Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, P. R. China;
Quant Imaging Med Surg. 2012 Mar;2(1):53-6. doi: 10.3978/j.issn.2223-4292.2011.12.01.
Intra-operative lymphatic mapping and sentinel lymph-adenectomy (LM/SL) maps the lymphatic path from the primary tumor to the regional nodes and permits selective excision of the first sentinel lymph nodes. It is a well established technique to detect occult regional node metastases for melanoma patients and breast cancer patients. In continuing attempts to improve accuracy, most surgeons now combine a dye (such as carbon particles) and radiopharmaceuticals when performing LM/SL. We developed a proto-type of carbon coated superparamagnetic iron oxide nanoparticles (SPIO@C) for sentinel lymph nodes mapping. Compared with combining carbon particles and radiopharmaceuticals for performing LM/SL, there are a number of advantages with our approach: I. SPIO is an MRI contrast agent, thus pre-operative MRI may be used for LM/SL instead of gamma camera. There is no radiation associated with MRI, and MRI offers good tissue contrast and detailed cross-sectional images. II. There will be only needed one injection of SPIO@C nanoparticles, instead of administrating two successive injections of radiopharmaceuticals and carbon particles. III. During the operation, an intra-operative MRI scanner can be used, or more conveniently by a simple magnetometer.
术中淋巴定位和前哨淋巴结切除术 (LM/SL) 描绘了从原发性肿瘤到区域淋巴结的淋巴路径,并允许选择性切除第一个前哨淋巴结。这是一种用于检测黑色素瘤患者和乳腺癌患者隐匿性区域淋巴结转移的成熟技术。为了不断提高准确性,大多数外科医生现在在进行 LM/SL 时同时使用染料(如碳颗粒)和放射性药物。我们开发了一种用于前哨淋巴结定位的碳涂覆超顺磁氧化铁纳米颗粒 (SPIO@C) 的原型。与联合使用碳颗粒和放射性药物进行 LM/SL 相比,我们的方法具有以下几个优点:I. SPIO 是一种 MRI 造影剂,因此术前 MRI 可用于 LM/SL,而不是伽马相机。MRI 没有辐射,并且提供良好的组织对比度和详细的横截面图像。II. 只需要注射一次 SPIO@C 纳米颗粒,而不是连续两次注射放射性药物和碳颗粒。III. 在手术过程中,可以使用术中 MRI 扫描仪,或者更方便地使用简单的磁力计。