Intraoperative Multispectral Fluorescence Imaging for the Detection of the Sentinel Lymph Node in Cervical Cancer: A Novel Concept

Lucia M A Crane; George Themelis; Rick G Pleijhuis; Niels J Harlaar; Athanasios Sarantopoulos; Henriette J G Arts; Ate G J van der Zee; Vasilis Ntziachristos; Ntziachristos Vasilis; Gooitzen M van Dam

doi:10.1007/s11307-010-0425-7

Intraoperative Multispectral Fluorescence Imaging for the Detection of the Sentinel Lymph Node in Cervical Cancer: A Novel Concept

Lucia M A Crane, George Themelis, Rick G Pleijhuis, Niels J Harlaar, Athanasios Sarantopoulos, Henriette J G Arts, Ate G J van der Zee, Vasilis Ntziachristos, Ntziachristos Vasilis, Gooitzen M van Dam

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Abstract

Real-time intraoperative near-infrared fluorescence (NIRF) imaging is a promising technique for lymphatic mapping and sentinel lymph node (SLN) detection. The purpose of this technical feasibility pilot study was to evaluate the applicability of NIRF imaging with indocyanin green (ICG) for the detection of the SLN in cervical cancer.

In ten patients with early stage cervical cancer, a mixture of patent blue and ICG was injected into the cervix uteri during surgery. Real-time color and fluorescence videos and images were acquired using a custom-made multispectral fluorescence camera system.

Real-time fluorescence lymphatic mapping was observed in vivo in six patients; a total of nine SLNs were detected, of which one (11%) contained metastases. Ex vivo fluorescence imaging revealed the remaining fluorescent signal in 11 of 197 non-sentinel LNs (5%), of which one contained metastatic tumor tissue. None of the non-fluorescent LNs contained metastases.

We conclude that lymphatic mapping and detection of the SLN in cervical cancer using intraoperative NIRF imaging is technically feasible. However, the technique needs to be refined for full applicability in cervical cancer in terms of sensitivity and specificity.

Original language	English
Pages (from-to)	1043-1049
Number of pages	7
Journal	Molecular Imaging and Biology
Volume	13
Issue number	5
DOIs	https://doi.org/10.1007/s11307-010-0425-7
Publication status	Published - Oct-2011

Keywords

Cervical cancer
Near-infrared fluorescence
Sentinel lymph node
Multispectral intraoperative imaging
UTERINE CERVIX
TOPOGRAPHIC DISTRIBUTION
RADICAL HYSTERECTOMY
BREAST-CANCER
SQUAMOUS-CELL
CARCINOMA
BIOPSY
LYMPHADENECTOMY
DISSECTION

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Crane, L. M. A., Themelis, G., Pleijhuis, R. G., Harlaar, N. J., Sarantopoulos, A., Arts, H. J. G., van der Zee, A. G. J., Ntziachristos, V., Vasilis, N., & van Dam, G. M. (2011). Intraoperative Multispectral Fluorescence Imaging for the Detection of the Sentinel Lymph Node in Cervical Cancer: A Novel Concept. Molecular Imaging and Biology, 13(5), 1043-1049. https://doi.org/10.1007/s11307-010-0425-7

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title = "Intraoperative Multispectral Fluorescence Imaging for the Detection of the Sentinel Lymph Node in Cervical Cancer: A Novel Concept",

abstract = "Real-time intraoperative near-infrared fluorescence (NIRF) imaging is a promising technique for lymphatic mapping and sentinel lymph node (SLN) detection. The purpose of this technical feasibility pilot study was to evaluate the applicability of NIRF imaging with indocyanin green (ICG) for the detection of the SLN in cervical cancer.In ten patients with early stage cervical cancer, a mixture of patent blue and ICG was injected into the cervix uteri during surgery. Real-time color and fluorescence videos and images were acquired using a custom-made multispectral fluorescence camera system.Real-time fluorescence lymphatic mapping was observed in vivo in six patients; a total of nine SLNs were detected, of which one (11%) contained metastases. Ex vivo fluorescence imaging revealed the remaining fluorescent signal in 11 of 197 non-sentinel LNs (5%), of which one contained metastatic tumor tissue. None of the non-fluorescent LNs contained metastases.We conclude that lymphatic mapping and detection of the SLN in cervical cancer using intraoperative NIRF imaging is technically feasible. However, the technique needs to be refined for full applicability in cervical cancer in terms of sensitivity and specificity.",

keywords = "Cervical cancer, Near-infrared fluorescence, Sentinel lymph node, Multispectral intraoperative imaging, UTERINE CERVIX, TOPOGRAPHIC DISTRIBUTION, RADICAL HYSTERECTOMY, BREAST-CANCER, SQUAMOUS-CELL, CARCINOMA, BIOPSY, LYMPHADENECTOMY, DISSECTION",

author = "Crane, {Lucia M A} and George Themelis and Pleijhuis, {Rick G} and Harlaar, {Niels J} and Athanasios Sarantopoulos and Arts, {Henriette J G} and {van der Zee}, {Ate G J} and Vasilis Ntziachristos and Ntziachristos Vasilis and {van Dam}, {Gooitzen M}",

year = "2011",

month = oct,

doi = "10.1007/s11307-010-0425-7",

language = "English",

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Crane, LMA, Themelis, G, Pleijhuis, RG, Harlaar, NJ, Sarantopoulos, A, Arts, HJG , van der Zee, AGJ, Ntziachristos, V, Vasilis, N & van Dam, GM 2011, 'Intraoperative Multispectral Fluorescence Imaging for the Detection of the Sentinel Lymph Node in Cervical Cancer: A Novel Concept', Molecular Imaging and Biology, vol. 13, no. 5, pp. 1043-1049. https://doi.org/10.1007/s11307-010-0425-7

TY - JOUR

T1 - Intraoperative Multispectral Fluorescence Imaging for the Detection of the Sentinel Lymph Node in Cervical Cancer

T2 - A Novel Concept

AU - Crane, Lucia M A

AU - Themelis, George

AU - Pleijhuis, Rick G

AU - Harlaar, Niels J

AU - Sarantopoulos, Athanasios

AU - Arts, Henriette J G

AU - van der Zee, Ate G J

AU - Ntziachristos, Vasilis

AU - Vasilis, Ntziachristos

AU - van Dam, Gooitzen M

PY - 2011/10

Y1 - 2011/10

N2 - Real-time intraoperative near-infrared fluorescence (NIRF) imaging is a promising technique for lymphatic mapping and sentinel lymph node (SLN) detection. The purpose of this technical feasibility pilot study was to evaluate the applicability of NIRF imaging with indocyanin green (ICG) for the detection of the SLN in cervical cancer.In ten patients with early stage cervical cancer, a mixture of patent blue and ICG was injected into the cervix uteri during surgery. Real-time color and fluorescence videos and images were acquired using a custom-made multispectral fluorescence camera system.Real-time fluorescence lymphatic mapping was observed in vivo in six patients; a total of nine SLNs were detected, of which one (11%) contained metastases. Ex vivo fluorescence imaging revealed the remaining fluorescent signal in 11 of 197 non-sentinel LNs (5%), of which one contained metastatic tumor tissue. None of the non-fluorescent LNs contained metastases.We conclude that lymphatic mapping and detection of the SLN in cervical cancer using intraoperative NIRF imaging is technically feasible. However, the technique needs to be refined for full applicability in cervical cancer in terms of sensitivity and specificity.

AB - Real-time intraoperative near-infrared fluorescence (NIRF) imaging is a promising technique for lymphatic mapping and sentinel lymph node (SLN) detection. The purpose of this technical feasibility pilot study was to evaluate the applicability of NIRF imaging with indocyanin green (ICG) for the detection of the SLN in cervical cancer.In ten patients with early stage cervical cancer, a mixture of patent blue and ICG was injected into the cervix uteri during surgery. Real-time color and fluorescence videos and images were acquired using a custom-made multispectral fluorescence camera system.Real-time fluorescence lymphatic mapping was observed in vivo in six patients; a total of nine SLNs were detected, of which one (11%) contained metastases. Ex vivo fluorescence imaging revealed the remaining fluorescent signal in 11 of 197 non-sentinel LNs (5%), of which one contained metastatic tumor tissue. None of the non-fluorescent LNs contained metastases.We conclude that lymphatic mapping and detection of the SLN in cervical cancer using intraoperative NIRF imaging is technically feasible. However, the technique needs to be refined for full applicability in cervical cancer in terms of sensitivity and specificity.

KW - Cervical cancer

KW - Near-infrared fluorescence

KW - Sentinel lymph node

KW - Multispectral intraoperative imaging

KW - UTERINE CERVIX

KW - TOPOGRAPHIC DISTRIBUTION

KW - RADICAL HYSTERECTOMY

KW - BREAST-CANCER

KW - SQUAMOUS-CELL

KW - CARCINOMA

KW - BIOPSY

KW - LYMPHADENECTOMY

KW - DISSECTION

U2 - 10.1007/s11307-010-0425-7

DO - 10.1007/s11307-010-0425-7

M3 - Article

C2 - 20835767

SN - 1536-1632

VL - 13

SP - 1043

EP - 1049

JO - Molecular Imaging and Biology

JF - Molecular Imaging and Biology

IS - 5

ER -

Intraoperative Multispectral Fluorescence Imaging for the Detection of the Sentinel Lymph Node in Cervical Cancer: A Novel Concept

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