A novel method for sentinel lymph node mapping using magnetite in patients with non–small cell lung cancer

Abstract

Intraoperative sentinel lymph node mapping using ferumoxides and a highly sensitive magnetometer is a safe, accurate, and sensitive way to detect sentinel lymph nodes in non-small cell lung cancer patients.

Results of Initial Operations in Non–Small Cell Lung Cancer Patients With Single-Level N2 Disease

“…From the viewpoint of sentinel lymph node mapping, the results of recently launched clinical trials support the anatomical concept. While the percentage of skip metastasis in lung cancer patients with N2 disease has been reported to be around 20-40% [1][2][3][4][5][6][7], sentinel node mapping in non-small cell lung cancer patients in various stages revealed a similar percentage of mediastinal (N2) sentinel nodes of 16.7-31% with a high sensitivity rate of more than 90% [16][17][18]. Arguably, the direct drainage system appears the most plausible main channel of skip mediastinal nodal spread of cancer cells.…”

Intraoperative Sentinel Lymph Node Mapping of the Lung Using Near-Infrared Fluorescent Quantum Dots

“…The need for CT-guided tracer injection 12-24 hours before surgery, however, severely limits the usefulness of this agent. To avoid the use of a radioactive tracer, Nakagawa and associates used ferumoxides, a 100 nm diameter nonradioactive superparamagnetic tracer particle, to perform SLN mapping in NSCLC patients [26]. Because of technical limitations regarding their magnetometer, they could only perform ex vivo SLN identification after complete nodal dissection.…”

Tumor-Derived TGFβ-1 Induces Dendritic Cell Apoptosis in the Sentinel Lymph Node

“…NSCLC patients were enrolled in the study after obtaining signed informed consent. LNs showing no evidence of metastasis were obtained from each patient, after which SLNs were identified using the method developed at our institute (5). Briefly, a magnetic tracer (ferumoxides) was injected around the lung tumor during surgery, after which the magnetic force within the LNs was measured using a highly sensitive handheld magnetometer, and LNs in which magnetic force was detected were defined as SLNs.…”

“…vidence suggests that, for some types of cancer, lymph fluid and tumor cells from the primary tumor initially flow into a tumor-draining lymph node (LN), 2 the so-called sentinel LN (SLN), before flowing into more distal LNs (1)(2)(3)(4)(5)(6)(7)(8). If correct, then when metastasis is not found in an SLN, it most likely will not be present in more distal nodes; and, in fact, the adverse effects of lymphadenectomy have been avoided in cases of breast cancer (1,2) and melanoma (3,4) based on that idea.…”