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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doaj-41b3dec02a4c45c595f320e33161c1c42021-03-25T05:31:38ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01163e024853110.1371/journal.pone.0248531Intraoperative laparoscopic detection of sentinel lymph nodes with indocyanine green and superparamagnetic iron oxide in a swine gallbladder cancer model.Kisyo MiharaSachiko MatsudaYuki NakamuraKoichi AiuraAkihiro KuwahataShinichi ChikakiMasaki SekinoMoriaki KusakabeShunichi SuzukiDaiichiro FuchimotoAkira OnishiJunko KuramotoKaori KameyamaOsamu ItanoHiroshi YagiYuta AbeMinoru KitagoMasahiro ShinodaYuko KitagawaMapping 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.https://doi.org/10.1371/journal.pone.0248531 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Kisyo Mihara Sachiko Matsuda Yuki Nakamura Koichi Aiura Akihiro Kuwahata Shinichi Chikaki Masaki Sekino Moriaki Kusakabe Shunichi Suzuki Daiichiro Fuchimoto Akira Onishi Junko Kuramoto Kaori Kameyama Osamu Itano Hiroshi Yagi Yuta Abe Minoru Kitago Masahiro Shinoda Yuko Kitagawa |
spellingShingle |
Kisyo Mihara Sachiko Matsuda Yuki Nakamura Koichi Aiura Akihiro Kuwahata Shinichi Chikaki Masaki Sekino Moriaki Kusakabe Shunichi Suzuki Daiichiro Fuchimoto Akira Onishi Junko Kuramoto Kaori Kameyama Osamu Itano Hiroshi Yagi Yuta Abe Minoru Kitago Masahiro Shinoda Yuko Kitagawa Intraoperative laparoscopic detection of sentinel lymph nodes with indocyanine green and superparamagnetic iron oxide in a swine gallbladder cancer model. PLoS ONE |
author_facet |
Kisyo Mihara Sachiko Matsuda Yuki Nakamura Koichi Aiura Akihiro Kuwahata Shinichi Chikaki Masaki Sekino Moriaki Kusakabe Shunichi Suzuki Daiichiro Fuchimoto Akira Onishi Junko Kuramoto Kaori Kameyama Osamu Itano Hiroshi Yagi Yuta Abe Minoru Kitago Masahiro Shinoda Yuko Kitagawa |
author_sort |
Kisyo Mihara |
title |
Intraoperative laparoscopic detection of sentinel lymph nodes with indocyanine green and superparamagnetic iron oxide in a swine gallbladder cancer model. |
title_short |
Intraoperative laparoscopic detection of sentinel lymph nodes with indocyanine green and superparamagnetic iron oxide in a swine gallbladder cancer model. |
title_full |
Intraoperative laparoscopic detection of sentinel lymph nodes with indocyanine green and superparamagnetic iron oxide in a swine gallbladder cancer model. |
title_fullStr |
Intraoperative laparoscopic detection of sentinel lymph nodes with indocyanine green and superparamagnetic iron oxide in a swine gallbladder cancer model. |
title_full_unstemmed |
Intraoperative laparoscopic detection of sentinel lymph nodes with indocyanine green and superparamagnetic iron oxide in a swine gallbladder cancer model. |
title_sort |
intraoperative laparoscopic detection of sentinel lymph nodes with indocyanine green and superparamagnetic iron oxide in a swine gallbladder cancer model. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2021-01-01 |
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. |
url |
https://doi.org/10.1371/journal.pone.0248531 |
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