Melanoma Sentinel Lymph Node Biopsy Guided By a Fluorescent Probe
Accurate localization of tumor-draining lymph nodes and nodal micrometastases is crucial to staging and treating melanoma. Researchers have developed a new optical imaging probe to enable high-contrast real-time identification of sentinel lymph nodes in head and neck melanoma.
This procedure video illustrates
A. [0:00] Probe injection into a scalp melanoma in a man in his 50s, and
B. [0:06] A postauricular sentinel lymph node fluoresces through intact skin under near-infrared (NIR) imaging in an area more focal than the planned broader non–image-guided dissection site noted by the purple marker line.
Then
C. [0:15] Focused incision,
D. [0:19] Limited surgical dissection and resection cavity, and
E. [0:30] Progressive dissection
retrieves the node. Postbiopsy,
F. [0:51] The node continues to fluoresce ex vivo with
G. [0:57] Minimal residual wound.
The probe uses new, ultrasmall, core-shell silica nanoparticles (Cornell prime dots [or C′ dots]), which fluoresce under handheld NIR light, linked via polyethylene glycol chains (PEGs) to peptides (cyclic arginine-glycine–aspartic acid–tyrosine [cRGDY] peptides) that target the C′ dots to integrins expressed on the surface of the melanoma cells. Click https://ja.ma/2QeF3VW for additional images, examples, and complete details.
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