1
|
Yan Y, Liu Y, Li T, Liang Q, Thakur A, Zhang K, Liu W, Xu Z, Xu Y. Functional roles of magnetic nanoparticles for the identification of metastatic lymph nodes in cancer patients. J Nanobiotechnology 2023; 21:337. [PMID: 37735449 PMCID: PMC10512638 DOI: 10.1186/s12951-023-02100-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 09/08/2023] [Indexed: 09/23/2023] Open
Abstract
Staging lymph nodes (LN) is crucial in diagnosing and treating cancer metastasis. Biotechnologies for the specific localization of metastatic lymph nodes (MLNs) have attracted significant attention to efficiently define tumor metastases. Bioimaging modalities, particularly magnetic nanoparticles (MNPs) such as iron oxide nanoparticles, have emerged as promising tools in cancer bioimaging, with great potential for use in the preoperative and intraoperative tracking of MLNs. As radiation-free magnetic resonance imaging (MRI) probes, MNPs can serve as alternative MRI contrast agents, offering improved accuracy and biological safety for nodal staging in cancer patients. Although MNPs' application is still in its initial stages, exploring their underlying mechanisms can enhance the sensitivity and multifunctionality of lymph node mapping. This review focuses on the feasibility and current application status of MNPs for imaging metastatic nodules in preclinical and clinical development. Furthermore, exploring novel and promising MNP-based strategies with controllable characteristics could lead to a more precise treatment of metastatic cancer patients.
Collapse
Affiliation(s)
- Yuanliang Yan
- Department of Pharmacy, Xiangya Hospital, Central South University, 410008, Changsha, Hunan, China
| | - Yuanhong Liu
- Department of Pharmacy, Xiangya Hospital, Central South University, 410008, Changsha, Hunan, China
| | - Tongfei Li
- Hubei Key Laboratory of Embryonic Stem Cell Research, School of Basic Medical Sciences, Hubei University of Medicine, 442000, Shiyan, Hubei, China
| | - Qiuju Liang
- Department of Pharmacy, Xiangya Hospital, Central South University, 410008, Changsha, Hunan, China
| | - Abhimanyu Thakur
- Pritzker School of Molecular Engineering, Ben May Department for Cancer Research, University of Chicago, 60637, Chicago, IL, USA
| | - Kui Zhang
- Pritzker School of Molecular Engineering, Ben May Department for Cancer Research, University of Chicago, 60637, Chicago, IL, USA
| | - Wei Liu
- Department of Pathology, Xiangya Hospital, Central South University, 410008, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, 410008, Changsha, Hunan, China
| | - Zhijie Xu
- Department of Pathology, Xiangya Hospital, Central South University, 410008, Changsha, Hunan, China.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, 410008, Changsha, Hunan, China.
| | - Yuzhen Xu
- Department of Rehabilitation, The Second Affiliated Hospital of Shandong First Medical University, 271000, Taian, Shandong, China.
| |
Collapse
|
2
|
Yu Z, He Y, Schomann T, Wu K, Hao Y, Suidgeest E, Zhang H, Eich C, Cruz LJ. Rare-Earth-Metal (Nd 3+, Ce 3+ and Gd 3+)-Doped CaF 2: Nanoparticles for Multimodal Imaging in Biomedical Applications. Pharmaceutics 2022; 14:2796. [PMID: 36559291 PMCID: PMC9784532 DOI: 10.3390/pharmaceutics14122796] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 12/01/2022] [Accepted: 12/08/2022] [Indexed: 12/15/2022] Open
Abstract
Here, we describe the synthesis of a novel type of rare-earth-doped nanoparticles (NPs) for multimodal imaging, by combining the rare-earth elements Ce, Gd and Nd in a crystalline host lattice consisting of CaF2 (CaF2: Ce, Gd, Nd). CaF2: Ce, Gd, Nd NPs are small (15-20 nm), of uniform shape and size distribution, and show good biocompatibility and low immunogenicity in vitro. In addition, CaF2: Ce, Gd, Nd NPs possess excellent optical properties. CaF2: Ce, Gd, Nd NPs produce downconversion emissions in the second near-infrared window (NIR-II, 1000-1700 nm) under 808 nm excitation, with a strong emission peak at 1056 nm. Excitation in the first near- infrared window (NIR-I, 700-900 nm) has the advantage of deeper tissue penetration power and reduced autofluorescence, compared to visible light. Thus, CaF2: Ce, Gd, Nd NPs are ideally suited for in vivo fluorescence imaging. In addition, the presence of Gd3+ makes the NPs intrinsically monitorable by magnetic resonance imaging (MRI). Moreover, next to fluorescence and MR imaging, our results show that CaF2: Ce, Gd, Nd NPs can be used as imaging probes for photoacoustic imaging (PAI) in vitro. Therefore, due to their biocompatibility and suitability as multimodal imaging probes, CaF2: Ce, Gd, Nd NPs exhibit great potential as a traceable imaging agent in biomedical applications.
Collapse
Affiliation(s)
- Zhenfeng Yu
- Translational Nanobiomaterials and Imaging Group, Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Yuanyuan He
- Translational Nanobiomaterials and Imaging Group, Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Timo Schomann
- Translational Nanobiomaterials and Imaging Group, Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- Percuros B.V., Zernikedreef 8, 2333 CL Leiden, The Netherlands
| | - Kefan Wu
- Van ‘t Hoff Institute for Molecular Sciences, University of Amsterdam, Science Park 904, 1098 XH Amsterdam, The Netherlands
| | - Yang Hao
- Translational Nanobiomaterials and Imaging Group, Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Ernst Suidgeest
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Hong Zhang
- Van ‘t Hoff Institute for Molecular Sciences, University of Amsterdam, Science Park 904, 1098 XH Amsterdam, The Netherlands
| | - Christina Eich
- Translational Nanobiomaterials and Imaging Group, Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Luis J. Cruz
- Translational Nanobiomaterials and Imaging Group, Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| |
Collapse
|
3
|
Yu Z, He Y, Schomann T, Wu K, Hao Y, Suidgeest E, Zhang H, Eich C, Cruz LJ. Achieving Effective Multimodal Imaging with Rare-Earth Ion-Doped CaF 2 Nanoparticles. Pharmaceutics 2022; 14:840. [PMID: 35456674 PMCID: PMC9024546 DOI: 10.3390/pharmaceutics14040840] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/06/2022] [Accepted: 04/08/2022] [Indexed: 01/16/2023] Open
Abstract
Nowadays, cancer poses a significant hazard to humans. Limitations in early diagnosis techniques not only result in a waste of healthcare resources but can even lead to delays in diagnosis and treatment, consequently reducing cure rates. Therefore, it is crucial to develop an imaging probe that can provide diagnostic information precisely and rapidly. Here, we used a simple hydrothermal method to design a multimodal imaging probe based on the excellent properties of rare-earth ions. Calcium fluoride co-doped with ytterbium, gadolinium, and neodymium (CaF2:Y,Gd,Nd) nanoparticles (NPs) is highly crystalline, homogeneous in morphology, and displays a high biosafety profile. In addition, in vitro and ex vivo experiments explored the multimodal imaging capability of CaF2:Y,Gd,Nd and demonstrated the efficient performance of CaF2:Y,Gd,Nd during NIR-II fluorescence/photoacoustic/magnetic resonance imaging. Collectively, our novel diagnosis nanoparticle will generate new ideas for the development of multifunctional nanoplatforms for disease diagnosis and treatment.
Collapse
Affiliation(s)
- Zhenfeng Yu
- Translational Nanobiomaterials and Imaging Group, Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (Z.Y.); (Y.H.); (T.S.); (Y.H.)
| | - Yuanyuan He
- Translational Nanobiomaterials and Imaging Group, Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (Z.Y.); (Y.H.); (T.S.); (Y.H.)
| | - Timo Schomann
- Translational Nanobiomaterials and Imaging Group, Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (Z.Y.); (Y.H.); (T.S.); (Y.H.)
- Percuros B.V., Zernikedreef 8, 2333 CL Leiden, The Netherlands
| | - Kefan Wu
- Van’t Hoff Institute for Molecular Sciences, University of Amsterdam, Science Park 904, 1098 XH Amsterdam, The Netherlands; (K.W.); (H.Z.)
| | - Yang Hao
- Translational Nanobiomaterials and Imaging Group, Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (Z.Y.); (Y.H.); (T.S.); (Y.H.)
| | - Ernst Suidgeest
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands;
| | - Hong Zhang
- Van’t Hoff Institute for Molecular Sciences, University of Amsterdam, Science Park 904, 1098 XH Amsterdam, The Netherlands; (K.W.); (H.Z.)
| | - Christina Eich
- Translational Nanobiomaterials and Imaging Group, Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (Z.Y.); (Y.H.); (T.S.); (Y.H.)
| | - Luis J. Cruz
- Translational Nanobiomaterials and Imaging Group, Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (Z.Y.); (Y.H.); (T.S.); (Y.H.)
| |
Collapse
|
4
|
Amendola V, Guadagnini A, Agnoli S, Badocco D, Pastore P, Fracasso G, Gerosa M, Vurro F, Busato A, Marzola P. Polymer-coated silver-iron nanoparticles as efficient and biodegradable MRI contrast agents. J Colloid Interface Sci 2021; 596:332-341. [PMID: 33839358 DOI: 10.1016/j.jcis.2021.03.096] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 02/24/2021] [Accepted: 03/15/2021] [Indexed: 12/22/2022]
Abstract
Bimetallic nanoparticles allow new and synergistic properties compared to the monometallic equivalents, often leading to unexpected results. Here we present on silver-iron nanoparticles coated with polyethylene glycol, which exhibit a high transverse relaxivity (316 ± 13 mM-1s-1, > 3 times that of the most common clinical benchmark based on iron oxide), excellent colloidal stability and biocompatibility in vivo. Ag-Fe nanoparticles are obtained through a one-step, low-cost laser-assisted synthesis, which makes surface functionalization with the desired biomolecules very easy. Besides, Ag-Fe nanoparticles show biodegradation over a few months, as indicated by incubation in the physiological environment. This is crucial for nanomaterials removal from the living organism and, in fact, in vivo biodistribution studies evidenced that Ag-Fe nanoparticles tend to be cleared from liver over a period in which the benchmark iron oxide contrast agent persisted. Therefore, the Ag-Fe NPs offer positive prospects for solving the problems of biopersistence, contrast efficiency, difficulties of synthesis and surface functionalization usually encountered in nanoparticulate contrast agents.
Collapse
Affiliation(s)
- Vincenzo Amendola
- Department of Chemical Sciences, University of Padova, Padova I-35131, Italy.
| | - Andrea Guadagnini
- Department of Chemical Sciences, University of Padova, Padova I-35131, Italy
| | - Stefano Agnoli
- Department of Chemical Sciences, University of Padova, Padova I-35131, Italy
| | - Denis Badocco
- Department of Chemical Sciences, University of Padova, Padova I-35131, Italy
| | - Paolo Pastore
- Department of Chemical Sciences, University of Padova, Padova I-35131, Italy
| | | | - Marco Gerosa
- Department of Computer Science, University of Verona, Verona 37134, Italy
| | - Federica Vurro
- Department of Computer Science, University of Verona, Verona 37134, Italy
| | - Alice Busato
- Department of Computer Science, University of Verona, Verona 37134, Italy
| | - Pasquina Marzola
- Department of Computer Science, University of Verona, Verona 37134, Italy.
| |
Collapse
|
5
|
Pouw JJ, Grootendorst MR, Klaase JM, van Baarlen J, Ten Haken B. Ex vivo sentinel lymph node mapping in colorectal cancer using a magnetic nanoparticle tracer to improve staging accuracy: a pilot study. Colorectal Dis 2016; 18:1147-1153. [PMID: 27218666 DOI: 10.1111/codi.13395] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 02/24/2016] [Accepted: 02/29/2016] [Indexed: 02/08/2023]
Abstract
AIM Nodal status is the most important prognostic factor in colorectal cancer (CRC). Small occult metastases may remain undetected on conventional histopathological examination, potentially resulting in undertreatment. Ex vivo sentinel lymph node mapping (SLNM) can be used to improve the accuracy of nodal staging, but the currently used tracers suffer from drawbacks, which hamper implementation of the technique in routine clinical practice. Magnetic tracers are the optimal size for sentinel lymph node (SLN) retention and allow objective quantitative selection of SLNs; they therefore have great potential for SLNM in CRC. The study evaluates the feasibility of ex vivo magnetic SLNM and compares the performance of this technique with blue dye SLNM. METHOD Twenty-eight ex vivo SLNM procedures were performed in 27 histological node-negative patients with CRC using a magnetic tracer and blue dye. A magnetometer was used to select magnetic SLNs after formalin fixation of the CRC specimen. Both magnetic and blue SLNs were subjected to serial sectioning and immunohistochemical staining to reveal occult metastases. RESULTS At least one SLN was successfully identified in 27/28 (96%) and 25/28 (89%) of the cases with the magnetic technique and blue dye. Isolated tumour cells were detected in 10 patients. This was predicted with 100% sensitivity and accuracy using the magnetic technique, and with 91% sensitivity and 96% accuracy using the blue dye technique. CONCLUSION This study demonstrates that ex vivo magnetic SLNM is a feasible technique for use in routine clinical practice, improving nodal staging accuracy of CRC patients.
Collapse
Affiliation(s)
- J J Pouw
- MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands
| | - M R Grootendorst
- MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands.,Department of Surgery, Medisch Spectrum Twente, Enschede, The Netherlands
| | - J M Klaase
- Department of Surgery, Medisch Spectrum Twente, Enschede, The Netherlands
| | - J van Baarlen
- Laboratorium Pathologie Oost Nederland, Hengelo, The Netherlands
| | - B Ten Haken
- MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands
| |
Collapse
|
6
|
Coene A, Crevecoeur G, Dupre L. Robustness Assessment of 1-D Electron Paramagnetic Resonance for Improved Magnetic Nanoparticle Reconstructions. IEEE Trans Biomed Eng 2015; 62:1635-43. [DOI: 10.1109/tbme.2015.2399654] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
7
|
Ahmed M, Anninga B, Pouw JJ, Vreemann S, Peek M, Van Hemelrijck M, Pinder S, Ten Haken B, Pankhurst Q, Douek M. Optimising magnetic sentinel lymph node biopsy in an in vivo porcine model. NANOMEDICINE-NANOTECHNOLOGY BIOLOGY AND MEDICINE 2015; 11:993-1002. [PMID: 25680540 DOI: 10.1016/j.nano.2015.01.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Revised: 01/05/2015] [Accepted: 01/20/2015] [Indexed: 12/14/2022]
Abstract
UNLABELLED The magnetic technique for sentinel lymph node biopsy (SLNB) has been evaluated in several clinical trials. An in vivo porcine model was developed to optimise the magnetic technique by evaluating the effect of differing volume, concentration and time of injection of magnetic tracer. A total of 60 sentinel node procedures were undertaken. There was a significant correlation between magnetometer counts and iron content of excised sentinel lymph nodes (SLNs) (r=0.82; P<0.001). Total number of SLNs increased with increasing volumes of magnetic tracer (P<0.001). Transcutaneous magnetometer counts increased with increasing time from injection of magnetic tracer (P<0.0001), plateauing within 60min. Increasing concentration resulted in higher iron content of SLNs (P=0.006). Increasing magnetic tracer volume and injecting prior to surgery improve transcutaneous 'hotspot' identification but very high volumes, increase the number of nodes excised. FROM THE CLINICAL EDITOR Sentinel lymph node biopsy (SLNB) is the standard of care for axillary staging of breast cancer patients. Although the current gold standard technique is the combined injection of technetium-labelled nanocolloid and blue dye into the breast, the magnetic technique, using superparamagnetic carboxydextran-coated iron oxide (SPIO), has also been demonstrated as a feasible alternative. In this article, the authors set up to study factors in order to optimize the magnetic tracers.
Collapse
Affiliation(s)
- 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
| | - Joost J Pouw
- Institute for Biomedical Technology and Technical Medicine, Universiteit Twente, Enschede, The Netherlands
| | - Suzan Vreemann
- Institute for Biomedical Technology and Technical Medicine, Universiteit Twente, Enschede, The Netherlands
| | - Mirjam Peek
- Research Oncology, Division of Cancer Studies, King's College London, Guy's Hospital, London, UK; Institute for Biomedical Technology and Technical Medicine, Universiteit Twente, Enschede, The Netherlands
| | - Mieke Van Hemelrijck
- King's College London, School of Medicine, Cancer Epidemiology Group, Guy's Hospital, London, UK
| | - Sarah Pinder
- Research Oncology, Division of Cancer Studies, King's College London, Guy's Hospital, London, UK
| | - Bennie Ten Haken
- Institute for Biomedical Technology and Technical Medicine, Universiteit Twente, Enschede, The Netherlands
| | - Quentin Pankhurst
- 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.
| |
Collapse
|
8
|
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.
Collapse
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
| |
Collapse
|
9
|
Anninga B, Ahmed M, Van Hemelrijck M, Pouw J, Westbroek D, Pinder S, Ten Haken B, Pankhurst Q, Douek M. Magnetic sentinel lymph node biopsy and localization properties of a magnetic tracer in an in vivo porcine model. Breast Cancer Res Treat 2013; 141:33-42. [PMID: 23954989 DOI: 10.1007/s10549-013-2657-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Accepted: 07/28/2013] [Indexed: 11/28/2022]
Abstract
The standard for the treatment of early non-palpable breast cancers is wide local excision directed by wire-guided localization and sentinel lymph node biopsy (SLNB). This has drawbacks technically and due to reliance upon radioisotopes. We evaluated the use of a magnetic tracer for its localization capabilities and concurrent performance of SLNB using a handheld magnetometer in a porcine model as a novel alternative to the current standard. Ethical approval by the IRCAD Ethics Review Board, Strasbourg (France) was received. A magnetic tracer was injected in varying volumes (0.1-5 mL) subcutaneously into the areolar of the left and right 3rd inguinal mammary glands in 16 mini-pigs. After 4 h magnetometer counts were taken at the injection sites and in the groins. The magnetometer was used to localize any in vivo signal from the draining inguinal lymph nodes. Magnetic SLNB followed by excision of the injection site was performed. The iron content of sentinel lymph nodes (SLNs) were graded and quantified. All excised specimens were weighed and volumes were calculated. Univariate analyses were performed to evaluate correlation. Magnetic SLNB was successful in all mini-pigs. There was a significant correlation (r = 0.86; p < 0.01) between magnetometer counts and iron content of SLNs. Grading of SLNs on both H&E and Perl's staining correlated significantly with the iron content (p = 0.001; p = 0.003) and magnetometer counts (p < 0.001; p = 0.004). The peak counts corresponded to the original magnetic tracer injection sites 4 h after injection in all cases. The mean volume and weight of excised injection site specimens was 2.9 cm(3) (SD 0.81) and 3.1 g (SD 0.85), respectively. Injection of ≥0.5 mL magnetic tracer was associated with significantly greater volume (p = 0.05) and weight of excision specimens (p = 0.01). SLNB and localization can be performed in vivo using a magnetic tracer. This could provide a viable alternative for lesion localization and concurrent SLNB in the treatment of non-palpable breast cancer.
Collapse
Affiliation(s)
- Bauke Anninga
- Breast Surgery, Department of Research Oncology, King's College London, 3rd Floor Bermondsey Wing, Guy's Hospital Campus, Great Maze Pond, London, SE1 9RT, UK
| | | | | | | | | | | | | | | | | |
Collapse
|