title: Preclinical evaluation of robotic-assisted sentinel lymph node fluorescence imaging.
abstract: An ideal substance to provide convenient and accurate targeting for sentinel lymph node (SLN) mapping during robotic-assisted surgery has yet to be found. We used an animal model to determine the ability of the FireFly camera system to detect fluorescent SLNs after administration of a dual-labeled molecular imaging agent.
  
  
  METHODS
  We injected the footpads of New Zealand White rabbits with 1.7 or 8.4 nmol of tilmanocept labeled with (99m)Tc and a near-infrared fluorophore, IRDye800CW. One and 36 h after injection, popliteal lymph nodes, representing the SLNs, were dissected with the assistance of the FireFly camera system, a fluorescence-capable endoscopic imaging system. After excision of the paraaortic lymph nodes, which represented non-SLNs, we assayed all lymph nodes for radioactivity and fluorescence intensity.
  
  
  RESULTS
  Fluorescence within all popliteal lymph nodes was easily detected by the FireFly camera system. Fluorescence within the lymph channel could be imaged during the 1-h studies. When compared with the paraaortic lymph nodes, the popliteal lymph nodes retain greater than 95% of the radioactivity at both 1 and 36 h after injection. At both doses (1.7 and 8.4 nmol), the popliteal nodes had higher (P < 0.050) optical fluorescence intensity than the paraaortic nodes at the 1- and 36-h time points.
  
  
  CONCLUSIONS
  The FireFly camera system can easily detect tilmanocept labeled with a near-infrared fluorophore at least 36 h after administration. This ability will permit image acquisition and subsequent verification of fluorescence-labeled SLNs during robotic-assisted surgery.
authors.affiliation: Department of Urology, University of California, San Diego, La Jolla, California UCSD Moores Cancer Center. University of California, San Diego, La Jolla, California.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Liss
authors.affiliation: Department of Radiology, University of California, San Diego, La Jolla, California UCSD In Vivo Cancer and Molecular Imaging Center, University of California, San Diego, La Jolla, California.
authors.forename: Salman
authors.initials: S
authors.lastname: Farshchi-Heydari
authors.affiliation: Department of Radiology, University of California, San Diego, La Jolla, California UCSD In Vivo Cancer and Molecular Imaging Center, University of California, San Diego, La Jolla, California Department of Chemistry and Biochemistry, University of California, San Diego, La Jolla, California; and.
authors.forename: Zhengtao
authors.initials: Z
authors.lastname: Qin
authors.affiliation: Department of Surgery, University of California, San Diego, La Jolla, California.
authors.forename: Sean A
authors.initials: SA
authors.lastname: Hickey
authors.affiliation: Department of Radiology, University of California, San Diego, La Jolla, California UCSD In Vivo Cancer and Molecular Imaging Center, University of California, San Diego, La Jolla, California.
authors.forename: David J
authors.initials: DJ
authors.lastname: Hall
authors.affiliation: Department of Urology, University of California, San Diego, La Jolla, California UCSD Moores Cancer Center. University of California, San Diego, La Jolla, California Department of Surgery, University of California, San Diego, La Jolla, California.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Kane
authors.affiliation: UCSD Moores Cancer Center. University of California, San Diego, La Jolla, California Department of Radiology, University of California, San Diego, La Jolla, California UCSD In Vivo Cancer and Molecular Imaging Center, University of California, San Diego, La Jolla, California Department of Surgery, University of California, San Diego, La Jolla, California dvera@ucsd.edu.
authors.forename: David R
authors.initials: DR
authors.lastname: Vera
mesh_terms: D000818:Animals; D008197:Lymph Node Excision; D011817:Rabbits; D012371:Robotics / Q000379:methods*; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D013050:Spectrometry, Fluorescence
keywords: fluorescent tilmanocept; robotic-assisted surgery; sentinel lymph node mapping