2019 STS: Imaging Nanoagent for Sentinel Lymph Node Mapping in Lung Surgery
Posted: Friday, February 15, 2019
Hideki Ujiie, MD, PhD, of the University Health Network in Toronto, Ontario, and colleagues developed CF800, a dual-modality nanoliposomal imaging agent containing indocyanine green and iohexol for real-time image-guided sentinel lymph node localization. The method, discussed in more detail at the 2019 Society of Thoracic Surgeons (STS) Annual Meeting in San Diego, may have clinical advantages during image-guided surgery in animal lung tumors and supports “further investigation and advancement of this nanoagent to enhance intraoperative visualization in patients with non–small cell lung cancer.”
The researchers injected CF800 into rabbit (n = 3) and swine (n = 2) lung tumors and used near-infrared fluorescence and cone-beam computed tomography (CT) to detect sentinel lymph nodes. After lymph nodes were identified, a near-infrared imaging system was used to guide resection.
After surgery, the researchers evaluated nanoliposomal accumulation within the sentinel lymph nodes using an ex vivo fluorescence system and a near-infrared confocal microscope.
The injection of CF800 enhanced CT lymphography imagery of oval-shaped lymph nodes and the lymph node tract. In the rabbit and swine cases, sentinel lymph nodes were successfully identified by near-infrared thoracoscope and CT lymphography imagery. The researchers identified sentinel lymph nodes by completely exposing lymph nodes and examining ex vivo fluorescence. The lymph nodes identified in vivo were bright and had a high fluorescence signal on ex vivo imaging, demonstrating the utility of CF800 for both pre- and intraoperative image-based three-dimensional localization.
Disclosure: The study authors’ disclosure information can be found at sts.org.
