Intraoperative laparoscopic detection of sentinel lymph nodes with indocyanine green and superparamagnetic iron oxide in a swine gallbladder cancer model
Mapping of sentinel lymph nodes (SLNs) can enable less invasive surgery. However, mapping is challenging for cancers of difficult-to-access visceral organs, such as the gallbladder, because the standard method using radioisotopes (RIs) requires preoperative tracer injection. Indocyanine green (ICG)...
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| Veröffentlicht in: | PloS one 2021-03, Vol.16 (3), p.e0248531 |
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| creator | Mihara, Kisyo Matsuda, Sachiko Nakamura, Yuki Aiura, Koichi Kuwahata, Akihiro Chikaki, Shinichi Sekino, Masaki Kusakabe, Moriaki Suzuki, Shunichi Fuchimoto, Daiichiro Onishi, Akira Kuramoto, Junko Kameyama, Kaori Itano, Osamu Yagi, Hiroshi Abe, Yuta Kitago, Minoru Shinoda, Masahiro Kitagawa, Yuko |
| description | Mapping of sentinel lymph nodes (SLNs) can enable less invasive surgery. However, mapping is challenging for cancers of difficult-to-access visceral organs, such as the gallbladder, because the standard method using radioisotopes (RIs) requires preoperative tracer injection. Indocyanine green (ICG) and superparamagnetic iron oxide (SPIO) have also been used as alternative tracers. In this study, we modified a previously reported magnetic probe for laparoscopic use and evaluated the feasibility of detecting SLNs of the gallbladder using a laparoscopic dual tracer method by injecting ICG and SPIO into five swine and one cancer-bearing swine. The laparoscopic probe identified SPIO nanoparticles in the nodes of 4/5 swine in situ, the magnetic field counts were 2.5-15.9 μT, and fluorescence was detected in SLNs in all five swine. ICG showed a visual lymph flow map, and SPIO more accurately identified each SLN with a measurable magnetic field quite similar to the RI. We then developed an advanced gallbladder cancer model with lymph node metastasis using recombination activating gene 2-knockout swine. We identified an SLN in the laparoscopic investigation, and the magnetic field count was 3.5 μT. The SLN was histologically determined to be one of the two metastatic lymph nodes. In conclusion, detecting the SLNs of gallbladder cancer in situ using a dual tracer laparoscopic technique with ICG and SPIO was feasible in a swine model. |
| doi_str_mv | 10.1371/journal.pone.0248531 |
| format | Article |
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However, mapping is challenging for cancers of difficult-to-access visceral organs, such as the gallbladder, because the standard method using radioisotopes (RIs) requires preoperative tracer injection. Indocyanine green (ICG) and superparamagnetic iron oxide (SPIO) have also been used as alternative tracers. In this study, we modified a previously reported magnetic probe for laparoscopic use and evaluated the feasibility of detecting SLNs of the gallbladder using a laparoscopic dual tracer method by injecting ICG and SPIO into five swine and one cancer-bearing swine. The laparoscopic probe identified SPIO nanoparticles in the nodes of 4/5 swine in situ, the magnetic field counts were 2.5-15.9 μT, and fluorescence was detected in SLNs in all five swine. ICG showed a visual lymph flow map, and SPIO more accurately identified each SLN with a measurable magnetic field quite similar to the RI. We then developed an advanced gallbladder cancer model with lymph node metastasis using recombination activating gene 2-knockout swine. We identified an SLN in the laparoscopic investigation, and the magnetic field count was 3.5 μT. The SLN was histologically determined to be one of the two metastatic lymph nodes. In conclusion, detecting the SLNs of gallbladder cancer in situ using a dual tracer laparoscopic technique with ICG and SPIO was feasible in a swine model.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0248531</identifier><identifier>PMID: 33705492</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Agricultural research ; Agriculture ; Animal sciences ; Animals ; Biology and Life Sciences ; Biotechnology ; Breast cancer ; Cell culture ; Contrast media ; Data analysis ; Diagnosis ; Editing ; Endoscopy ; Engineering ; Engineering schools ; Epidermal growth factor ; Food ; Gallbladder ; Gallbladder cancer ; Gastrointestinal cancer ; Graduate schools ; Graduate studies ; Growth factors ; Immunodeficiency ; Invasiveness ; Iron oxides ; Laparoscopic surgery ; Laparoscopy ; Livestock ; Lymph nodes ; Lymphatic system ; Magnetic probes ; Medicine ; Medicine and Health Sciences ; Metastases ; Metastasis ; Methodology ; Methods ; Nanoparticles ; Pathology ; Potassium ; RAG2 protein ; Recombination ; Research facilities ; Sentinel lymph node biopsy ; Skin ; Skin cancer ; Supervision ; Surgery ; Swine ; Tissue culture ; Tracers ; Tumors ; Visualization</subject><ispartof>PloS one, 2021-03, Vol.16 (3), p.e0248531</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Mihara et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 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However, mapping is challenging for cancers of difficult-to-access visceral organs, such as the gallbladder, because the standard method using radioisotopes (RIs) requires preoperative tracer injection. Indocyanine green (ICG) and superparamagnetic iron oxide (SPIO) have also been used as alternative tracers. In this study, we modified a previously reported magnetic probe for laparoscopic use and evaluated the feasibility of detecting SLNs of the gallbladder using a laparoscopic dual tracer method by injecting ICG and SPIO into five swine and one cancer-bearing swine. The laparoscopic probe identified SPIO nanoparticles in the nodes of 4/5 swine in situ, the magnetic field counts were 2.5-15.9 μT, and fluorescence was detected in SLNs in all five swine. ICG showed a visual lymph flow map, and SPIO more accurately identified each SLN with a measurable magnetic field quite similar to the RI. We then developed an advanced gallbladder cancer model with lymph node metastasis using recombination activating gene 2-knockout swine. We identified an SLN in the laparoscopic investigation, and the magnetic field count was 3.5 μT. The SLN was histologically determined to be one of the two metastatic lymph nodes. In conclusion, detecting the SLNs of gallbladder cancer in situ using a dual tracer laparoscopic technique with ICG and SPIO was feasible in a swine model.</description><subject>Agricultural research</subject><subject>Agriculture</subject><subject>Animal sciences</subject><subject>Animals</subject><subject>Biology and Life Sciences</subject><subject>Biotechnology</subject><subject>Breast cancer</subject><subject>Cell culture</subject><subject>Contrast media</subject><subject>Data analysis</subject><subject>Diagnosis</subject><subject>Editing</subject><subject>Endoscopy</subject><subject>Engineering</subject><subject>Engineering schools</subject><subject>Epidermal growth factor</subject><subject>Food</subject><subject>Gallbladder</subject><subject>Gallbladder cancer</subject><subject>Gastrointestinal cancer</subject><subject>Graduate schools</subject><subject>Graduate studies</subject><subject>Growth 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Koichi</au><au>Kuwahata, Akihiro</au><au>Chikaki, Shinichi</au><au>Sekino, Masaki</au><au>Kusakabe, Moriaki</au><au>Suzuki, Shunichi</au><au>Fuchimoto, Daiichiro</au><au>Onishi, Akira</au><au>Kuramoto, Junko</au><au>Kameyama, Kaori</au><au>Itano, Osamu</au><au>Yagi, Hiroshi</au><au>Abe, Yuta</au><au>Kitago, Minoru</au><au>Shinoda, Masahiro</au><au>Kitagawa, Yuko</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intraoperative laparoscopic detection of sentinel lymph nodes with indocyanine green and superparamagnetic iron oxide in a swine gallbladder cancer model</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2021-03-11</date><risdate>2021</risdate><volume>16</volume><issue>3</issue><spage>e0248531</spage><pages>e0248531-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Mapping of sentinel lymph nodes (SLNs) can enable less invasive surgery. However, mapping is challenging for cancers of difficult-to-access visceral organs, such as the gallbladder, because the standard method using radioisotopes (RIs) requires preoperative tracer injection. Indocyanine green (ICG) and superparamagnetic iron oxide (SPIO) have also been used as alternative tracers. In this study, we modified a previously reported magnetic probe for laparoscopic use and evaluated the feasibility of detecting SLNs of the gallbladder using a laparoscopic dual tracer method by injecting ICG and SPIO into five swine and one cancer-bearing swine. The laparoscopic probe identified SPIO nanoparticles in the nodes of 4/5 swine in situ, the magnetic field counts were 2.5-15.9 μT, and fluorescence was detected in SLNs in all five swine. ICG showed a visual lymph flow map, and SPIO more accurately identified each SLN with a measurable magnetic field quite similar to the RI. We then developed an advanced gallbladder cancer model with lymph node metastasis using recombination activating gene 2-knockout swine. We identified an SLN in the laparoscopic investigation, and the magnetic field count was 3.5 μT. The SLN was histologically determined to be one of the two metastatic lymph nodes. In conclusion, detecting the SLNs of gallbladder cancer in situ using a dual tracer laparoscopic technique with ICG and SPIO was feasible in a swine model.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>33705492</pmid><doi>10.1371/journal.pone.0248531</doi><tpages>e0248531</tpages><orcidid>https://orcid.org/0000-0003-4797-1149</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2021-03, Vol.16 (3), p.e0248531 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2500367538 |
| source | Open Access: PubMed Central; Public Library of Science; DOAJ Directory of Open Access Journals; Free E-Journal (出版社公開部分のみ）; Free Full-Text Journals in Chemistry |
| subjects | Agricultural research Agriculture Animal sciences Animals Biology and Life Sciences Biotechnology Breast cancer Cell culture Contrast media Data analysis Diagnosis Editing Endoscopy Engineering Engineering schools Epidermal growth factor Food Gallbladder Gallbladder cancer Gastrointestinal cancer Graduate schools Graduate studies Growth factors Immunodeficiency Invasiveness Iron oxides Laparoscopic surgery Laparoscopy Livestock Lymph nodes Lymphatic system Magnetic probes Medicine Medicine and Health Sciences Metastases Metastasis Methodology Methods Nanoparticles Pathology Potassium RAG2 protein Recombination Research facilities Sentinel lymph node biopsy Skin Skin cancer Supervision Surgery Swine Tissue culture Tracers Tumors Visualization |
| title | Intraoperative laparoscopic detection of sentinel lymph nodes with indocyanine green and superparamagnetic iron oxide in a swine gallbladder cancer model |
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