Journal
EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING
Volume 50, Issue 4, Pages 1111-1133Publisher
SPRINGER
DOI: 10.1007/s00259-022-06056-5
Keywords
Molecular imaging; Lymph node metastasis; Cancer; Imaging probes; Imaging biomarkers
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Lymph node metastasis is an indicator of cancer invasiveness and aggressiveness, playing a crucial role in treatment decisions and prognosis. Traditional invasive methods for lymph node detection are prone to errors, while novel molecular imaging technologies offer non-invasive investigation and guidance for surgeons. This review summarizes the application of different molecular imaging modalities and probes in lymph node metastasis management, highlighting the limitations of molecular imaging for improved detection.
Lymph node metastasis is an indicator of the invasiveness and aggressiveness of cancer. It is a vital prognostic factor in clinical staging of the disease and therapeutic decision-making. Patients with positive metastatic lymph nodes are likely to develop recurrent disease, distant metastasis, and succumb to death in the coming few years. Lymph node dissection and histological analysis are needed to detect whether regional lymph nodes have been infiltrated by cancer cells and determine the likely outcome of treatment and the patient's chances of survival. However, these procedures are invasive, and tissue biopsies are prone to sampling error. In recent years, advanced molecular imaging with novel imaging probes has provided new technologies that are contributing to comprehensive management of cancer, including non-invasive investigation of lymphatic drainage from tumors, identifying metastatic lymph nodes, and guiding surgeons to operate efficiently in patients with complex lesions. In this review, first, we outline the current status of different molecular imaging modalities applied for lymph node metastasis management. Second, we summarize the multi-functional imaging probes applied with the different imaging modalities as well as applications of cancer lymph node metastasis from preclinical studies to clinical translations. Third, we describe the limitations that must be considered in the field of molecular imaging for improved detection of lymph node metastasis. Finally, we propose future directions for molecular imaging technology that will allow more personalized treatment plans for patients with lymph node metastasis.
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