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Clinical Translation of Ex Vivo Sentinel Lymph Node Mapping for Colorectal Cancer Using Invisible Near-Infrared Fluorescence Light

BACKGROUND: Sentinel lymph node (SLN) mapping in colorectal cancer may have prognostic and therapeutic significance; however, currently available techniques are not optimal. We hypothesized that the combination of invisible near-infrared (NIR) fluorescent light and ex vivo injection could solve rema...

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Autores principales: Hutteman, Merlijn, Choi, Hak Soo, Mieog, J. Sven D., van der Vorst, Joost R., Ashitate, Yoshitomo, Kuppen, Peter J. K., van Groningen, Marian C., Löwik, Clemens W. G. M., Smit, Vincent T. H. B. M., van de Velde, Cornelis J. H., Frangioni, John V., Vahrmeijer, Alexander L.
Formato: Texto
Lenguaje:English
Publicado: Springer-Verlag 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3052497/
https://www.ncbi.nlm.nih.gov/pubmed/21080086
http://dx.doi.org/10.1245/s10434-010-1426-0
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author Hutteman, Merlijn
Choi, Hak Soo
Mieog, J. Sven D.
van der Vorst, Joost R.
Ashitate, Yoshitomo
Kuppen, Peter J. K.
van Groningen, Marian C.
Löwik, Clemens W. G. M.
Smit, Vincent T. H. B. M.
van de Velde, Cornelis J. H.
Frangioni, John V.
Vahrmeijer, Alexander L.
author_facet Hutteman, Merlijn
Choi, Hak Soo
Mieog, J. Sven D.
van der Vorst, Joost R.
Ashitate, Yoshitomo
Kuppen, Peter J. K.
van Groningen, Marian C.
Löwik, Clemens W. G. M.
Smit, Vincent T. H. B. M.
van de Velde, Cornelis J. H.
Frangioni, John V.
Vahrmeijer, Alexander L.
author_sort Hutteman, Merlijn
collection PubMed
description BACKGROUND: Sentinel lymph node (SLN) mapping in colorectal cancer may have prognostic and therapeutic significance; however, currently available techniques are not optimal. We hypothesized that the combination of invisible near-infrared (NIR) fluorescent light and ex vivo injection could solve remaining problems of SLN mapping in colorectal cancer. METHODS: The FLARE imaging system was used for real-time identification of SLNs after injection of the NIR lymphatic tracer HSA800 in the colon and rectum of (n = 4) pigs. A total of 32 SLN mappings were performed in vivo and ex vivo after oncologic resection using an identical injection technique. Guided by these results, SLN mappings were performed in ex vivo tissue specimens of 24 consecutive colorectal cancer patients undergoing resection. RESULTS: Lymph flow could be followed in real-time from the injection site to the SLN using NIR fluorescence. In pigs, the SLN was identified in 32 of 32 (100%) of SLN mappings under both in vivo and ex vivo conditions. Clinically, SLNs were identified in all patients (n = 24) using the ex vivo strategy within 5 min after injection of fluorescent tracer. Also, 9 patients showed lymph node involvement (N1 disease). In 1 patient, a 3-mm mesenteric metastasis was found adjacent to a tumor-negative SLN. CONCLUSIONS: The current pilot study shows proof of principle that ex vivo NIR fluorescence-guided SLN mapping can provide high-sensitivity, rapid, and accurate identification of SLNs in colon and rectum. This creates an experimental platform to test optimized, non-FDA-approved NIR fluorescent lymphatic tracers in a clinical setting.
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spelling pubmed-30524972011-04-05 Clinical Translation of Ex Vivo Sentinel Lymph Node Mapping for Colorectal Cancer Using Invisible Near-Infrared Fluorescence Light Hutteman, Merlijn Choi, Hak Soo Mieog, J. Sven D. van der Vorst, Joost R. Ashitate, Yoshitomo Kuppen, Peter J. K. van Groningen, Marian C. Löwik, Clemens W. G. M. Smit, Vincent T. H. B. M. van de Velde, Cornelis J. H. Frangioni, John V. Vahrmeijer, Alexander L. Ann Surg Oncol Colorectal Cancer BACKGROUND: Sentinel lymph node (SLN) mapping in colorectal cancer may have prognostic and therapeutic significance; however, currently available techniques are not optimal. We hypothesized that the combination of invisible near-infrared (NIR) fluorescent light and ex vivo injection could solve remaining problems of SLN mapping in colorectal cancer. METHODS: The FLARE imaging system was used for real-time identification of SLNs after injection of the NIR lymphatic tracer HSA800 in the colon and rectum of (n = 4) pigs. A total of 32 SLN mappings were performed in vivo and ex vivo after oncologic resection using an identical injection technique. Guided by these results, SLN mappings were performed in ex vivo tissue specimens of 24 consecutive colorectal cancer patients undergoing resection. RESULTS: Lymph flow could be followed in real-time from the injection site to the SLN using NIR fluorescence. In pigs, the SLN was identified in 32 of 32 (100%) of SLN mappings under both in vivo and ex vivo conditions. Clinically, SLNs were identified in all patients (n = 24) using the ex vivo strategy within 5 min after injection of fluorescent tracer. Also, 9 patients showed lymph node involvement (N1 disease). In 1 patient, a 3-mm mesenteric metastasis was found adjacent to a tumor-negative SLN. CONCLUSIONS: The current pilot study shows proof of principle that ex vivo NIR fluorescence-guided SLN mapping can provide high-sensitivity, rapid, and accurate identification of SLNs in colon and rectum. This creates an experimental platform to test optimized, non-FDA-approved NIR fluorescent lymphatic tracers in a clinical setting. Springer-Verlag 2010-11-16 2011 /pmc/articles/PMC3052497/ /pubmed/21080086 http://dx.doi.org/10.1245/s10434-010-1426-0 Text en © The Author(s) 2010 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.
spellingShingle Colorectal Cancer
Hutteman, Merlijn
Choi, Hak Soo
Mieog, J. Sven D.
van der Vorst, Joost R.
Ashitate, Yoshitomo
Kuppen, Peter J. K.
van Groningen, Marian C.
Löwik, Clemens W. G. M.
Smit, Vincent T. H. B. M.
van de Velde, Cornelis J. H.
Frangioni, John V.
Vahrmeijer, Alexander L.
Clinical Translation of Ex Vivo Sentinel Lymph Node Mapping for Colorectal Cancer Using Invisible Near-Infrared Fluorescence Light
title Clinical Translation of Ex Vivo Sentinel Lymph Node Mapping for Colorectal Cancer Using Invisible Near-Infrared Fluorescence Light
title_full Clinical Translation of Ex Vivo Sentinel Lymph Node Mapping for Colorectal Cancer Using Invisible Near-Infrared Fluorescence Light
title_fullStr Clinical Translation of Ex Vivo Sentinel Lymph Node Mapping for Colorectal Cancer Using Invisible Near-Infrared Fluorescence Light
title_full_unstemmed Clinical Translation of Ex Vivo Sentinel Lymph Node Mapping for Colorectal Cancer Using Invisible Near-Infrared Fluorescence Light
title_short Clinical Translation of Ex Vivo Sentinel Lymph Node Mapping for Colorectal Cancer Using Invisible Near-Infrared Fluorescence Light
title_sort clinical translation of ex vivo sentinel lymph node mapping for colorectal cancer using invisible near-infrared fluorescence light
topic Colorectal Cancer
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3052497/
https://www.ncbi.nlm.nih.gov/pubmed/21080086
http://dx.doi.org/10.1245/s10434-010-1426-0
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