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Booka E, Takeuchi H. Recent Advances in Sentinel Node Navigation Surgery for Early Gastric Cancer. J Gastric Cancer 2023; 23:159-170. [PMID: 36750996 PMCID: PMC9911613 DOI: 10.5230/jgc.2023.23.e4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 12/16/2022] [Accepted: 12/20/2022] [Indexed: 01/18/2023] Open
Abstract
Maintaining the postoperative quality of life (QOL) while ensuring curability without overtreatment is important in the treatment of early gastric cancer. Postoperative QOL is anticipated to be maintained through minimally invasive function-preserving gastrectomy in early gastric cancer. The concept of the sentinel lymph node (SN) basin is essential to maintain the curability of early gastric cancer using minimally invasive function-preserving gastrectomy. However, additional resection after surgery is difficult to perform in gastric cancer. Thus, the SN basin theory is important. Recently, a multicenter randomized phase III trial in South Korea (SENORITA trial) proved that laparoscopic sentinel node navigation surgery (LSNNS) for stomach preservation results in better postoperative QOL compared with standard gastrectomy in patients with early gastric cancer. LSNNS contributes to patients' QOL based on the concept that curability is not impaired. A multicenter nonrandomized phase III trial is ongoing in Japan, and oncologic safety is expected to be demonstrated. LSNNS has been established as a treatment option for selected patients with early gastric cancer, and its application will become widespread in the future.
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Affiliation(s)
- Eisuke Booka
- Department of Surgery, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Hiroya Takeuchi
- Department of Surgery, Hamamatsu University School of Medicine, Shizuoka, Japan.
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2
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Ballinger JR. Challenges in Preparation of Albumin Nanoparticle-Based Radiopharmaceuticals. Molecules 2022; 27:8596. [PMID: 36500689 PMCID: PMC9740174 DOI: 10.3390/molecules27238596] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/22/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
Albumin nanocolloids have been used as radiopharmaceuticals for more than 40 years. Their main use is in lymphoscintigraphy and the detection of the sentinel lymph node as part of the surgical treatment of a variety of solid tumours. The main licensed products are labelled with the gamma emitter technetium-99m. Recently, two analogues labelled with positron emitters have been reported, using gallium-68 and zirconium-89. For about 10 years, there has been interest in dual-modal agents with both radioactive and fluorescent labels to improve the localisation of the sentinel lymph node. Indocyanine green (ICG) has been the most widely used fluorescent label, largely due to its availability as a licensed agent and its ease of application. The further development of alternative radiolabels or improved fluorescent tags will require investment in the development and licensing. There is also a vast potential for the targeting of albumin nanocolloids using existing strategies, which could be promising for the development of both diagnostic and therapeutic agents.
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Affiliation(s)
- James R Ballinger
- School of Biomedical Engineering and Imaging Sciences, King's College London, London WC2R 2LS, UK
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3
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Li Z, Li X, Zhu X, Ai S, Guan W, Liu S. Tracers in Gastric Cancer Surgery. Cancers (Basel) 2022; 14:cancers14235735. [PMID: 36497216 PMCID: PMC9741333 DOI: 10.3390/cancers14235735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/14/2022] [Accepted: 11/18/2022] [Indexed: 11/24/2022] Open
Abstract
The treatment of gastric cancer mainly depends on radical gastrectomy. Determination of appropriate surgical margins and adequate lymph node (LN) resection are two major surgical steps that directly correlate with prognosis in gastric cancer. Due to the expanding use of minimally invasive procedures, it is no longer possible to locate tumors and LNs through touch. As an alternative, tracers have begun to enter the field due to their capacities for intraoperative visualization. Herein, we summarize the application of contemporary tracers in gastric cancer surgery, including isosulfan blue, methylene blue, patent blue, indocyanine green, carbon particles, and radioactive tracers. Their mechanisms, administration methods, detection efficiency, and challenges, as well as perspectives on them, are also outlined.
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Affiliation(s)
| | | | | | | | - Wenxian Guan
- Correspondence: (W.G.); (S.L.); Tel.: +86-25-68182222-60931 (W.G.); +86-25-68182222-60930 (S.L.)
| | - Song Liu
- Correspondence: (W.G.); (S.L.); Tel.: +86-25-68182222-60931 (W.G.); +86-25-68182222-60930 (S.L.)
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Zeeshan F, Madheswaran T, Panneerselvam J, Taliyan R, Kesharwani P. Human Serum Albumin as Multifunctional Nanocarrier for Cancer Therapy. J Pharm Sci 2021; 110:3111-3117. [PMID: 33989679 DOI: 10.1016/j.xphs.2021.05.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 04/30/2021] [Accepted: 05/03/2021] [Indexed: 01/05/2023]
Abstract
Human serum albumin or simply called albumin is a flexible protein employed as a carrier in the fabrication of albumin-based nanocarriers (ANCs) for the administration of cancer therapeutics. Albumin can contribute enhanced tumour specificity, reduced drug induced cytotoxicity and retain concentration of the therapeutically active agent such as drug, peptide, protein, and gene for a prolonged time duration. Nevertheless, apart from cancer management, ANCs are also employed in the diagnosis, imaging, and multimodal cancer therapy. This article figures out salient characteristics, design as well as categories of ANCs in the context of their application in cancer management. In addition, this review article discusses the fabrication methods of ANCs, use of ANCs in gene, cancer, and multimodal therapy along with cancer diagnosis and imaging. Lastly, this review also briefly discusses about (ANCs) formulations, commercial products, and those under clinical testing.
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Affiliation(s)
- Farrukh Zeeshan
- Department of Pharmaceutical Technology, School of Pharmacy, International Medical University (IMU), Kuala Lumpur, Malaysia
| | - Thiagarajan Madheswaran
- Department of Pharmaceutical Technology, School of Pharmacy, International Medical University (IMU), Kuala Lumpur, Malaysia
| | - Jithendra Panneerselvam
- Department of Pharmaceutical Technology, School of Pharmacy, International Medical University (IMU), Kuala Lumpur, Malaysia
| | - Rajeev Taliyan
- Neuropsychopharmacology Division, Department of Pharmacy, Birla Institute of Technology and Science, Pilani, India
| | - Prashant Kesharwani
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi - 110062, India.
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5
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Nanomedicines accessible in the market for clinical interventions. J Control Release 2021; 330:372-397. [DOI: 10.1016/j.jconrel.2020.12.034] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 12/17/2020] [Accepted: 12/17/2020] [Indexed: 02/06/2023]
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6
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Matsuda S, Irino T, Kawakubo H, Takeuchi H, Kitagawa Y. Current status and challenges in sentinel node navigation surgery for early gastric cancer. Chin J Cancer Res 2021; 33:150-158. [PMID: 34158735 PMCID: PMC8181877 DOI: 10.21147/j.issn.1000-9604.2021.02.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
As an optimal surgical procedure to accurately evaluate lymph node (LN) metastasis during surgery with minimal surgical resection, we have been developing sentinel node (SN) biopsy for early gastric cancer since the 1990s. Twelve institutions from the Japanese Society of Sentinel Node Navigation Surgery (SNNS), including Keio University Hospital, conducted a multicenter prospective trial to validate the SN concept using the dual-tracer method with blue dye and a radioisotope. According to the results, 397 patients were included in the final analysis, and the overall accuracy in detecting LN metastasis using SN biopsy was 99% (383 of 387). Based on the validation study, we are targeting cT1N0 with a primary tumor of ≤4 cm in diameter as an indication for SN biopsy for gastric cancer. We are currently running a multicenter nonrandomized phase III trial to assess the safety and efficacy of SN navigation surgery. The Korean group has reported the result of a multicenter randomized phase III trial. Since meticulous gastric cancer in the remnant stomach was rescued by subsequent gastrectomy, the disease-specific survival was comparable between the two techniques, implying that SN navigation surgery can be an alternative to standard gastrectomy. With the development of SN biopsy procedure and treatment modalities, the application of SN biopsy will be expanded to achieve an individualized minimally invasive surgery.
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Affiliation(s)
- Satoru Matsuda
- Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Tomoyuki Irino
- Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Hirofumi Kawakubo
- Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Hiroya Takeuchi
- Department of Surgery, Hamamatsu University School of Medicine, Shizuoka 431-3192, Japan
| | - Yuko Kitagawa
- Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
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Technetium-Radiolabeled Mannose-Functionalized Gold Nanoparticles as Nanoprobes for Sentinel Lymph Node Detection. Molecules 2020; 25:molecules25081982. [PMID: 32340310 PMCID: PMC7221884 DOI: 10.3390/molecules25081982] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 04/19/2020] [Accepted: 04/20/2020] [Indexed: 12/13/2022] Open
Abstract
Gold nanoparticles (AuNPs) are considered valuable nanomaterials for the design of radiolabeled nanoprobes for single-photon emission computed tomography (SPECT) imaging. Radiolabeled and functionalized AuNPs could improve lymphatic mapping by enhancing the radioactive signaling of individual particles in the sentinel node. In this study, an alternative method for functionalizing commercial AuNps with mannose is described. The chemical derivatization and biofunctionalization of AuNPs were performed with lipoic acid and mannose, respectively. Several levels of mannose were tested; the thiolate hydrazinonicotinamide-glycine-glycine-cysteine (HYNIC) molecule was also used for 99mTc radiolabeling. Physicochemical characterization of this system includes U-V spectroscopy, dynamic light scattering, Fourier-transform infrared spectroscopy, and transmission electron microscopy. The most stable nanoprobe, in terms of the aggregation, radiolabeling efficiency, and purity, was tested in a sentinel lymph node model in a rat by microSPECT/computed tomography (CT) imaging. The SPECT images revealed that 99mTc-radiolabeled AuNPs functionalized with mannose can track and accumulate in lymph nodes in a similar way to the commercial 99mTc-Sulfur colloid, commonly used in clinical practice for sentinel lymph node detection. These promising results support the idea that 99mTc-AuNPs-mannose could be used as a SPECT contrast agent for lymphatic mapping.
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Moncrieff MD, O'Leary FM, Beadsmoore CJ, Pawaroo D, Heaton MJ, Isaksson K, Olofsson Bagge R. Effect of delay between nuclear medicine scanning and sentinel node biopsy on outcome in patients with cutaneous melanoma. Br J Surg 2020; 107:669-676. [PMID: 32077090 DOI: 10.1002/bjs.11460] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 09/16/2019] [Accepted: 11/12/2019] [Indexed: 11/11/2022]
Abstract
BACKGROUND Sentinel lymph node biopsy (SLNB) is an important staging tool for the management of melanoma. A multicentre study was done to validate previous findings that the timing of lymphoscintigraphy influences the accuracy of SLNB and patient outcomes, particularly survival. METHODS Data were reviewed on patients undergoing SLNB for melanoma at three centres in the UK and Sweden, examining the effect of timing of SLNB after nuclear medicine scanning. Kaplan-Meier survival analysis was used to assess overall (OS), disease-specific (DSS) and progression-free (PFS) survival, stratified by timing of lymphoscintigraphy. Independent risk factors for survival were identified by Cox multivariable regression analysis. RESULTS A total of 2270 patients were identified. Median follow-up was 56 months. Univariable analysis showed a 4·2 per cent absolute and 35·5 per cent relative benefit in DSS (hazard ratio 1·36, 95 per cent c.i. 1·05 to 1·74; P = 0·018) for 863 patients whose SLNB was performed up to 12 h after lymphoscintigraphy compared with 1407 patients who had surgery after more than 12 h. There were similar OS and PFS benefits (P = 0·036 and P = 0·022 respectively). Multivariable analysis identified timing of lymphoscintigraphy as an independent predictor of OS (P = 0·017) and DSS (P = 0·030). There was an excess of nodal recurrences as first site of recurrence in the group with delayed surgery (4·5 versus 2·5 per cent; P = 0·008). CONCLUSION Delaying SLNB beyond 12 h after lymphoscintigraphy with 99 Tc-labelled nanocolloid has a significant negative survival impact in patients with melanoma.
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Affiliation(s)
- M D Moncrieff
- Department of Plastic and Reconstructive Surgery, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK.,Norwich Medical School, University of East Anglia Norwich Research Park, Norwich, UK
| | - F M O'Leary
- Department of Plastic and Reconstructive Surgery, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - C J Beadsmoore
- Department of Nuclear Medicine, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - D Pawaroo
- Department of Nuclear Medicine, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - M J Heaton
- Department of Plastic and Reconstructive Surgery, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - K Isaksson
- Department of Clinical Sciences, Surgery, Lund University, Skåne University Hospital, Lund, Sweden
| | - R Olofsson Bagge
- Department of Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.,Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
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Parodi A, Miao J, Soond SM, Rudzińska M, Zamyatnin AA. Albumin Nanovectors in Cancer Therapy and Imaging. Biomolecules 2019; 9:E218. [PMID: 31195727 PMCID: PMC6627831 DOI: 10.3390/biom9060218] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 05/29/2019] [Accepted: 05/31/2019] [Indexed: 12/12/2022] Open
Abstract
Albumin nanovectors represent one of the most promising carriers recently generated because of the cost-effectiveness of their fabrication, biocompatibility, safety, and versatility in delivering hydrophilic and hydrophobic therapeutics and diagnostic agents. In this review, we describe and discuss the recent advances in how this technology has been harnessed for drug delivery in cancer, evaluating the commonly used synthesis protocols and considering the key factors that determine the biological transport and the effectiveness of such technology. With this in mind, we highlight how clinical and experimental albumin-based delivery nanoplatforms may be designed for tackling tumor progression or improving the currently established diagnostic procedures.
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Affiliation(s)
- Alessandro Parodi
- Institute of Molecular Medicine, Sechenov First Moscow State Medical University, 119991, Moscow, Russia.
| | - Jiaxing Miao
- Ohio State University, 410 W 10th Ave. Columbus, 43210, Ohio, USA.
| | - Surinder M Soond
- Institute of Molecular Medicine, Sechenov First Moscow State Medical University, 119991, Moscow, Russia.
| | - Magdalena Rudzińska
- Institute of Molecular Medicine, Sechenov First Moscow State Medical University, 119991, Moscow, Russia.
| | - Andrey A Zamyatnin
- Institute of Molecular Medicine, Sechenov First Moscow State Medical University, 119991, Moscow, Russia.
- Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, Moscow, 119992, Russia.
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10
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Radiochemical purity of technetium-99m-nanocolloid rhenium sulphide is not influenced by heating. Nucl Med Commun 2019; 40:565-567. [PMID: 30720668 DOI: 10.1097/mnm.0000000000000988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Despite a mistake during the preparation of technetium-99m (Tc)-nanocolloid rhenium sulphide (Nanocis) because of lack of heating, the apparent radiochemical purity (RCP) of this product was correct. The objectives of this study were to evaluate the impact of absence of heating on the RCP of Tc-nanocolloid rhenium sulphide and the effect of heating on particle size. Five Tc-Nanocis were prepared according to the manufacturer's instructions and five others were realized without any heating step. Quality controls were performed for each preparation. To evaluate the effect of heating on particle size, preparations were filtered through a 0.22 µm sterilizing membrane filter before and after 30 min of heating. The radioactivity was measured before and after the filtration. The results showed that absence of heating does not influence the apparent RCP of Tc-nanocolloid of rhenium sulphide. In terms of the particle size, 72% of particles had a diameter less than 0.22 µm before heating, as opposed to 21% after heating. To conclude, this study underlines a problem of quality control of the Tc-nanocolloid rhenium sulphide preparation, which cannot detect a lack of heating and can lead to the release of preparations that would not be suitable for scintigraphy.
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11
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Translational Nanodiagnostics for In Vivo Cancer Detection. Bioanalysis 2019. [DOI: 10.1007/978-3-030-01775-0_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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12
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Takeuchi H, Kitagawa Y. Sentinel node navigation surgery in esophageal cancer. Ann Gastroenterol Surg 2019; 3:7-13. [PMID: 30697605 PMCID: PMC6345658 DOI: 10.1002/ags3.12206] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 08/05/2018] [Accepted: 08/08/2018] [Indexed: 12/21/2022] Open
Abstract
Over the last 20 years, the sentinel node (SN) concept has been widely applied to the surgical staging of both breast cancer and melanoma. However, the validity of this concept has been controversial for esophageal cancer, because SN mapping for esophageal cancer is not considered to be technically easy because of the complicated multidirectional lymphatic networks of the esophagus and mediastinum. Nevertheless, studies including meta-analyses indicated that SN mapping may be feasible in early esophageal cancer. Transthoracic esophagectomy with three-field lymphadenectomy was developed as a potential curative procedure for thoracic esophageal cancer. However, this highly invasive procedure might increase morbidity and reduce patients' quality of life (QOL) after esophagectomy. Although further validation based on multicenter trials using the standard protocol of SN mapping for esophageal cancer is required, SN navigation surgery would enable us to carry out personalized and limited lymph node dissection which might reduce morbidity and maintain patients' QOL.
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Affiliation(s)
- Hiroya Takeuchi
- Department of SurgeryHamamatsu University School of MedicineHamamatsuJapan
| | - Yuko Kitagawa
- Department of SurgeryKeio University School of MedicineTokyoJapan
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Abstract
OBJECTIVE The aim of this study was to determine whether technetium-99m (Tc) nanocolloid was a suitable alternative tracer for carrying out milk scan studies in pediatric patients. PARTICIPANTS AND METHODS Twenty-seven milk scans performed with Tc nanocolloid were retrospectively assessed for identification of significant esophageal hold-up, gastroesophageal reflux, pulmonary aspiration, and gastric emptying (GE). Scans were also assessed for liver, spleen, and bone marrow uptake. GE results were compared with those of 27 randomly selected normal GE studies carried out using Tc tin colloid. RESULTS None of the studies had liver, spleen, or bone marrow uptake, and all studies were interpretable. Significant esophageal hold-up and gastroesophageal reflux was observed in 11 and 48% of the patients, respectively. Only one patient had evidence of pulmonary aspiration, and all patients had normal GE at 2 h after radiolabeled milk ingestion. The average rate of GE at 2 h was faster in the Tc nanocolloid group compared with the Tc tin colloid group (8.85% retained±8.96% vs. 15.48% retained±10.52%, P=0.016). CONCLUSION Our findings show that Tc nanocolloid is technically a suitable alternative to Tc sulfur colloid for performing milk scans. However, we could not conclude with certainty on the comparison of the GE rates of Tc nanocolloid and Tc tin colloid. This was because of the variability in the two population groups as well as the fact that the milk that was used in each patient was individualized to the patient and was not standardized.
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O'Leary FM, Beadsmoore CJ, Pawaroo D, Skrypniuk J, Heaton MJ, Moncrieff MD. Survival outcomes and interval between lymphoscintigraphy and SLNB in cutaneous melanoma- findings of a large prospective cohort study. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2018; 44:1768-1772. [PMID: 30343702 DOI: 10.1016/j.ejso.2018.06.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 04/26/2018] [Accepted: 06/12/2018] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Sentinel lymph node biopsy (SLNB) in cutaneous melanoma (CM) is performed to identify patient at risk of regional and distant relapse. We hypothesized that timing of lymphoscintigraphy may influence the accuracy of SLNB and patient outcomes. METHODS We reviewed prospective data on patients undergoing SLNB for CM at a large university cancer-center between 2008 and 2015, examining patient and tumor demographics and time between lymphoscintigraphy (LS) and SLNB. Kaplan-Meier survival analysis assessed disease-specific (DSS) and overall-survival (OS), stratified by timing of LS. Cox multivariate regression analysis assessed independent risk factors for survival. RESULTS We identified 1015 patients. Median follow-up was 45 months (IQR 26-68 months). Univariate analysis showed a 6.8% absolute DSS (HR 1.6 [1.03-2.48], p = 0.04) benefit and a 10.7% absolute OS (HR 1.64 [1.13-2.38], p = 0.01) benefit for patients whose SLNB was performed < 12 h of LS (n = 363) compared to those performed >12 h (n = 652). Multivariate analysis identified timing of LS as an independent predictor of OS (p = 0.007) and DSS (p = 0.016) when competing with age, sex, Breslow thickness (BT) and SLN status. No difference in nodal relapse rates (5.2% v 4.6%; p = 0.67) was seen. Both groups were matched for age, sex, BT and SLN status. CONCLUSION These data have significant implications for SLNB services, suggesting delaying SLNB >12 h after LS using a Tc99-labelled nanocolloid has a significant negative survival impact for patients and should be avoided. We hypothesise that temporal tracer migration is the underlying cause and advocate further trials investigating alternative, 'stable' tracer-agents.
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Affiliation(s)
- Fionnuala M O'Leary
- Department of Plastic & Reconstructive Surgery, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich, Norfolk, NR4 7UY, UK. fionnuala.o'
| | - Clare J Beadsmoore
- Department of Nuclear Medicine, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich, Norfolk, NR4 7UY, UK
| | - Davina Pawaroo
- Department of Nuclear Medicine, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich, Norfolk, NR4 7UY, UK
| | - John Skrypniuk
- Department of Nuclear Medicine, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich, Norfolk, NR4 7UY, UK
| | - Martin J Heaton
- Department of Plastic & Reconstructive Surgery, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich, Norfolk, NR4 7UY, UK
| | - Marc D Moncrieff
- Department of Plastic & Reconstructive Surgery, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich, Norfolk, NR4 7UY, UK; Norwich Medical School, University of East Anglia Norwich Research Park, Norwich, NR4 7TJ, UK
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Manuilov BM, Ermakov AV. Preparation and Properties of Nanocolloidal Rhenium Sulfide Solution for Lymphoscintigraphic Methods of Micrometastase Examination. APPL BIOCHEM MICRO+ 2018. [DOI: 10.1134/s000368381708004x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Zengel B, Yararbas U, Sirinocak A, Ozkok G, Denecli AG, Postaci H, Uslu A. Sentinel Lymph Node Biopsy in Breast Cancer: Review on Various Methodological Approaches. TUMORI JOURNAL 2018; 99:149-53. [DOI: 10.1177/030089161309900205] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims and background Sentinel lymph node biopsy has been accepted as a standard procedure for early stage breast cancer. In this retrospective analysis, the results obtained with different methodological approaches using radiocolloid with or without blue dye were examined. Methods A total of 158 sentinel lymph node biopsies were performed in 152 patients. Group A (85 patients) underwent lymphatic mapping using a combination of periareolar intradermal radiocolloid and subareolar blue dye injections. Group B (73 patients) underwent only periareolar intradermal radiocolloid injection. One large tin colloid and two small radiocolloids (nanocolloid of serum albumin -NC- and colloidal rhenium sulphide -CS-) were used. Results Successful lymphatic mapping was attained in 157 of 158 procedures (99.4%). Radiocolloids localized sentinel lymph nodes in 99.4% and blue dye in 75.3% of the cases. The number of sentinel lymph nodes removed was greater in nanocolloid and colloidal rhenium sulphide groups ( P ≤0.05). Among 60 metastatic sentinel lymph nodes, frozen section analysis using hematoxylin and eosin staining failed to detect 1 macro- and 10 micrometastasis. Radiocolloid uptake was higher in sentinel lymph nodes accumulating blue dye (1643 ± 3216 counts/10 sec vs 526 ± 1284 counts/10 sec, P <0.001). Higher count rates were obtained by using larger sized colloids (median and interquartile range: tin colloid, 2050 and 4548; nanocolloid, 835 and 1799; colloidal rhenium sulphide, 996 and 2079; P = 0.01). Only 2 extra-axillary sentinel lymph nodes were visualized using periareolar intradermal injection modality. Conclusions Radiocolloids were more successful than blue dye in sentinel lymph node detection. More sentinel lymph nodes were harvested with small colloids, but different sized radiocolloids were similarly successful. Sentinel lymph nodes having higher radiocolloid uptake tended to accumulate blue dye more frequently. Sentinel lymph nodes manifested higher count rates when a larger colloid was used. Frozen section was very successful in detecting macrometastatic disease in sentinel lymph nodes, but the technique failed in most of the micrometastates.
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Affiliation(s)
- Baha Zengel
- Turkish Ministry of Health Izmir Bozyaka Research and Training Hospital, Department of General Surgery, Izmir, Turkey
| | - Ulkem Yararbas
- Ege University, Medical Faculty, Department of Nuclear Medicine, Bornova, Izmir, Turkey
| | - Ahmet Sirinocak
- Turkish Ministry of Health Izmir Bozyaka Research and Training Hospital, Department of General Surgery, Izmir, Turkey
| | - Guliz Ozkok
- Turkish Ministry of Health Izmir Bozyaka Research and Training Hospital, Department of Pathology, Izmir, Turkey
| | - Ali Galip Denecli
- Turkish Ministry of Health Izmir Bozyaka Research and Training Hospital, Department of General Surgery, Izmir, Turkey
| | - Hakan Postaci
- Turkish Ministry of Health Izmir Bozyaka Research and Training Hospital, Department of Pathology, Izmir, Turkey
| | - Adam Uslu
- Turkish Ministry of Health Izmir Bozyaka Research and Training Hospital, Department of General Surgery, Izmir, Turkey
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Moncayo VM, Alazraki AL, Alazraki NP, Aarsvold JN. Sentinel Lymph Node Biopsy Procedures. Semin Nucl Med 2017; 47:595-617. [DOI: 10.1053/j.semnuclmed.2017.06.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Use of the ROLL technique for lumpectomy in non-palpable breast lesions. Rev Esp Med Nucl Imagen Mol 2017. [DOI: 10.1016/j.remnie.2017.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Sentinel Node Mapping Using a Fluorescent Dye and Visible Light During Laparoscopic Gastrectomy for Early Gastric Cancer: Result of a Prospective Study From a Single Institute. Ann Surg 2017; 265:766-773. [PMID: 27058946 DOI: 10.1097/sla.0000000000001739] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the feasibility of sentinel node mapping using a fluorescent dye and visible light in patients with gastric cancer. BACKGROUND Recently, fluorescent imaging technology offers improved visibility with the possibility of better sensitivity or accuracy in sentinel node mapping. METHODS Twenty patients with early gastric cancer, for whom laparoscopic distal gastrectomy with standard lymphadenectomy had been planned, were enrolled in this study. Before lymphadenectomy, the patients received a gastrofiberoscopic peritumoral injection of fluorescein solution. The sentinel basin was investigated via laparoscopic fluorescent imaging under blue light (wavelength of 440-490 nm) emitted from an LED curing light. The detection rate and lymph node status were analyzed in the enrolled patients. In addition, short-term clinical outcomes were also investigated. RESULTS No hypersensitivity to the dye was identified in any enrolled patients. Sentinel nodes were detected in 19 of 20 enrolled patients (95.0%), and metastatic lymph nodes were found in 2 patients. The latter lymph nodes belonged to the sentinel basin of each patient. Meanwhile, 1 patient (5.0%) experienced a postoperative complication that was unrelated to sentinel node mapping. No mortality was recorded among enrolled cases. CONCLUSIONS Sentinel node mapping with visible light fluorescence was a feasible method for visualizing sentinel nodes in patients with early gastric cancer. In addition, this method is advantageous in terms of visualizing the concrete relationship between the sentinel nodes and surrounding structures.
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Use of the ROLL technique for lumpectomy in non-palpable breast lesions. Rev Esp Med Nucl Imagen Mol 2017; 36:285-291. [PMID: 28341228 DOI: 10.1016/j.remn.2017.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 02/08/2017] [Accepted: 02/13/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate the efficiency of radioguided occult lesion localising in non-palpable breast lesions (NPBL) compared to the surgical wire technique. METHOD A prospective study was conducted on 161 women with NPBL, of whom 80 marked with the wire (group 1), whereas 81 women were marked with an intratumour injection of 99mTc-nanocoloid (group 2). The NPBL were located by ultrasound or stereotactic guidance. The lumpectomies were performed following the wire direction in group 1, and with the aid of a gamma-probe in group 2. Surgical margins were then checked, determining the need of extension if the margin was less than 5mm in the intra-surgical study, and less than 2mm in the deferred study. Data were collected on the mean number detected by surgery, surgical margins, number of extensions, presence of residual tumour in the extension, second surgeries, lumpectomy volume, as well as total resected volume, volume/tumour ratio, and complications. RESULTS No significant differences were observed between the two groups in the mean number detected, surgical margins, number of extensions, presence of residual tumour in the extension, second surgeries, lumpectomy volume, total resected volume, volume/tumour ratio or complications. The multivariate analysis showed the determining factors of the resected volume were the radiological guidance technique, as well as the surgeon. CONCLUSIONS The radioguided occult lesion localising technique helps in the detection and resection of NPBL with the same efficiency as the surgical wire, and adds the possibility of sentinel node detection in the same surgery. The determining factors of the resected volume were the radiological guidance technique and the surgeon.
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Persico MG, Lodola L, Buroni FE, Morandotti M, Pallavicini P, Aprile C. (99m)Tc-human serum albumin nanocolloids: particle sizing and radioactivity distribution. J Labelled Comp Radiopharm 2015. [PMID: 26198778 DOI: 10.1002/jlcr.3317] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Several parameters affect the biodistribution of administered nanocolloids (NC) for Sentinel Lymph Node (SLN) detection: particle size distribution, number of Tc atoms per particle and specific activity (SA). Relatively few data are available with frequently conflicting results. (99m)Tc-NC-human serum albumin (HSA) Nanocoll®, Nanoalbumon® and Nanotop® were analysed for particles' dimensional and radioactivity distribution, and a mathematical model was elaborated to estimate the number of particles involved. Commercially available kits were reconstituted at maximal SA of 11 MBq/µg HSA. Particles size distribution was evaluated by Dynamic Light Scattering. These data were related to the radioactivity distribution analysis passing labelled NC through three polycarbonate filters (15-30-50-nm pore size) under vacuum. Highest radioactivity was carried by 30-50 nm particles. The smallest ones, even though most numerous, carried only the 10% of (99m)Tc atoms. Nanocoll and Nanotop are not significantly different, while Nanoalbumon is characterized by largest particles (>30 nm) that carried the most of radioactivity (80%). Smallest particles could saturate the clearing capacity of macrophages; therefore, if the tracer is used for SLN detection, more node tiers could be visualized, reducing accuracy of SLN mapping. Manufacturers could implement technical leaflets with particle size distribution and could improve the labelling protocol to provide clinicians useful information.
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Affiliation(s)
- Marco G Persico
- Nuclear Medicine Unit, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Lorenzo Lodola
- Nuclear Medicine Unit, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Federica E Buroni
- Nuclear Medicine Unit, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Marco Morandotti
- Mathematics Area, SISSA International School for Advanced Studies, Trieste, Italy
| | | | - Carlo Aprile
- Nuclear Medicine Unit, IRCCS San Matteo Hospital Foundation, Pavia, Italy
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Pouw JJ, Ahmed M, Anninga B, Schuurman K, Pinder SE, Van Hemelrijck M, Pankhurst QA, Douek M, Ten Haken B. Comparison of three magnetic nanoparticle tracers for sentinel lymph node biopsy in an in vivo porcine model. Int J Nanomedicine 2015; 10:1235-43. [PMID: 25709445 PMCID: PMC4334341 DOI: 10.2147/ijn.s76962] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Introduction Breast cancer staging with sentinel lymph node biopsy relies on the use of radioisotopes, which limits the availability of the procedure worldwide. The use of a magnetic nanoparticle tracer and a handheld magnetometer provides a radiation-free alternative, which was recently evaluated in two clinical trials. The hydrodynamic particle size of the used magnetic tracer differs substantially from the radioisotope tracer and could therefore benefit from optimization. The aim of this study was to assess the performance of three different-sized magnetic nanoparticle tracers for sentinel lymph node biopsy within an in vivo porcine model. Materials and methods Sentinel lymph node biopsy was performed within a validated porcine model using three magnetic nanoparticle tracers, approved for use in humans (ferumoxytol, with hydrodynamic diameter dH =32 nm; Sienna+®, dH =59 nm; and ferumoxide, dH =111 nm), and a handheld magnetometer. Magnetometer counts (transcutaneous and ex vivo), iron quantification (vibrating sample magnetometry), and histopathological assessments were performed on all ex vivo nodes. Results Transcutaneous “hotspots” were present in 12/12 cases within 30 minutes of injection for the 59 nm tracer, compared to 7/12 for the 32 nm tracer and 8/12 for the 111 nm tracer, at the same time point. Ex vivo magnetometer counts were significantly greater for the 59 nm tracer than for the other tracers. Significantly more nodes per basin were excised for the 32 nm tracer compared to other tracers, indicating poor retention of the 32 nm tracer. Using the 59 nm tracer resulted in a significantly higher iron accumulation compared to the 32 nm tracer. Conclusion The 59 nm tracer demonstrated rapid lymphatic uptake, retention in the first nodes reached, and accumulation in high concentration, making it the most suitable tracer for intraoperative sentinel lymph node localization.
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Affiliation(s)
- Joost J Pouw
- MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, the Netherlands
| | - Muneer Ahmed
- Research Oncology, Division of Cancer Studies, King's College London, Guy's Hospital, London, UK
| | - Bauke Anninga
- Research Oncology, Division of Cancer Studies, King's College London, Guy's Hospital, London, UK
| | - Kimberley Schuurman
- MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, the Netherlands
| | - Sarah E Pinder
- Research Oncology, Division of Cancer Studies, King's College London, Guy's Hospital, London, UK
| | - Mieke Van Hemelrijck
- Cancer Epidemiology Group, Division of Cancer Studies, King's College London, London, UK
| | - Quentin A Pankhurst
- Healthcare Biomagnetics Laboratory, University College London, London, UK ; Institute of Biomedical Engineering, University College London, London, UK
| | - Michael Douek
- Research Oncology, Division of Cancer Studies, King's College London, Guy's Hospital, London, UK
| | - Bennie Ten Haken
- MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, the Netherlands
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Comment on: the EANM and SNMMI practice guideline for lymphoscintigraphy and sentinel node localization in breast cancer. Eur J Nucl Med Mol Imaging 2014; 41:1257-8. [PMID: 24668275 DOI: 10.1007/s00259-014-2747-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Accepted: 02/27/2014] [Indexed: 10/25/2022]
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Cousins A, Thompson SK, Wedding AB, Thierry B. Clinical relevance of novel imaging technologies for sentinel lymph node identification and staging. Biotechnol Adv 2013; 32:269-79. [PMID: 24189095 DOI: 10.1016/j.biotechadv.2013.10.011] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Revised: 10/12/2013] [Accepted: 10/27/2013] [Indexed: 01/07/2023]
Abstract
The sentinel lymph node (SLN) concept has become a standard of care for patients with breast cancer and melanoma, yet its clinical application to other cancer types has been somewhat limited. This is mainly due to the reduced accuracy of conventional SLN mapping techniques (using blue dye and/or radiocolloids as lymphatic tracers) in cancer types where lymphatic drainage is more complex, and SLNs are within close proximity to other nodes or the tumour site. In recent years, many novel techniques for SLN mapping have been developed including fluorescence, x-ray, and magnetic resonant detection. Whilst each technique has its own advantages/disadvantages, the role of targeted contrast agents (for enhanced retention in the SLN, or for immunostaging) is increasing, and may represent the new standard for mapping the SLN in many solid organ tumours. This review article discusses current limitations of conventional techniques, limiting factors of nanoparticulate based contrast agents, and efforts to circumvent these limitations with modern tracer architecture.
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Affiliation(s)
- Aidan Cousins
- Ian Wark Research Institute, University of South Australia, Mawson Lakes Campus, Mawson Lakes, SA 5095, Australia
| | - Sarah K Thompson
- Discipline of Surgery, University of Adelaide, Royal Adelaide Hospital, Adelaide, SA 5000, Australia
| | - A Bruce Wedding
- School of Engineering, University of South Australia, Mawson Lakes Campus, Mawson Lakes, SA 5095, Australia
| | - Benjamin Thierry
- Ian Wark Research Institute, University of South Australia, Mawson Lakes Campus, Mawson Lakes, SA 5095, Australia.
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Johnsrud K, Skretting A, Naum AG, Bogsrud TV, Bach-Gansmo T. Characterization of an asymmetric add-on collimator used with a hand-held gamma probe for radioguided surgery and sentinel node detection: a demonstration of an alternative collimation method. Clin Physiol Funct Imaging 2013; 33:478-82. [PMID: 23758686 DOI: 10.1111/cpf.12057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Accepted: 05/05/2013] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The aim of the study was to investigate a new principle for collimation of gamma probes for radioguided surgery and sentinel node detection: the use of asymmetric lateral shielding. The intension was to maintain the sensitivity in the lateral and forward directions on the unshielded side while at the same time to shield the probe against high activity sources that could mask the signal from the object to be detected. METHODS The device was constructed to shield only against photons that come from a region in space that spans approximately 180° sideways and forwards relative to the detector. The intension of the study was to demonstrate the principle rather than to document its use in the clinic. Sensitivity profiles were derived from measurements obtained while stepwise moving the probe relatively to a point source of known activity surrounded by water. The measurements were taken in the symmetry plane of the collimator where the shielding effects were expected to be most pronounced. RESULTS The asymmetric collimator led to nearly unchanged sensitivity in the lateral and forward directions. At the same time, the field of view was effectively shrunk on the shielded side. Contributions from sources lateral and close to the shield were reduced by factors up to 45. CONCLUSION By rotating the probe around its longitudinal axis, an asymmetric add-on shield collimator could potentially make it easier to detect a sentinel node when this is located close to a neighbouring high activity region like the urinary bladder or the injection site.
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Affiliation(s)
- Kjersti Johnsrud
- Department of Radiology and Nuclear medicine, Oslo University Hospital, Oslo, Norway
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Iida S, Imai K, Matsuda S, Itano O, Hatakeyama M, Sakamoto S, Kokuryo D, Okabayashi K, Endo T, Ishii Y, Hasegawa H, Aoki I, Handa H, Kitagawa Y. In vivo identification of sentinel lymph nodes using MRI and size-controlled and monodispersed magnetite nanoparticles. J Magn Reson Imaging 2013; 38:1346-55. [PMID: 23554026 DOI: 10.1002/jmri.24108] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2012] [Accepted: 02/11/2013] [Indexed: 02/06/2023] Open
Abstract
PURPOSE To develop a sentinel lymph node (SN) identification method using accurately synthesized magnetic nanoparticles (MNPs), as an enhanced specific SN tracer in combination with magnetic resonance imaging (MRI) in intact rodent and SN metastasis models. MATERIALS AND METHODS Three sizes of MNPs were originally synthesized. We developed an experimental rat SN model, with brachial lymph nodes (Br) as the SN and the axillary lymph node (Ax) as the second lymph node, and injection of MNPs via the front paw. SN detectability was evaluated in vivo using T1 -weighted MR images after injection of the synthesized MNPs, and the amount of iron in the Br and in the Ax was assessed using inductively coupled plasma optical emission spectrometry. RESULTS The highest ratios of the amount of iron in the Br versus the Ax were 3.1 and 3.3, using 20-nm MNPs after 2- and 24-hour injections. The appropriate dose and particle diameter for MRI detection was optimized, and the SN was optimally distinguished in the normal and metastatic rat models using MRI after a 0.4 mg/kg 20-nm MNP injection. CONCLUSION We developed and optimized a useful SN identification method using MRI in rodent models.
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Affiliation(s)
- Shuji Iida
- Department of Surgery, School of Medicine, Keio University, Tokyo, Japan
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Au KM, Armes SP. Heterocoagulation as a facile route to prepare stable serum albumin-nanoparticle conjugates for biomedical applications: synthetic protocols and mechanistic insights. ACS NANO 2012; 6:8261-8279. [PMID: 22913736 DOI: 10.1021/nn302968j] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
There is increasing interest in using serum albumin, the most abundant plasma protein, as a stabilizing agent in the context of nanomedicine. Using poly(vinyl amine)-stabilized polypyrrole nanoparticles as an example, we report a facile generic route to prepare serum albumin-nanoparticle conjugates via heterocoagulation. Time-resolved dynamic light scattering (DLS), disk centrifuge photosedimentometry (DCP), and circular dichroism (CD) spectroscopy studies confirm that bovine serum albumin (BSA) adsorbs rapidly onto the cationic poly(vinyl amine)-stabilized polypyrrole nanoparticles and suggest that the initial well-defined protein coronal is subsequently cross-linked via thiol-disulfide exchange. These BSA-nanoparticle conjugates were further characterized by X-ray photoelectron spectroscopy (XPS), aqueous electrophoresis, field emission scanning electron microscopy (FE SEM), and transmission electron microscopy (TEM). They exhibit excellent long-term colloidal stability under physiological conditions without further purification, suggesting strong irreversible adsorption by the BSA. Protein adsorption appears to be co-operative and both thermodynamic and mechanistic aspects were examined via aqueous electrophoresis, DCP, and DLS studies.
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Affiliation(s)
- Kin Man Au
- Department of Chemistry, The University of Sheffield, Brook Hill, Sheffield, South Yorkshire S3 7HF, UK
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Takeuchi H, Kawakubo H, Takeda F, Omori T, Kitagawa Y. Sentinel node navigation surgery in early-stage esophageal cancer. Ann Thorac Cardiovasc Surg 2012; 18:306-13. [PMID: 22673610 DOI: 10.5761/atcs.ra.12.01951] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The sentinel node (SN) concept has revolutionized the surgical staging of both melanoma and breast cancer over the past two decades. However, the validity of the SN hypothesis has been controversial for esophageal cancer, because SN mapping for esophageal cancer is technically complicated, and the number of early-stage esophageal cancer is very limited. Nevertheless previous studies nicely demonstrated that SN mapping may be feasible in patients with early-stage esophageal cancer. Transthoracic extended esophagectomy with three-field radical lymph node dissection has been recognized as a curative procedure for thoracic esophageal cancer in Japan. However, uniform application of this highly invasive procedure might increase the morbidity and markedly reduce the quality of life (QOL) after surgery. Although further accumulation of evidence based on multicenter clinical trials using a standard protocol is needed, SN mapping and SN navigation surgery would provide significant information to perform individualized selective lymphadenectomy which might reduce the morbidity and retain the patients' QOL. In addition, technical innovation including the development of new tracers is expected to confirm the accuracy and reliability of SN mapping in esophageal cancer.
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Affiliation(s)
- Hiroya Takeuchi
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan.
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Jensen MR, Simonsen L, Karlsmark T, Bülow J. The washout rate of a subcutaneous 99mTc-HSA depot in lower extremity lymphoedema. Clin Physiol Funct Imaging 2011; 32:126-32. [DOI: 10.1111/j.1475-097x.2011.01066.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Seo Y, Aparici CM, Chen CP, Hsu C, Kased N, Schreck C, Costouros N, Hawkins R, Shinohara K, Roach Iii M. Mapping of lymphatic drainage from the prostate using filtered 99mTc-sulfur nanocolloid and SPECT/CT. J Nucl Med 2011; 52:1068-72. [PMID: 21680690 DOI: 10.2967/jnumed.110.085944] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED We have developed a practice procedure for prostate lymphoscintigraphy using SPECT/CT and filtered (99m)Tc-sulfur nanocolloid, as an alternative to the proprietary product (99m)Tc-Nanocoll, which is not approved in the United States. METHODS Ten patients were enrolled for this study, and all received radiotracer prepared using a 100-nm membrane filter at a commercial radiopharmacy. Whole-body scans and SPECT/CT studies were performed within 1.5-3 h after the radiotracer had been administered directly into 6 locations of the prostate gland under transrectal ultrasound guidance. The radiation dose was estimated from the first 3 patients. Lymphatic drainage mapping was performed, and lymph nodes were identified. RESULTS The estimated radiation dose ranged from 3.9 to 5.2 mSv/MBq. The locations of lymph nodes draining the prostate gland were similar to those found using the proprietary product. CONCLUSION When the proprietary radiolabeled nanocolloid indicated for lymphoscintigraphy is not available, prostate lymph node mapping and identification are still feasible using filtered (99m)Tc-sulfur nanocolloid.
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Affiliation(s)
- Youngho Seo
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California 94107-1739, USA.
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Ocampo-García BE, Ramírez FDM, Ferro-Flores G, De León-Rodríguez LM, Santos-Cuevas CL, Morales-Avila E, de Murphy CA, Pedraza-López M, Medina LA, Camacho-López MA. (99m)Tc-labelled gold nanoparticles capped with HYNIC-peptide/mannose for sentinel lymph node detection. Nucl Med Biol 2011; 38:1-11. [PMID: 21220124 DOI: 10.1016/j.nucmedbio.2010.07.007] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2010] [Revised: 07/16/2010] [Accepted: 07/17/2010] [Indexed: 11/24/2022]
Abstract
UNLABELLED The aim of this research was to prepare a multifunctional system of technetium-99m-labelled gold nanoparticles conjugated to HYNIC-GGC/mannose and to evaluate its biological behaviour as a potential radiopharmaceutical for sentinel lymph node detection (SLND). METHODS Hydrazinonicotinamide-Gly-Gly-Cys-NH(2) (HYNIC-GGC) peptide and a thiol-triazole-mannose derivative were synthesized, characterized and conjugated to gold nanoparticles (AuNP, 20 nm) to prepare a multifunctional system of HYNIC-GGC-AuNP-mannose by means of spontaneous reaction of the thiol (Cys) present in HYNIC-GGC sequence and in the thiol-mannose derivative. The nanoconjugate was characterized by transmission electron microscopy (TEM), IR, UV-Vis, Raman, fluorescence and X-ray photoelectron spectroscopy (XPS). Technetium-99m labelling was carried out using EDDA/tricine as coligands and SnCl(2) as reducing agent with further size-exclusion chromatography purification. Radiochemical purity was determined by size-exclusion HPLC and ITLC-SG analyses. In vitro binding studies were carried out in rat liver homogenized tissue (mannose-receptor positive tissue). Biodistribution studies were accomplished in Wistar rats and images obtained using a micro-SPECT/CT system. RESULTS TEM and spectroscopy techniques demonstrated that AuNPs were functionalized with HYNIC-GGC-NH(2) and thiol-mannose through interactions with thiol groups and the N-terminal amine of cysteine. Radio-chromatograms showed radiochemical purity higher than 95%. (99m)Tc-EDDA/HYNIC-GGC-AuNP-mannose ((99m)Tc-AuNP-mannose) showed specific recognition for mannose receptors in rat liver tissue. After subcutaneous administration of (99m)Tc-AuNP-mannose in rats (footpad), radioactivity levels in the popliteal and inguinal lymph nodes revealed that 99% of the activity was extracted by the first lymph node (popliteal extraction). Biodistribution studies and in vivo micro-SPECT/CT images in Wistar rats showed an evident lymph node uptake (11.58 ± 1.98 %ID at 1 h) which was retained during 24 h with minimal kidney accumulation (0.98 ± 0.10 %ID) and negligible uptake in all other tissues. CONCLUSIONS This study demonstrated that (99m)Tc-AuNP-mannose remains within the first lymph node during 24 h and therefore might be useful as a target-specific radionanoconjugate for SLND using "1-day" or "2-day" conventional protocols.
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Abstract
ObjectiveTo examine whether the intraoperative combined injection technique is feasible in locating the sentinel node(s) of the ovary.Methods/MaterialsIn 16 patients with high-risk uterine cancer and normal postmenopausal ovaries, technetium isotope and blue dye were injected in the right or left ovary during laparotomy, respectively. During the operation, the pelvic and para-aortic lymphatic areas were searched, and the number, method of detection, and location(s) of the hot and/or blue node(s) were recorded.ResultsOne to 3 sentinel nodes per patient were identified in all but 1 patient (15 of 16, 94%). The sentinel nodes (n = 30) were all located in the para-aortic area. The sentinel nodes of the left ovary were mainly (9 of 14, 64%) located above the inferior mesenteric artery level, as the most sentinel nodes of the right ovary (15 of 16, 94%) were found below the inferior mesenteric artery level (P = 0.001). There were no contralateral or bilateral sentinel nodes.ConclusionsThe combined intraoperative injection technique with radioisotope and blue dye is fast enough to identify the ovarian sentinel node(s). The stained nodes were consistently located on a certain lymphatic area. The sentinel node concept for the early ovarian cancer deserves more attention.
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Cattaneo AG, Gornati R, Sabbioni E, Chiriva-Internati M, Cobos E, Jenkins MR, Bernardini G. Nanotechnology and human health: risks and benefits. J Appl Toxicol 2011; 30:730-44. [PMID: 21117037 DOI: 10.1002/jat.1609] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Nanotechnology is expected to be promising in many fields of medical applications, mainly in cancer treatment. While a large number of very attractive exploitations open up for the clinics, regulatory agencies are very careful in admitting new nanomaterials for human use because of their potential toxicity. The very active research on new nanomaterials that are potentially useful in medicine has not been counterbalanced by an adequate knowledge of their pharmacokinetics and toxicity. The different nanocarriers used to transport and release the active molecules to the target tissues should be treated as additives, with potential side effects of themselves or by virtue of their dissolution or aggregation inside the body. Only recently has a systematic classification of nanomaterials been proposed, posing the basis for dedicated modeling at the nanoscale level. The use of in silico methods, such as nano-QSAR and PSAR, while highly desirable to expedite and rationalize the following stages of toxicological research, are not an alternative, but an introduction to mandatory experimental work.
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Affiliation(s)
- Anna Giulia Cattaneo
- Department of Biotechnology and Molecular Sciences, University of Insubria, Varese, Italy
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Liu Y, Solomon M, Achilefu S. Perspectives and potential applications of nanomedicine in breast and prostate cancer. Med Res Rev 2010; 33:3-32. [PMID: 23239045 DOI: 10.1002/med.20233] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Nanomedicine is a branch of nanotechnology that includes the development of nanostructures and nanoanalytical systems for various medical applications. Among these applications, utilization of nanotechnology in oncology has captivated the attention of many research endeavors in recent years. The rapid development of nano-oncology raises new possibilities in cancer diagnosis and treatment. It also holds great promise for realization of point-of-care, theranostics, and personalized medicine. In this article, we review advances in nano-oncology, with an emphasis on breast and prostate cancer because these organs are amenable to the translation of nanomedicine from small animals to humans. As new drugs are developed, the incorporation of nanotechnology approaches into medicinal research becomes critical. Diverse aspects of nano-oncology are discussed, including nanocarriers, targeting strategies, nanodevices, as well as nanomedical diagnostics, therapeutics, and safety. The review concludes by identifying some limitations and future perspectives of nano-oncology in breast and prostate cancer management.
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Affiliation(s)
- Yang Liu
- Department of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA
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Matsumoto T, Shibata S, Yasue S, Sakakibara A, Yokota K, Sawada M, Kono M, Kato K, Shimoyama Y, Tomita Y. Interval sentinel lymph nodes in patients with cutaneous melanoma: a single-institution study in Japan. J Dermatol 2010; 37:629-34. [PMID: 20629829 DOI: 10.1111/j.1346-8138.2010.00856.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Interval sentinel lymph nodes (ISLN) are defined as the lymph nodes located between the primary melanoma and anatomically well-defined lymph nodal basins. It was reported that the ISLN appeared to be at the same metastatic risk as sentinel lymph nodes (SLN) in the traditional nodal basins. This study aimed to examine the incidence and metastatic risk of the ISLN in melanoma patients. Between June of 1999 and December of 2008, 117 patients enrolled at Nagoya University Hospital underwent SLN biopsy for primary cutaneous melanoma with a Breslow thickness of at least 1.0 mm. Triple techniques with lymphoscintigraphy, blue dye injection and gamma probe were used for the biopsy except for 13 cases that underwent lymphoscintigraphy, ultrasonography and blue dye injection, but without gamma probe. Patients who had melanoma of the head and neck were excluded from this analysis. The SLN were identified in 253 nodal basins from 117 patients, and ISLN were found in six patients (5%). We recognized 41 (17%) SLN metastases in 246 conventional nodal basins and one (14%) in seven ISLN. Although ISLN were identified infrequently, the incidence of metastasis into the ISLN was similar to that into SLN in conventional nodal basins. It is therefore recommended that preoperative lymphoscintigraphy and intraoperative recognition of ISLN should be performed.
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Affiliation(s)
- Takaaki Matsumoto
- Department of Dermatology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Japan.
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Yararbas U, Argon AM, Yeniay L, Zengel B, Kapkaç M. The effect of radiocolloid preference on major parameters in sentinel lymph node biopsy practice in breast cancer. Nucl Med Biol 2010; 37:805-10. [DOI: 10.1016/j.nucmedbio.2010.03.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2010] [Revised: 03/29/2010] [Accepted: 03/31/2010] [Indexed: 11/16/2022]
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Joint practice guidelines for radionuclide lymphoscintigraphy for sentinel node localization in oral/oropharyngeal squamous cell carcinoma. Eur J Nucl Med Mol Imaging 2010; 36:1915-36. [PMID: 19784646 PMCID: PMC2764079 DOI: 10.1007/s00259-009-1248-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Involvement of the cervical lymph nodes is the most important prognostic factor for patients with oral/oropharyngeal squamous cell carcinoma (OSCC), and the decision whether to electively treat patients with clinically negative necks remains a controversial topic. Sentinel node biopsy (SNB) provides a minimally invasive method of determining the disease status of the cervical node basin, without the need for a formal neck dissection. This technique potentially improves the accuracy of histological nodal staging and avoids over-treating three-quarters of this patient population, minimizing associated morbidity. The technique has been validated for patients with OSCC, and larger-scale studies are in progress to determine its exact role in the management of this patient population. This article was designed to outline the current best practice guidelines for the provision of SNB in patients with early-stage OSCC, and to provide a framework for the currently evolving recommendations for its use. These guidelines were prepared by a multidisciplinary surgical/nuclear medicine/pathology expert panel under the joint auspices of the European Association of Nuclear Medicine (EANM) Oncology Committee and the Sentinel European Node Trial Committee.
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Chakera AH, Hesse B, Burak Z, Ballinger JR, Britten A, Caracò C, Cochran AJ, Cook MG, Drzewiecki KT, Essner R, Even-Sapir E, Eggermont AMM, Stopar TG, Ingvar C, Mihm MC, McCarthy SW, Mozzillo N, Nieweg OE, Scolyer RA, Starz H, Thompson JF, Trifirò G, Viale G, Vidal-Sicart S, Uren R, Waddington W, Chiti A, Spatz A, Testori A. EANM-EORTC general recommendations for sentinel node diagnostics in melanoma. Eur J Nucl Med Mol Imaging 2009; 36:1713-42. [PMID: 19714329 DOI: 10.1007/s00259-009-1228-4] [Citation(s) in RCA: 134] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The accurate diagnosis of a sentinel node in melanoma includes a sequence of procedures from different medical specialities (nuclear medicine, surgery, oncology, and pathology). The items covered are presented in 11 sections and a reference list: (1) definition of a sentinel node, (2) clinical indications, (3) radiopharmaceuticals and activity injected, (4) dosimetry, (5) injection technique, (6) image acquisition and interpretation, (7) report and display, (8) use of dye, (9) gamma probe detection, (10) surgical techniques in sentinel node biopsy, and (11) pathological evaluation of melanoma-draining sentinel lymph nodes. If specific recommendations given cannot be based on evidence from original, scientific studies, referral is given to "general consensus" and similar expressions. The recommendations are designed to assist in the practice of referral to, performance, interpretation and reporting of all steps of the sentinel node procedure in the hope of setting state-of-the-art standards for good-quality evaluation of possible spread to the lymphatic system in intermediate-to-high risk melanoma without clinical signs of dissemination.
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Affiliation(s)
- Annette H Chakera
- Department of Plastic Surgery and Burns Unit, Rigshospitalet, Copenhagen, Denmark.
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Alkureishi LWT, Burak Z, Alvarez JA, Ballinger J, Bilde A, Britten AJ, Calabrese L, Chiesa C, Chiti A, de Bree R, Gray HW, Hunter K, Kovacs AF, Lassmann M, Leemans CR, Mamelle G, McGurk M, Mortensen J, Poli T, Shoaib T, Sloan P, Sorensen JA, Stoeckli SJ, Thomsen JB, Trifiro G, Werner J, Ross GL. Joint Practice Guidelines for Radionuclide Lymphoscintigraphy for Sentinel Node Localization in Oral/Oropharyngeal Squamous Cell Carcinoma. Ann Surg Oncol 2009; 16:3190-210. [PMID: 19795174 PMCID: PMC2766455 DOI: 10.1245/s10434-009-0726-8] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2009] [Indexed: 02/06/2023]
Abstract
Involvement of the cervical lymph nodes is the most important prognostic factor for patients with oral/oropharyngeal squamous cell carcinoma (OSCC), and the decision of whether to electively treat patients with clinically negative necks remains a controversial topic. Sentinel node biopsy (SNB) provides a minimally invasive method for determining the disease status of the cervical node basin, without the need for a formal neck dissection. This technique potentially improves the accuracy of histologic nodal staging and avoids overtreating three-quarters of this patient population, minimizing associated morbidity. The technique has been validated for patients with OSCC, and larger-scale studies are in progress to determine its exact role in the management of this patient population. This document is designed to outline the current best practice guidelines for the provision of SNB in patients with early-stage OSCC, and to provide a framework for the currently evolving recommendations for its use. Preparation of this guideline was carried out by a multidisciplinary surgical/nuclear medicine/pathology expert panel under the joint auspices of the European Association of Nuclear Medicine (EANM) Oncology Committee and the Sentinel European Node Trial (SENT) Committee.
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Affiliation(s)
- L W T Alkureishi
- Department of Plastic Surgery, University of Chicago Medical Center, Chicago, USA.
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Stability of the mixture of technetium-99m human serum albumin and lidocaine hydrochloride for clinical application. Nucl Med Commun 2009; 30:494-7. [PMID: 19430321 DOI: 10.1097/mnm.0b013e32832b9a5c] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM To evaluate the stability of the mixture of technetium-99m (99mTc) human serum albumin (HSA) with the local anesthetic lidocaine hydrochloride. MATERIALS AND METHODS We assessed three preparations of the radiotracer, 99mTc-HSA, filtered 99mTc-HSA, and a mixture of 99mTc-HSA with lidocaine hydrochloride and then filtered. Time sequence evaluation was performed on all the specimens (n= 10) at 0, 30, 60, 90, 120, 150, and 180 min after preparation. Measurements of radiochemical purity as labeling stability and pH value change were conducted for each group of specimens. RESULTS We found no definite difference in the stability before and after the filtering procedure for 99mTc-HSA. However, we showed a decline of stability in the mixture of 99mTc-HSA with lidocaine. The filtered specimens showed a relatively higher pH value, towards a more neutral status, as compared with the unfiltered specimens. CONCLUSION Though pain relief for the patient receiving sentinel lymph node mapping is important, a preparation of a mixture of 99mTc-HSA and lidocaine may cause radiolabeling instability. Furthermore, compared with the filtered 99mTc-sulfur colloid, a filtering procedure does not change the labeling stability of the 99mTc-HSA. On the contrary, the filtered preparation was neutralized closer to the physiologic condition. For lymphoscintigraphic studies,our results suggested that pretreatment with local anesthesia followed by subdermal injection of a filtered 99mTc-HSA rather than a pre-mixture with lidocaine is appropriate for clinical application.
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Influence of temperature on the radiochemical purity of 99mTc-colloidal rhenium sulfide for use in sentinel node localization. Nucl Med Commun 2008; 29:1015-20. [DOI: 10.1097/mnm.0b013e32830ebd13] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Kratz F. Albumin as a drug carrier: design of prodrugs, drug conjugates and nanoparticles. J Control Release 2008; 132:171-83. [PMID: 18582981 DOI: 10.1016/j.jconrel.2008.05.010] [Citation(s) in RCA: 1547] [Impact Index Per Article: 96.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2008] [Revised: 05/05/2008] [Accepted: 05/07/2008] [Indexed: 02/07/2023]
Abstract
Albumin is playing an increasing role as a drug carrier in the clinical setting. Principally, three drug delivery technologies can be distinguished: coupling of low-molecular weight drugs to exogenous or endogenous albumin, conjugation with bioactive proteins and encapsulation of drugs into albumin nanoparticles. The accumulation of albumin in solid tumors forms the rationale for developing albumin-based drug delivery systems for tumor targeting. Clinically, a methotrexate-albumin conjugate, an albumin-binding prodrug of doxorubicin, i.e. the (6-maleimido)caproylhydrazone derivative of doxorubicin (DOXO-EMCH), and an albumin paclitaxel nanoparticle (Abraxane) have been evaluated clinically. Abraxane has been approved for treating metastatic breast cancer. An alternative strategy is to bind a therapeutic peptide or protein covalently or physically to albumin to enhance its stability and half-life. This approach has been applied to peptides with antinociceptive, antidiabetes, antitumor or antiviral activity: Levemir, a myristic acid derivative of insulin that binds to the fatty acid binding sites of circulating albumin, has been approved for the treatment of diabetes. Furthermore, Albuferon, a fusion protein of albumin and interferon, is currently being assessed in phase III clinical trials for the treatment of hepatitis C and could become an alternative to pegylated interferon. This review gives an account of the different drug delivery systems which make use of albumin as a drug carrier with a focus on those systems that have reached an advanced stage of preclinical evaluation or that have entered clinical trials.
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Affiliation(s)
- Felix Kratz
- Head of Macromolecular Prodrugs, Tumor Biology Center, Breisacher Strasse 117, D-79106 Freiburg, Germany.
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