期刊
ANNALS OF SURGICAL ONCOLOGY
卷 13, 期 12, 页码 1671-1681出版社
SPRINGER
DOI: 10.1245/s10434-006-9194-6
关键词
sentinel lymph node mapping; pre-clinical development; near-infrared light; near-infrared fluorescence; melanoma; Sinclair pigs
资金
- NCI NIH HHS [R01 CA115296-04, R01 CA115296, R01 CA115296-03, R21 CA110185, R21 CA110185-02, R21-CA- 110185, R01-CA-115296] Funding Source: Medline
- NIBIB NIH HHS [R21 EB000673-01, R33-EB-000673, R33 EB000673, R33 EB000673-03, R21 EB000673] Funding Source: Medline
Background: Invisible near-infrared (NIR) fluorescent light permits high sensitivity, real-time image-guidance during oncologic surgery without changing the look of the surgical field. In this study, we complete pre-clinical development of the technology for sentinel lymph node (SLN) mapping using a large animal model of spontaneous melanoma. Methods: Sinclair swine with spontaneous melanoma metastatic to regional lymph nodes were used because of their similarity to human melanoma. Organic lymphatic tracers tested included FDA-approved indocyanine green adsorbed non-covalently to human serum albumin (HSA), and NIR fluorophore CW800 conjugated covalently to HSA (HSA800). The inorganic/organic hybrid tracer tested was type II NIR quantum dots with an anionic coating. Primary tumors received four peri-tumoral injections of each tracer, with a fluorophore dose of 100 pmol to 1 nmol per injection. SLN mapping and image-guided resection were performed in real-time. Results: Each of the 3 lymphatic tracers was injected into n = 4 separate primary melanomas in a total of 6 animals. All 12 injections resulted in identification of the SLN(s) and their associated lymphatic channels within 1 minute in 100% of cases, despite highly pigmented skin and black fur. Hydrodynamic diameter had a profound impact on tracer behavior in vivo. Conclusion: This study completes the pre-clinical development of NIR fluorescence-guided SLN mapping and provides insight into imaging system optimization and tracer choice for future human clinical trials. The technology is likely to eliminate the need for radioactive and colored tracers, permits real-time image guidance throughout the procedure, and assists the pathologist in tissue analysis.
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