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Correia Duarte M, Hemington-Gorse SJ, Cubitt JJ. Single centre experience with magtrace in cutaneous melanoma in six patients. J Plast Reconstr Aesthet Surg 2024; 93:183-184. [PMID: 38703706 DOI: 10.1016/j.bjps.2024.04.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 04/14/2024] [Indexed: 05/06/2024]
Affiliation(s)
- M Correia Duarte
- Welsh Centre for Burns and Plastic Surgery, Swansea Bay University Health Board, Morriston Hospital, Heol Maes Eglwys, Morriston, Swansea SA6 6NL, United Kingdom.
| | - S J Hemington-Gorse
- Welsh Centre for Burns and Plastic Surgery, Swansea Bay University Health Board, Morriston Hospital, Heol Maes Eglwys, Morriston, Swansea SA6 6NL, United Kingdom
| | - J J Cubitt
- Welsh Centre for Burns and Plastic Surgery, Swansea Bay University Health Board, Morriston Hospital, Heol Maes Eglwys, Morriston, Swansea SA6 6NL, United Kingdom
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Izzo S, Molle M, Gesuete FP, De Intinis C, Izzo P, Izzo L, Nicoletti GF. Comparison of Different Techniques for the Assessment of Sentinel Lymph Node Biopsy in Melanoma: A Systematic Review. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5447. [PMID: 38145154 PMCID: PMC10745233 DOI: 10.1097/gox.0000000000005447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 10/03/2023] [Indexed: 12/26/2023]
Abstract
Background The gold standard for sentinel lymph node staging in melanoma is the use of the combined technique of radioisotope plus blue dye. New techniques and alternative methods have been proposed, with the promise of achieving comparable efficacy. We then carried out a literature search. Methods We conducted a literature search using the "sentinel lymph node biopsy" and "melanoma" keywords, then selected the case-control studies (the quality of which was assessed using the STROBE criteria). Results Twelve studies of 13,017 were selected, concerning the identification rate of indocyanine green fluorescence and indocyanine green-99mtc-nanocolloid techniques. We have found a comparable identification rate between the various techniques, even if given the small population present for some techniques, the results did not reach statistical significance. Conclusions The use of new techniques in sentinel lymph node detection promises results comparable to the gold standard techniques, but further studies are needed to validate these methods in the context of melanoma surgery.
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Affiliation(s)
- Sara Izzo
- From the Università Degli Studi Della Campania “L. Vanvitelli,” Naples, Italy
| | - Marcello Molle
- From the Università Degli Studi Della Campania “L. Vanvitelli,” Naples, Italy
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Aldenhoven L, Frotscher C, Körver-Steeman R, Martens MH, Kuburic D, Janssen A, Beets GL, van Bastelaar J. Sentinel lymph node mapping with superparamagnetic iron oxide for melanoma: a pilot study in healthy participants to establish an optimal MRI workflow protocol. BMC Cancer 2022; 22:1062. [PMID: 36241982 PMCID: PMC9563818 DOI: 10.1186/s12885-022-10146-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 09/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Current pre-operative Sentinel Lymph Node (SLN) mapping using dual tracing is associated with drawbacks (radiation exposure, logistic challenges). Superparamagnetic iron oxide (SPIO) is a non-inferior alternative for SLN mapping in breast cancer patients. Limited research has been performed on SPIO use and pre-operative MRI in melanoma patients to identify SLNs. METHODS: Healthy participants underwent MRI-scanning pre- and post SPIO-injection during 20 min. Workflow protocols varied in dosage, massage duration, route of administration and injection sites. The first lymph node showing a susceptibility artefact caused by SPIO accumulation was considered as SLN. RESULTS Artefacts were identified in 5/6 participants. Two participants received a 0.5 ml subcutaneous injection and 30-s massage, of which one showed an artefact after one hour. Four participants received a 1.0 ml intracutaneous injection and two-minute massage, leading to artefacts in all participants. All SLNs were observed within five minutes, except after lower limb injection (30 min). CONCLUSION SPIO and pre-operative MRI-scanning seems to be a promising alternative for SLN visualization in melanoma patients. An intracutaneous injection of 1.0 ml SPIO tracer, followed by a two-minute massage seems to be the most effective technique, simplifying the pre-operative pathway. Result will be used in a larger prospective study with melanoma patients. TRIAL REGISTRATION ClinicalTrials.gov (NCT05054062) - September 9, 2021.
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Affiliation(s)
- Loeki Aldenhoven
- Department of Surgery, Zuyderland Medical Center, Dr. H. van der Hoffplein 1, 6262 BG, Sittard-Geleen, the Netherlands. .,Present address: Department of Surgery, Zuyderland Medical Center, Postbus 5500 , 6130 , MB, Sittard, the Netherlands. .,GROW - School for Oncology and Developmental Biology, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, the Netherlands.
| | - Caroline Frotscher
- Department of Radiology, Zuyderland Medical Center, Dr. H. van der Hoffplein 1, 6262 BG, Sittard-Geleen, the Netherlands
| | - Rachelle Körver-Steeman
- Department of Radiology, Zuyderland Medical Center, Dr. H. van der Hoffplein 1, 6262 BG, Sittard-Geleen, the Netherlands
| | - Milou H Martens
- Department of Surgery, Zuyderland Medical Center, Dr. H. van der Hoffplein 1, 6262 BG, Sittard-Geleen, the Netherlands
| | - Damir Kuburic
- Department of Radiology, Zuyderland Medical Center, Dr. H. van der Hoffplein 1, 6262 BG, Sittard-Geleen, the Netherlands
| | - Alfred Janssen
- Department of Surgery, Zuyderland Medical Center, Dr. H. van der Hoffplein 1, 6262 BG, Sittard-Geleen, the Netherlands
| | - Geerard L Beets
- Present address: Department of Surgery, Zuyderland Medical Center, Postbus 5500 , 6130 , MB, Sittard, the Netherlands.,Department of Surgery, Netherlands Cancer Institute - Antoni Van Leeuwenhoek, Plesmanlaan 121, 1066 CX, Amsterdam, the Netherlands
| | - James van Bastelaar
- Department of Surgery, Zuyderland Medical Center, Dr. H. van der Hoffplein 1, 6262 BG, Sittard-Geleen, the Netherlands
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Wendler T, van Leeuwen FWB, Navab N, van Oosterom MN. How molecular imaging will enable robotic precision surgery : The role of artificial intelligence, augmented reality, and navigation. Eur J Nucl Med Mol Imaging 2021; 48:4201-4224. [PMID: 34185136 PMCID: PMC8566413 DOI: 10.1007/s00259-021-05445-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 06/01/2021] [Indexed: 02/08/2023]
Abstract
Molecular imaging is one of the pillars of precision surgery. Its applications range from early diagnostics to therapy planning, execution, and the accurate assessment of outcomes. In particular, molecular imaging solutions are in high demand in minimally invasive surgical strategies, such as the substantially increasing field of robotic surgery. This review aims at connecting the molecular imaging and nuclear medicine community to the rapidly expanding armory of surgical medical devices. Such devices entail technologies ranging from artificial intelligence and computer-aided visualization technologies (software) to innovative molecular imaging modalities and surgical navigation (hardware). We discuss technologies based on their role at different steps of the surgical workflow, i.e., from surgical decision and planning, over to target localization and excision guidance, all the way to (back table) surgical verification. This provides a glimpse of how innovations from the technology fields can realize an exciting future for the molecular imaging and surgery communities.
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Affiliation(s)
- Thomas Wendler
- Chair for Computer Aided Medical Procedures and Augmented Reality, Technische Universität München, Boltzmannstr. 3, 85748 Garching bei München, Germany
| | - Fijs W. B. van Leeuwen
- Department of Radiology, Interventional Molecular Imaging Laboratory, Leiden University Medical Center, Leiden, The Netherlands
- Department of Urology, The Netherlands Cancer Institute - Antonie van Leeuwenhoek Hospital, Amsterdam, The Netherlands
- Orsi Academy, Melle, Belgium
| | - Nassir Navab
- Chair for Computer Aided Medical Procedures and Augmented Reality, Technische Universität München, Boltzmannstr. 3, 85748 Garching bei München, Germany
- Chair for Computer Aided Medical Procedures Laboratory for Computational Sensing + Robotics, Johns-Hopkins University, Baltimore, MD USA
| | - Matthias N. van Oosterom
- Department of Radiology, Interventional Molecular Imaging Laboratory, Leiden University Medical Center, Leiden, The Netherlands
- Department of Urology, The Netherlands Cancer Institute - Antonie van Leeuwenhoek Hospital, Amsterdam, The Netherlands
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Azargoshasb S, Molenaar L, Rosiello G, Buckle T, van Willigen DM, van de Loosdrecht MM, Welling MM, Alic L, van Leeuwen FWB, Winter A, van Oosterom MN. Advancing intraoperative magnetic tracing using 3D freehand magnetic particle imaging. Int J Comput Assist Radiol Surg 2021; 17:211-218. [PMID: 34333740 PMCID: PMC8738628 DOI: 10.1007/s11548-021-02458-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 07/09/2021] [Indexed: 11/25/2022]
Abstract
Purpose Sentinel lymph node biopsy is a routine procedure for nodal staging in penile cancer. Most commonly, this procedure is guided by radioactive tracers, providing various forms of preoperative and intraoperative guidance. This is further extended with fluorescence imaging using hybrid radioactive–fluorescence tracers. Alternatively, a magnetic-based approach has become available using superparamagnetic iron-oxide nanoparticles (SPIONs). This study investigates a novel freehand magnetic particle imaging and navigation modality (fhMPI) for intraoperative localization, along with a hybrid approach, combining magnetic and fluorescence guidance. Materials and methods The fhMPI set-up was built with a surgical navigation device, optical tracking system and magnetometer probe. A dedicated reconstruction software based on a look-up-table method was used to reconstruct a superficial 3D volume of the SPION distribution in tissue. For fluorescence guidance, indocyanine green (ICG) was added to the SPIONs. The fhMPI modality was characterized in phantoms, ex vivo human skin and in vivo porcine surgery. Results Phantom and human skin explants illustrated that the current fhMPI modality had a sensitivity of 2.2 × 10–2 mg/mL SPIONs, a resolving power of at least 7 mm and a depth penetration up to 1.5 cm. Evaluation during porcine surgery showed that fhMPI allowed for an augmented reality image overlay of the tracer distribution in tissue, as well as 3D virtual navigation. Besides, using the hybrid approach, fluorescence imaging provided a visual confirmation of localized nodes. Conclusion fhMPI is feasible in vivo, providing 3D imaging and navigation for magnetic nanoparticles in the operating room, expanding the guidance possibilities during magnetic sentinel lymph node procedures. Furthermore, the integration of ICG provides the ability to visually refine and confirm correct localization. Further clinical evaluation should verify these findings in human patients as well.
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Affiliation(s)
- Samaneh Azargoshasb
- Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Lennert Molenaar
- Magnetic Detection & Imaging Group, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Giuseppe Rosiello
- Department of Urology, Onze-Lieve-Vrouw Hospital, Aalst, Belgium.,ORSI Academy, Melle, Belgium.,Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Tessa Buckle
- Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.,Department of Urology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Danny M van Willigen
- Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Melissa M van de Loosdrecht
- Magnetic Detection & Imaging Group, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Mick M Welling
- Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Lejla Alic
- Magnetic Detection & Imaging Group, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Fijs W B van Leeuwen
- Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.,ORSI Academy, Melle, Belgium.,Department of Urology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Alexander Winter
- University Hospital for Urology, Klinikum Oldenburg, School of Medicine and Health Sciences, Carl Von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Matthias N van Oosterom
- Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands. .,Department of Urology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
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