title: A self-assembled multimodal complex for combined pre- and intraoperative imaging of the sentinel lymph node.
abstract: Specific removal of the sentinel lymph node (SLN) during breast cancer surgery presents physicians with the opportunity to detect early metastatic disease. To increase the accuracy of intraoperative SLN detection, new methods with higher sensitivity and specificity are required. We have quantitatively compared conventional preoperative lymphoscintigraphy with albumin radiocolloids ((99m)Tc-NanoColl) with optical intraoperative guidance using the near infrared dye indocyanine green (ICG) in an orthotopic mouse model for metastatic breast cancer. Furthermore, we have applied a self-assembled multimodal complex, in which ICG is non-covalently bound to the albumin radiocolloid, to attain identical dynamics of the radioactive and optical components. The SLN specificity of the multimodal complex is similar to conventional lymphoscintigraphy, while the fluorescent signal-to-noise ratio is improved by 86% compared to ICG alone. In addition, the multimodal complex permits scintigraphic validation of the fluorescent findings. The multimodal ICG-(99m)Tc-NanoColl complex can be used both for lymphoscintigraphy by preoperative single photon emission computed tomography/computed tomography and for surgical navigation by intraoperative fluorescence imaging.
authors.affiliation: Department of Radiology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: Tessa
authors.initials: T
authors.lastname: Buckle
authors.forename: Anne C
authors.initials: AC
authors.lastname: van Leeuwen
authors.forename: Patrick T K
authors.initials: PT
authors.lastname: Chin
authors.forename: Hans
authors.initials: H
authors.lastname: Janssen
authors.forename: Sara H
authors.initials: SH
authors.lastname: Muller
authors.forename: Jos
authors.initials: J
authors.lastname: Jonkers
authors.forename: Fijs W B
authors.initials: FW
authors.lastname: van Leeuwen
mesh_terms: D000818:Animals; D005260:Female; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000378:metabolism; D008325:Mammary Neoplasms, Experimental / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D051379:Mice; D011877:Radionuclide Imaging / Q000379:methods*; D015203:Reproducibility of Results; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D013668:Technetium Tc 99m Aggregated Albumin / Q000493:pharmacokinetics; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D051598:Whole Body Imaging / Q000379:methods
chemical_list: D013668:Technetium Tc 99m Aggregated Albumin; C083602:technetium Tc 99m nanocolloid