PURPOSE: Correctly identifying nodal status is recognized as a critical prognostic factor in many cancer types and is essential to guide adjuvant treatment. Currently, surgical removal of lymph nodes followed by pathological examination is commonly performed as a standard-of-care to detect node metastases. However, conventional pathology protocols are time-consuming, yet less than 1 % of lymph node volumes are examined, resulting in a 30-60 % rate of missed micrometastases (0.2-2 mm in size). PROCEDURES: This study presents a method to fluorescently stain excised lymph nodes using paired-agent molecular imaging principles, which entail co-administration of a molecular-targeted imaging agent with a suitable control (untargeted) agent, whereby any nonspecific retention of the targeted agent is accounted for by the signal from the control agent. Specifically, it was demonstrated that by dual-needle continuous infusion of either an antibody-based imaging agent pair (epidermal growth factor receptor (EGFR) targeted agent: IRDye-800CW labeled Cetuximab; control agent: IRDye-700DX-IgG) or an Affibody-based pair (EGFR targeted Affibody® agent: ABY-029; control agent IRDYe-700DX carboxylate) at 0.3 ml/min. RESULTS: The results demonstrated the possibility to achieve >99 % sensitivity and > 95 % specificity for detection of a single micrometastasis (~0.2 mm diameter) in a whole lymph node within 22 min of tissue processing time. CONCLUSION: The detection capabilities offer substantial improvements over existing intraoperative lymph node biopsy methods (e.g., frozen pathology has a micrometastasis sensitivity <20 %).
PURPOSE: Correctly identifying nodal status is recognized as a critical prognostic factor in many cancer types and is essential to guide adjuvant treatment. Currently, surgical removal of lymph nodes followed by pathological examination is commonly performed as a standard-of-care to detect node metastases. However, conventional pathology protocols are time-consuming, yet less than 1 % of lymph node volumes are examined, resulting in a 30-60 % rate of missed micrometastases (0.2-2 mm in size). PROCEDURES: This study presents a method to fluorescently stain excised lymph nodes using paired-agent molecular imaging principles, which entail co-administration of a molecular-targeted imaging agent with a suitable control (untargeted) agent, whereby any nonspecific retention of the targeted agent is accounted for by the signal from the control agent. Specifically, it was demonstrated that by dual-needle continuous infusion of either an antibody-based imaging agent pair (epidermal growth factor receptor (EGFR) targeted agent: IRDye-800CW labeled Cetuximab; control agent: IRDye-700DX-IgG) or an Affibody-based pair (EGFR targeted Affibody® agent: ABY-029; control agent IRDYe-700DX carboxylate) at 0.3 ml/min. RESULTS: The results demonstrated the possibility to achieve >99 % sensitivity and > 95 % specificity for detection of a single micrometastasis (~0.2 mm diameter) in a whole lymph node within 22 min of tissue processing time. CONCLUSION: The detection capabilities offer substantial improvements over existing intraoperative lymph node biopsy methods (e.g., frozen pathology has a micrometastasis sensitivity <20 %).
Authors: C Chao; S L Wong; D Ackermann; D Simpson; M B Carter; C M Brown; M J Edwards; K M McMasters Journal: Am J Surg Date: 2001-12 Impact factor: 2.565
Authors: Gary H Lyman; Armando E Giuliano; Mark R Somerfield; Al B Benson; Diane C Bodurka; Harold J Burstein; Alistair J Cochran; Hiram S Cody; Stephen B Edge; Sharon Galper; James A Hayman; Theodore Y Kim; Cheryl L Perkins; Donald A Podoloff; Visa Haran Sivasubramaniam; Roderick R Turner; Richard Wahl; Donald L Weaver; Antonio C Wolff; Eric P Winer Journal: J Clin Oncol Date: 2005-09-12 Impact factor: 44.544
Authors: Abigail S Caudle; Wei T Yang; Savitri Krishnamurthy; Elizabeth A Mittendorf; Dalliah M Black; Michael Z Gilcrease; Isabelle Bedrosian; Brian P Hobbs; Sarah M DeSnyder; Rosa F Hwang; Beatriz E Adrada; Simona F Shaitelman; Mariana Chavez-MacGregor; Benjamin D Smith; Rosalind P Candelaria; Gildy V Babiera; Basak E Dogan; Lumarie Santiago; Kelly K Hunt; Henry M Kuerer Journal: J Clin Oncol Date: 2016-01-25 Impact factor: 44.544