title: Tracer-cocktail injections for combined pre- and intraoperative multimodal imaging of lymph nodes in a spontaneous mouse prostate tumor model.
abstract: To improve surgical guidance toward prostate draining lymph nodes, we investigate the potential of intraoperative fluorescence imaging and combined pre- and intraoperative multimodality imaging approaches. Transgenic adenocarcinoma mouse prostate mice with spontaneous prostate tumors are injected intratumorally with: 1. a cocktail of patent blue (Pb) and indocyanine green (ICG); 2. a cocktail of albumin radiocolloids (99mTc-NanoColl), Pb, and ICG; or 3. a cocktail of radiolabeled albumin (99mTc-Vasculosis), Pb, and ICG. The distribution of these imaging agents over the lymph nodes (LNs) are studied at different time points after injection. We find that at 60-min postinjection, ICG significantly improves the detection of the LNs compared to Pb, 53 versus 7%, respectively. Moreover, a cocktail of ICG and 99mTc-NanoColl improves the fluorescent detection rate to 86%, equalling that of the clinically applied 99mTc-NanoColl. A similar overlap is observed in our initial clinical pilot data. Fluorescent detection of the LNs using a ICG with 99mTc-Vasculosis gives similar results as "free" ICG (58%; 60 min). A 99mTc-NanoColl, Pb, and cocktail ICG enriches the standard 99mTc-NanoColl approach by adding optical detection of the sentinel lymph nodes. Furthermore, this approach improves fluorescent-based guidance and enables both accurate surgical planning and intraoperative detection, based on a single injection.
authors.affiliation: Antoni van Leeuwenhoek Hospital, Division of Diagnostic Oncology, 1066 CX Amsterdam, The NetherlandsAntoni van Leeuwenhoek Hospital, Division of Immunology, 1066 CX Amsterdam, The NetherlandsAntoni van Leeuwenhoek Hospital, Netherlands Cancer Institute, Division of Surgical Oncology, 1066 CX Amsterdam, The Netherlands.
authors.forename: Anne C
authors.initials: AC
authors.lastname: van Leeuwen
authors.forename: Tessa
authors.initials: T
authors.lastname: Buckle
authors.forename: Gavin
authors.initials: G
authors.lastname: Bendle
authors.forename: Lenka
authors.initials: L
authors.lastname: Vermeeren
authors.forename: Renato
authors.initials: R
authors.lastname: Valdés Olmos
authors.forename: Henk G
authors.initials: HG
authors.lastname: van de Poel
authors.forename: Fijs W B
authors.initials: FW
authors.lastname: van Leeuwen
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000556:secondary*; D000818:Animals; D003287:Contrast Media / Q000008:administration & dosage; D007267:Injections; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D051379:Mice; D008856:Microscopy, Fluorescence / Q000379:methods*; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D011868:Radioisotopes / Q000008:administration & dosage; D011877:Radionuclide Imaging / Q000379:methods; D019275:Radiopharmaceuticals / Q000008:administration & dosage; D025321:Surgery, Computer-Assisted / Q000379:methods
chemical_list: D003287:Contrast Media; D011868:Radioisotopes; D019275:Radiopharmaceuticals