Dataset Information

Intraoperative laparoscopic detection of sentinel lymph nodes with indocyanine green and superparamagnetic iron oxide in a swine gallbladder cancer model.

ABSTRACT: Mapping of sentinel lymph nodes (SLNs) can enable less invasive surgery. However, mapping is challenging for cancers of difficult-to-access visceral organs, such as the gallbladder, because the standard method using radioisotopes (RIs) requires preoperative tracer injection. Indocyanine green (ICG) and superparamagnetic iron oxide (SPIO) have also been used as alternative tracers. In this study, we modified a previously reported magnetic probe for laparoscopic use and evaluated the feasibility of detecting SLNs of the gallbladder using a laparoscopic dual tracer method by injecting ICG and SPIO into five swine and one cancer-bearing swine. The laparoscopic probe identified SPIO nanoparticles in the nodes of 4/5 swine in situ, the magnetic field counts were 2.5-15.9 μT, and fluorescence was detected in SLNs in all five swine. ICG showed a visual lymph flow map, and SPIO more accurately identified each SLN with a measurable magnetic field quite similar to the RI. We then developed an advanced gallbladder cancer model with lymph node metastasis using recombination activating gene 2-knockout swine. We identified an SLN in the laparoscopic investigation, and the magnetic field count was 3.5 μT. The SLN was histologically determined to be one of the two metastatic lymph nodes. In conclusion, detecting the SLNs of gallbladder cancer in situ using a dual tracer laparoscopic technique with ICG and SPIO was feasible in a swine model.

SUBMITTER: Mihara K

PROVIDER: S-EPMC7951925 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Intraoperative laparoscopic detection of sentinel lymph nodes with indocyanine green and superparamagnetic iron oxide in a swine gallbladder cancer model.

Mihara Kisyo K Matsuda Sachiko S Nakamura Yuki Y Aiura Koichi K Kuwahata Akihiro A Chikaki Shinichi S Sekino Masaki M Kusakabe Moriaki M Suzuki Shunichi S Fuchimoto Daiichiro D Onishi Akira A Kuramoto Junko J Kameyama Kaori K Itano Osamu O Yagi Hiroshi H Abe Yuta Y Kitago Minoru M Shinoda Masahiro M Kitagawa Yuko Y

PloS one 20210311 3

Mapping of sentinel lymph nodes (SLNs) can enable less invasive surgery. However, mapping is challenging for cancers of difficult-to-access visceral organs, such as the gallbladder, because the standard method using radioisotopes (RIs) requires preoperative tracer injection. Indocyanine green (ICG) and superparamagnetic iron oxide (SPIO) have also been used as alternative tracers. In this study, we modified a previously reported magnetic probe for laparoscopic use and evaluated the feasibility o ...[more]

PMID: 33705492

Similar Datasets

Project description:Background and objectiveIndocyanine green-guided sentinel lymph node dissection (ICG-SLND) has demonstrated good diagnostic accuracy for lymph node metastasis in prostate cancer. This study aims to perform a meta-analysis of the diagnostic accuracy of ICG-SLND at both the per-patient and the per-node level.MethodsWe conducted a literature search on PubMed and Embase for relevant studies published up to June 2024. The inclusion criteria were prostate cancer patients undergoing radical prostatectomy, ICG-SLND, and subsequent extended pelvic lymph node dissection (ePLND). Data were extracted to calculate the pooled sensitivity and negative predictive value (NPV) at both the per-patient and the per-node level.Key findings and limitationsOur search identified 13 relevant studies, comprising a total of 748 patients. All studies were assessed as having a low risk of bias. At the per-patient level, the pooled sensitivity of ICG-SLND for diagnosing lymph node metastasis was 0.87 (95% confidence interval [CI]: 0.77-0.92), with a pooled NPV of 0.95 (95% CI: 0.90-0.98). At the per-node level, the pooled sensitivity was 0.53 (95% CI: 0.45-0.62), and the pooled NPV was 0.98 (95% CI: 0.97-0.98). Significant heterogeneity was observed in the per-node level sensitivity, NPV, and sentinel lymph node detection rate outcomes. The primary limitation is the lack of investigation into the impact of ICG-SLND on survival outcomes.Conclusions and clinical implicationsThe per-patient level sensitivity of ICG-SLND for diagnosing lymph node metastases is 87%, which better represents the diagnostic accuracy of ICG-SLND than the per-node level sensitivity. As ePLND has demonstrated a positive impact on oncologic outcomes, ICG-SLND cannot yet be recommended as the standard lymph node dissection approach. The significant heterogeneity observed in the pooled results highlights the need for further research to determine the optimal injection methods.Patient summaryIndocyanine green-guided sentinel lymph node dissection (ICG-SLND) has demonstrated favorable performance for diagnosing lymph node metastases in prostate cancer. The per-patient level sensitivity of ICG-SLND provides better diagnostic performance than its per-node level sensitivity. However, further research is needed for ICG-SLND to be recommended as the standard approach for lymph node dissection.

Project description:Background and objectivesSentinel lymph node (SLN) biopsy is a standard procedure for patients with breast cancer and normal axilla on imaging. Positive SLNs on histological examination can lead to a subsequent surgery for axillary lymph node clearance (ALNC). Here we report a non-destructive technique based on autofluorescence (AF) imaging and Raman spectroscopy for intra-operative assessment of SLNs excised in breast cancer surgery.MethodsA microscope integrating AF imaging and Raman spectroscopy modules was built to allow scanning of lymph node biopsy samples. During AF-Raman measurements, AF imaging determined optimal sampling locations for Raman spectroscopy measurements. After optimisation of the AF image analysis and training of classification models based on data from 85 samples, the AF-Raman technique was tested on an independent set of 81 lymph nodes comprising 58 fixed and 23 fresh specimens. The sensitivity and specificity of AF-Raman were calculated using post-operative histology as a standard of reference.ResultsThe independent test set contained 66 negative lymph nodes and 15 positive lymph nodes according to the reference standard, collected from 78 patients. For this set of specimens, the area under the receiver operating characteristic (ROC) curve for the AF-Raman technique was 0.93 [0.83-0.98]. AF-Raman was then operated in a regime that maximised detection specificity, producing a 94% detection accuracy: 80% sensitivity and 97% specificity. The main confounders for SLN metastasis were areas rich in histiocytes clusters, for which only few Raman spectra had been included in the training dataset.DiscussionThis preliminary study indicates that with further development and extension of the training dataset by inclusion of additional Raman spectra of histiocytes clusters and capsule, the AF-Raman may become a promising technique for intra-operative assessment of SLNs. Intra-operative detection of positive biopsies could avoid second surgery for axillary clearance.

Dataset Information

Intraoperative laparoscopic detection of sentinel lymph nodes with indocyanine green and superparamagnetic iron oxide in a swine gallbladder cancer model.

Publications

Intraoperative laparoscopic detection of sentinel lymph nodes with indocyanine green and superparamagnetic iron oxide in a swine gallbladder cancer model.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets