The Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi, P.R. China
| | - Ningbin Luo
- Department of Radiology, The Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi, P.R. China
| | - Yi Jiang
- Department of Breast Surgery, The Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi, P.R. China
| | - Qiuyun Li
- Department of Breast Surgery, The Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi, P.R. China
| | - Wei Wei
- Department of Breast Surgery, The Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi, P.R. China
| | - Huawei Yang
- Department of Breast Surgery, The Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi, P.R. China
| | - Jianlun Liu
- Department of Breast Surgery, The Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi, P.R. China.
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192
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Hidar S. Use of indocyanine green for detecting sentinel lymph nodes in breast cancer: letter to the editor. World J Surg Oncol 2017; 15:70. [PMID: 28347307 PMCID: PMC5368913 DOI: 10.1186/s12957-017-1138-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 03/22/2017] [Indexed: 12/22/2022] Open
Abstract
In a previous issue of the journal, Oldřich Coufal and Vuk Fait reported a pilot study that specifically addressed the use of indocyanine green for detecting sentinel lymph nodes in breast cancer within a European population. They concluded that fluorescence method cannot currently be considered a method fully comparable with using radioisotopes in this setting. We consider that the absence of a learning curve, the low mean of retrieved sentinel nodes, and the possibility that migration of indocyanine green occurred after the initial biopsy limit the strength of their conclusion.
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Affiliation(s)
- Samir Hidar
- F.Hached University Teaching Hospital, Sousse, Tunisia.
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193
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Yoon HJ, Lee HS, Lim JY, Park JH. Liposomal Indocyanine Green for Enhanced Photothermal Therapy. ACS APPLIED MATERIALS & INTERFACES 2017; 9:5683-5691. [PMID: 28152314 DOI: 10.1021/acsami.6b16801] [Citation(s) in RCA: 138] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
In this study, we engineered liposomal indocyanine green (ICG) to maximize its photothermal effects while maintaining the fluorescence intensity. Various liposomal formulations of ICG were prepared by varying the lipid composition and the molar ratio between total lipid and ICG, and their photothermal characteristics were evaluated under near-infrared irradiation. We showed that the ICG dispersity in the liposomal membrane and its physical interaction with phospholipids were the main factors determining the photothermal conversion efficiency. In phototherapeutic studies, the optimized formulation of liposomal ICG showed greater anticancer effects in a mouse tumor model compared with other liposomal formulations and the free form of ICG. Furthermore, we utilized liposomal ICG to visualize the metastatic lymph node around the primary tumor under fluorescence imaging guidance and ablate the lymph node with the enhanced photothermal effect, indicating the potential for selective treatment of metastatic lymph node.
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Affiliation(s)
- Hwan-Jun Yoon
- Department of Bio and Brain Engineering, §Program of Brain and Cognitive Engineering, ⊥Institute for Health Science and Technology, and #Institute for the Nanocentury, Korea Advanced Institute of Science and Technology (KAIST) , Daejeon 34141, Republic of Korea
| | - Hye-Seong Lee
- Department of Bio and Brain Engineering, §Program of Brain and Cognitive Engineering, ⊥Institute for Health Science and Technology, and #Institute for the Nanocentury, Korea Advanced Institute of Science and Technology (KAIST) , Daejeon 34141, Republic of Korea
| | - Ji-Young Lim
- Department of Bio and Brain Engineering, §Program of Brain and Cognitive Engineering, ⊥Institute for Health Science and Technology, and #Institute for the Nanocentury, Korea Advanced Institute of Science and Technology (KAIST) , Daejeon 34141, Republic of Korea
| | - Ji-Ho Park
- Department of Bio and Brain Engineering, §Program of Brain and Cognitive Engineering, ⊥Institute for Health Science and Technology, and #Institute for the Nanocentury, Korea Advanced Institute of Science and Technology (KAIST) , Daejeon 34141, Republic of Korea
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Mondal SB, Gao S, Zhu N, Habimana-Griffin L, Akers WJ, Liang R, Gruev V, Margenthaler J, Achilefu S. Optical See-Through Cancer Vision Goggles Enable Direct Patient Visualization and Real-Time Fluorescence-Guided Oncologic Surgery. Ann Surg Oncol 2017; 24:1897-1903. [PMID: 28213790 DOI: 10.1245/s10434-017-5804-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Indexed: 12/17/2022]
Abstract
BACKGROUND The inability to visualize the patient and surgical site directly, limits the use of current near infrared fluorescence-guided surgery systems for real-time sentinel lymph node biopsy and tumor margin assessment. METHODS We evaluated an optical see-through goggle augmented imaging and navigation system (GAINS) for near-infrared, fluorescence-guided surgery. Tumor-bearing mice injected with a near infrared cancer-targeting agent underwent fluorescence-guided, tumor resection. Female Yorkshire pigs received hind leg intradermal indocyanine green injection and underwent fluorescence-guided, popliteal lymph node resection. Four breast cancer patients received 99mTc-sulfur colloid and indocyanine green retroareolarly before undergoing sentinel lymph node biopsy using radioactive tracking and fluorescence imaging. Three other breast cancer patients received indocyanine green retroareolarly before undergoing standard-of-care partial mastectomy, followed by fluorescence imaging of resected tumor and tumor cavity for margin assessment. RESULTS Using near-infrared fluorescence from the dyes, the optical see-through GAINS accurately identified all mouse tumors, pig lymphatics, and four pig popliteal lymph nodes with high signal-to-background ratio. In 4 human breast cancer patients, 11 sentinel lymph nodes were identified with a detection sensitivity of 86.67 ± 0.27% for radioactive tracking and 100% for GAINS. Tumor margin status was accurately predicted by GAINS in all three patients, including clear margins in patients 1 and 2 and positive margins in patient 3 as confirmed by paraffin-embedded section histopathology. CONCLUSIONS The optical see-through GAINS prototype enhances near infrared fluorescence-guided surgery for sentinel lymph node biopsy and tumor margin assessment in breast cancer patients without disrupting the surgical workflow in the operating room.
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Affiliation(s)
- Suman B Mondal
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA.,Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, USA
| | - Shengkui Gao
- Department of Computer Science and Engineering, Washington University in St. Louis, St. Louis, MO, USA
| | - Nan Zhu
- College of Optical Science, The University of Arizona, Tucson, AZ, USA
| | - LeMoyne Habimana-Griffin
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA.,Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, USA
| | - Walter J Akers
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Rongguang Liang
- College of Optical Science, The University of Arizona, Tucson, AZ, USA
| | - Viktor Gruev
- Department of Computer Science and Engineering, Washington University in St. Louis, St. Louis, MO, USA
| | - Julie Margenthaler
- Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Samuel Achilefu
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA. .,Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, USA. .,Department of Biochemistry and Molecular Biophysics, Washington University School of Medicine, St. Louis, MO, USA. .,Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA.
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195
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Influence of Indocyanine Green on Hepatic Gd-EOB-DTPA Uptake: A Proof-of-Concept Study in Mice. Invest Radiol 2017; 52:441-445. [PMID: 28195848 DOI: 10.1097/rli.0000000000000359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The aim of this study was to explore the influence of indocyanine green (ICG) on hepatic uptake of gadolinium ethoxybenzyldiethylenetriaminepenta-acetic acid (Gd-EOB-DTPA). MATERIALS AND METHODS Groups of 6 female C57BL6 mice were injected with 5 mg/kg ICG, 20 mg/kg ICG, or phosphate-buffered saline (control group) 10 minutes before the injection of Gd-EOB-DTPA; identical 3-dimensional gradient echo T1-weighted images were subsequently obtained to create time-intensity curves and to measure the peak contrast ratios (CRs) of liver parenchyma. We studied both hypothermic and normothermic mice. Peak CRs for all experimental conditions were evaluated, and among-group differences were assessed using 2-way factorial analysis of variance with Bonferroni post hoc testing. RESULTS In hypothermic mice, the time-intensity curves of the 3 groups gradually increased from 5 to 30 minutes and almost plateaued after 30 minutes. The peak CR decreased as the amount of injected ICG increased (control group, 5 mg/kg ICG, 20 mg/kg ICG: 1.66 ± 0.09, 1.37 ± 0.18, 1.25 ± 0.24, respectively). In normothermic animals, the time-intensity curves of the control and ICG 5 mg/kg groups peaked 10 to 15 minutes after injection, the peak CRs were very similar (control group, 5 mg/kg ICG: 2.01 ± 0.16, 1.95 ± 0.14, respectively), and the intensities thereof then gradually fell until 60 minutes. Compared with these groups, the ICG 20 mg/kg group exhibited lower peak CR (1.48 ± 0.14) and a weaker decrease in intensity to 60 minutes. Both the amount of ICG injected (P < 0.001) and the experimental temperature (P < 0.001) significantly affected the measurements. CONCLUSIONS Indocyanine green inhibits the hepatic uptake of Gd-EOB-DTPA and affects the signal intensity upon Gd-EOB-DTPA-enhanced magnetic resonance imaging. Such inhibition was more obvious in hypothermic mice.
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Shinden Y, Nakajo A, Arima H, Tanoue K, Hirata M, Kijima Y, Maemura K, Natsugoe S. Intraoperative Identification of the Parathyroid Gland with a Fluorescence Detection System. World J Surg 2017; 41:1506-1512. [DOI: 10.1007/s00268-017-3903-0] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Contrast-enhanced dual mode imaging: photoacoustic imaging plus more. Biomed Eng Lett 2017; 7:121-133. [PMID: 30603159 DOI: 10.1007/s13534-016-0006-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 11/16/2016] [Accepted: 11/20/2016] [Indexed: 10/20/2022] Open
Abstract
Conventional biomedical imaging modalities in wide clinical use, such as ultrasound imaging, X-ray computed tomography, magnetic resonance imaging, and positron emission tomography, can provide morphological, anatomical, and functional information about biological tissues. However, single mode imaging in conventional medicine provides only limited information for definitive diagnoses. Thus, combinational diagnosis using multiple imaging modalities has become increasingly important. Recently, photoacoustic imaging (PAI) has gained significant attention, and several PAI prototypes have been used in clinical trials. At the same time, PAI has been tested in combination with conventional imaging modalities. For all these imaging modalities, various contrast-enhancing agents have been developed for various purposes. In this review article, we will focus on recent progress in developing dual mode contrast agents for PAI in combination with other conventional imaging modalities.
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198
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Kang HG, Lee HY, Kim KM, Song SH, Hong GC, Hong SJ. A feasibility study of an integrated NIR/gamma/visible imaging system for endoscopic sentinel lymph node mapping. Med Phys 2017; 44:227-239. [DOI: 10.1002/mp.12029] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Revised: 10/08/2016] [Accepted: 11/17/2016] [Indexed: 11/10/2022] Open
Affiliation(s)
- Han Gyu Kang
- Department of Senior Healthcare; Graduate School; Eulji University; Daejeon 34824 Korea
| | - Ho-Young Lee
- Department of Nuclear Medicine; College of Medicine; Seoul National University; Seoul 13620 Korea
| | - Kyeong Min Kim
- Korea Institute of Radiological and Medical Science; Seoul 01812 Korea
| | - Seong-Hyun Song
- Department of Senior Healthcare; Graduate School; Eulji University; Daejeon 34824 Korea
| | - Gun Chul Hong
- Department of Nuclear Medicine; Samsung Medical Center; Seoul 06351 Korea
| | - Seong Jong Hong
- Department of Senior Healthcare; Graduate School; Eulji University; Daejeon 34824 Korea
- Department of Radiological Science; Eulji University; 553 Sanseongdae-ro Seongnam-Si Gyeonggi-Do Sujeong-gu 431-713 Korea
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199
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Liu J, Huang L, Wang N, Chen P. Indocyanine green detects sentinel lymph nodes in early breast cancer. J Int Med Res 2017; 45:514-524. [PMID: 28415938 PMCID: PMC5536661 DOI: 10.1177/0300060516687149] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective To explore the clinical value of indocyanine green (ICG) for the fluorescence-guided detection of sentinel lymph nodes (SLNs) during sentinel lymph node biopsy (SLNB) in patients with early breast cancer. Methods This retrospective study included female patients with breast cancer. Patients were administered methylene blue and ICG using standard techniques. All SLNs that were collected during surgery were submitted for pathological examination. SLNs were defined as those that were either fluorescent, blue, fluorescent and blue or palpably suspicious. Surgical complications, axillary recurrence, distant metastasis and overall survival rates were observed postoperatively. Results A total of 60 patients were enrolled in the study. The fluorescence detection rate of SLNs was 100% (n = 177), with a mean of 2.95 SLNs per patient. The methylene blue staining rate was 88.3% (n = 106), with a mean of 1.77 SLNs per patient. Pathological assessment of intraoperative frozen specimens revealed SLN metastases in 10 patients, who immediately underwent axillary lymph node dissection. No patient had axillary recurrence or distant metastases, with a survival rate of 100%. Patients who underwent SLNB showed good appearance in the axillary wound, with no limited shoulder joint abduction and upper limb oedema. Conclusion Fluorescence-guided SLNB has several advantages and is suitable for clinical application.
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Affiliation(s)
- Jun Liu
- Breast Cancer Centre, China-Japan Friendship Hospital, Beijing, China
| | - Linping Huang
- Breast Cancer Centre, China-Japan Friendship Hospital, Beijing, China
| | - Ning Wang
- Breast Cancer Centre, China-Japan Friendship Hospital, Beijing, China
| | - Ping Chen
- Breast Cancer Centre, China-Japan Friendship Hospital, Beijing, China
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Polom W, Markuszewski M, Cytawa W, Czapiewski P, Lass P, Matuszewski M. Fluorescent Versus Radioguided Lymph Node Mapping in Bladder Cancer. Clin Genitourin Cancer 2016; 15:e405-e409. [PMID: 28007368 DOI: 10.1016/j.clgc.2016.11.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 10/30/2016] [Accepted: 11/20/2016] [Indexed: 12/26/2022]
Abstract
INTRODUCTION The aim of the study was to compare 2 methods of the sentinel lymph node biopsy (SLNB) procedure in bladder cancer: we applied technetium radiocolloid (RadCol) detected by a gamma ray detection probe, and indocyanine green (ICG) detected by a near-infrared fluorescent (NIRF) camera. MATERIAL AND METHODS The SLNB was performed on 50 patients using the RadCol and the ICG, followed by a lymphadenectomy and a pathologic examination. RESULTS In the analyzed group of 47 patients (3 patients were excluded owing to the lack of lymphatic drainage from the tumor), the SLNB was performed using the 2 methods. The ICG with a NIRF-guided camera detected all sentinel lymph nodes (SLNs) in 46 cases, whereas RadCol detected them in 45 cases. In 12 (25.6%) of 47 patients, the ICG-fluorescent method revealed more SLNs than the RadCol method. In 8 (17%) patients, the SLNs revealed in the ICG fluorescence were metastatic. In 3 (6.4%) patients, we found SLNs outside the standard lymphadenectomy template, but a histopathologic examination showed they were negative for cancer. In 3 (6.4%) patients, the SLNs detected by both methods were negative for cancer, but other resected lymph nodes revealed metastases. CONCLUSION Our study shows that SLNB procedure with the RadCol or the ICG method is useful for the evaluation of lymph nodes in bladder cancer. The new ICG fluorescent technique with a NIRF camera system is safe, enables live view of the results of the procedure, and does not create additional costs. However, it highlights more lymph nodes than the radioactive method.
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Affiliation(s)
- Wojciech Polom
- Urology Department, Medical University of Gdańsk, Gdańsk, Poland.
| | | | - Wojciech Cytawa
- Nuclear Medicine Department, Medical University of Gdańsk, Gdańsk, Poland
| | - Piotr Czapiewski
- Pathomorphology Department, Medical University of Gdańsk, Gdańsk, Poland; Pathology Department, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Piotr Lass
- Nuclear Medicine Department, Medical University of Gdańsk, Gdańsk, Poland
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