caa a22 4500 445335971 CHVBK 20180317142755.0 cr unu---uuuuu 170323e20110401xx s 000 0 eng 10.1245/s10434-010-1426-0 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1426-0 Clinical Translation of Ex Vivo Sentinel Lymph Node Mapping for Colorectal Cancer Using Invisible Near-Infrared Fluorescence Light [Elektronische Daten] [Merlijn Hutteman, Hak Choi, J. Mieog, Joost van der Vorst, Yoshitomo Ashitate, Peter Kuppen, Marian van Groningen, Clemens Löwik, Vincent Smit, Cornelis van de Velde, John Frangioni, Alexander Vahrmeijer] Background: Sentinel lymph node (SLN) mapping in colorectal cancer may have prognostic and therapeutic significance; however, currently available techniques are not optimal. We hypothesized that the combination of invisible near-infrared (NIR) fluorescent light and ex vivo injection could solve remaining problems of SLN mapping in colorectal cancer. Methods: The FLARE imaging system was used for real-time identification of SLNs after injection of the NIR lymphatic tracer HSA800 in the colon and rectum of (n=4) pigs. A total of 32 SLN mappings were performed in vivo and ex vivo after oncologic resection using an identical injection technique. Guided by these results, SLN mappings were performed in ex vivo tissue specimens of 24 consecutive colorectal cancer patients undergoing resection. Results: Lymph flow could be followed in real-time from the injection site to the SLN using NIR fluorescence. In pigs, the SLN was identified in 32 of 32 (100%) of SLN mappings under both in vivo and ex vivo conditions. Clinically, SLNs were identified in all patients (n=24) using the ex vivo strategy within 5 min after injection of fluorescent tracer. Also, 9 patients showed lymph node involvement (N1 disease). In 1 patient, a 3-mm mesenteric metastasis was found adjacent to a tumor-negative SLN. Conclusions: The current pilot study shows proof of principle that ex vivo NIR fluorescence-guided SLN mapping can provide high-sensitivity, rapid, and accurate identification of SLNs in colon and rectum. This creates an experimental platform to test optimized, non-FDA-approved NIR fluorescent lymphatic tracers in a clinical setting. The Author(s), 2010 Hutteman Merlijn Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands aut Choi Hak Division of Hematology/Oncology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA aut Mieog J. Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands aut van der Vorst Joost Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands aut Ashitate Yoshitomo Division of Hematology/Oncology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA aut Kuppen Peter Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands aut van Groningen Marian Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands aut Löwik Clemens Department of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands aut Smit Vincent Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands aut van de Velde Cornelis Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands aut Frangioni John Division of Hematology/Oncology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA aut Vahrmeijer Alexander Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands aut Annals of Surgical Oncology Springer-Verlag 18/4(2011-04-01), 1006-1014 1068-9265 18:4<1006 2011 18 10434 https://doi.org/10.1245/s10434-010-1426-0 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1426-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Hutteman Merlijn Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands aut NATIONALLICENCE 700 1- Choi Hak Division of Hematology/Oncology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA aut NATIONALLICENCE 700 1- Mieog J. Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands aut NATIONALLICENCE 700 1- van der Vorst Joost Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands aut NATIONALLICENCE 700 1- Ashitate Yoshitomo Division of Hematology/Oncology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA aut NATIONALLICENCE 700 1- Kuppen Peter Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands aut NATIONALLICENCE 700 1- van Groningen Marian Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands aut NATIONALLICENCE 700 1- Löwik Clemens Department of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands aut NATIONALLICENCE 700 1- Smit Vincent Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands aut NATIONALLICENCE 700 1- van de Velde Cornelis Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands aut NATIONALLICENCE 700 1- Frangioni John Division of Hematology/Oncology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA aut NATIONALLICENCE 700 1- Vahrmeijer Alexander Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/4(2011-04-01), 1006-1014 1068-9265 18:4<1006 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer