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前列腺癌和膀胱癌淋巴结清扫手术中荧光成像的进展

Progress of fluorescence imaging in lymph node dissection surgery for prostate and bladder cancer.

作者信息

Xu Mingquan, Li Panpan, Wei Jinzheng, Yan Pengyu, Zhang Yunmeng, Guo Xinyu, Liu Chao, Yang Xiaofeng

机构信息

Department of Urology, First Hospital of Shanxi Medical University, Taiyuan, ;China.

First Clinical Medical College, Shanxi Medical University, Taiyuan, ;China.

出版信息

Front Oncol. 2024 Oct 4;14:1395284. doi: 10.3389/fonc.2024.1395284. eCollection 2024.

Abstract

Fluorescence imaging is a relatively new imaging method used to visualize different tissue structures to help guide intraoperative operations, which has potential advantages with high sensitivity and contrast compared to conventional imaging. In this work, we review fluorescent contrast agents and devices used for lymphatic system imaging. Indocyanine green is the most widely utilized due to its high sensitivity, specificity, low background fluorescence, and safety profile. In prostate and bladder cancer lymph node dissection, the complex lymphatic drainage can result in missed metastatic nodes and extensive dissection increases the risk of complications like lymphocele, presenting a significant challenge for urologists. Fluorescence-guided sentinel lymph node dissection facilitates precise tumor staging. The combination of fluorescence and radiographic imaging improves the accuracy of lymph node staging. Multimodal imaging presents new potential for precisely identifying metastatic pelvic lymph nodes.

摘要

荧光成像技术是一种相对较新的成像方法,用于可视化不同的组织结构,以帮助指导术中操作,与传统成像相比,具有高灵敏度和高对比度的潜在优势。在这项工作中,我们回顾了用于淋巴系统成像的荧光造影剂和设备。吲哚菁绿因其高灵敏度、特异性、低背景荧光和安全性而被最广泛使用。在前列腺癌和膀胱癌淋巴结清扫术中,复杂的淋巴引流可能导致转移性淋巴结漏检,而广泛的清扫会增加诸如淋巴囊肿等并发症的风险,这给泌尿外科医生带来了重大挑战。荧光引导下的前哨淋巴结清扫有助于精确的肿瘤分期。荧光成像与放射成像相结合提高了淋巴结分期的准确性。多模态成像为精确识别盆腔转移性淋巴结提供了新的潜力。

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