Back to Search
Start Over
Detection of visually occult metastatic lymph nodes using molecularly targeted fluorescent imaging during surgical resection of pancreatic cancer
- Source :
- HPB: The official journal of the International Hepato Pancreato Biliary Association, 21(7), 883-890. John Wiley and Sons Inc., HPB, 21(7), 883-890. ELSEVIER SCI LTD
- Publication Year :
- 2019
-
Abstract
- Background: Although most patients with PDAC experience distant failure after resection, a significant portion still present with local recurrence. Intraoperative fluorescent imaging can potentially facilitate the visualization of involved peritumoral LNs and guide the locoregional extent of nodal dissection. Here, the efficacy of targeted intraoperative fluorescent imaging was examined in the detection of metastatic lymph nodes (LNs) during resection of pancreatic ductal adenocarcinoma (PDAC). Methods: A dose-escalation prospective study was performed to assess feasibility of tumor detection within peripancreatic LNs using cetuximab-IRDye800 in PDAC patients. Fluorescent imaging of dissected LNs was analyzed ex vivo macroscopically and microscopically and fluorescence was correlated with histopathology. Results: A total of 144 LNs (72 in the low-dose and 72 in the high-dose cohort) were evaluated. Detection of metastatic LNs by fluorescence was better in the low-dose (50 mg) cohort, where sensitivity and specificity was 100% and 78% macroscopically, and 91% and 66% microscopically. More importantly, this method was able to detect occult foci of tumor (measuring < 5 mm) with a sensitivity of 88% (15/17 LNs). Conclusion: This study provides proof of concept that intraoperative fluorescent imaging with cetuximab-IRDye800 can facilitate the detection of peripancreatic lymph nodes often containing subclinical foci of disease.
- Subjects :
- medicine.medical_specialty
Indoles
medicine.medical_treatment
Cetuximab
030218 nuclear medicine & medical imaging
03 medical and health sciences
Pancreatectomy
0302 clinical medicine
Predictive Value of Tests
Pancreatic cancer
Carcinoma
Humans
Medicine
Prospective Studies
Prospective cohort study
Fluorescent Dyes
Intraoperative Care
Spectroscopy, Near-Infrared
Hepatology
integumentary system
business.industry
Optical Imaging
Gastroenterology
medicine.disease
Molecular Imaging
ErbB Receptors
Pancreatic Neoplasms
Dissection
Treatment Outcome
Microscopy, Fluorescence
Lymphatic Metastasis
030220 oncology & carcinogenesis
Feasibility Studies
Lymph Node Excision
Histopathology
Lymph Nodes
Radiology
Lymph
Molecular imaging
business
Carcinoma, Pancreatic Ductal
Subjects
Details
- Language :
- English
- ISSN :
- 1365182X
- Database :
- OpenAIRE
- Journal :
- HPB: The official journal of the International Hepato Pancreato Biliary Association, 21(7), 883-890. John Wiley and Sons Inc., HPB, 21(7), 883-890. ELSEVIER SCI LTD
- Accession number :
- edsair.doi.dedup.....5dc632521856bd2d7e0d162acd0a0689