Deposition of superparamagnetic iron‐oxide nanoparticles in axillary sentinel lymph nodes following subcutaneous injection

Johnson, Laura; Pinder, Sarah; Douek, Michael

doi:10.1111/his.12019

Cited by 71 publications

(65 citation statements)

References 9 publications

(10 reference statements)

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“…In both cases, the iron was distributed in the subcapsular space and sinuses of nodes, consistent with previous histopathological studies. 20,27 However, the 111 nm tracer was found to be deposited mainly within macrophages -demonstrating its ability to activate the mononuclear phagocytic system -compared to the 59 nm tracer, which although demonstrating phagocytosis within the node also displayed extensive free iron granules peripherally. These two processes of activating the mononuclear phagocytic system and free iron granule deposition facilitate iron accumulation and hence SLN identification using a handheld magnetometer.…”

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confidence: 97%

Comparison of three magnetic nanoparticle tracers for sentinel lymph node biopsy in an in vivo porcine model

Pouw¹,

Ahmed²,

Anninga³

et al. 2015

IJN

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Introduction Breast cancer staging with sentinel lymph node biopsy relies on the use of radioisotopes, which limits the availability of the procedure worldwide. The use of a magnetic nanoparticle tracer and a handheld magnetometer provides a radiation-free alternative, which was recently evaluated in two clinical trials. The hydrodynamic particle size of the used magnetic tracer differs substantially from the radioisotope tracer and could therefore benefit from optimization. The aim of this study was to assess the performance of three different-sized magnetic nanoparticle tracers for sentinel lymph node biopsy within an in vivo porcine model. Materials and methods Sentinel lymph node biopsy was performed within a validated porcine model using three magnetic nanoparticle tracers, approved for use in humans (ferumoxytol, with hydrodynamic diameter d H =32 nm; Sienna+ ® , d H =59 nm; and ferumoxide, d H =111 nm), and a handheld magnetometer. Magnetometer counts (transcutaneous and ex vivo), iron quantification (vibrating sample magnetometry), and histopathological assessments were performed on all ex vivo nodes. Results Transcutaneous “hotspots” were present in 12/12 cases within 30 minutes of injection for the 59 nm tracer, compared to 7/12 for the 32 nm tracer and 8/12 for the 111 nm tracer, at the same time point. Ex vivo magnetometer counts were significantly greater for the 59 nm tracer than for the other tracers. Significantly more nodes per basin were excised for the 32 nm tracer compared to other tracers, indicating poor retention of the 32 nm tracer. Using the 59 nm tracer resulted in a significantly higher iron accumulation compared to the 32 nm tracer. Conclusion The 59 nm tracer demonstrated rapid lymphatic uptake, retention in the first nodes reached, and accumulation in high concentration, making it the most suitable tracer for intraoperative sentinel lymph node localization.

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confidence: 97%

Comparison of three magnetic nanoparticle tracers for sentinel lymph node biopsy in an in vivo porcine model

Pouw¹,

Ahmed²,

Anninga³

et al. 2015

IJN

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“…It has been shown that the iron content within SLNs after interstitial magnetic tracer injection is predominately distributed within the subcapsular space and sinuses of the lymph nodes. [14,20] Our results suggest that the porcine SLNs have a saturation limit for the iron content distributed within them. Once this saturation point is exceeded the iron is passed on to the next echelon SLN, which once its saturation point is exceeded will similarly result in passage to the next nodes.…”

Section: ]mentioning

confidence: 72%

“…per groin, range [4][5][6][7][8][9][10][11][12][13][14], of which 109 were SLNs (mean 2.2 nodes (SD 1.4) per groin, range 1-7).…”

Section: Resultsmentioning

confidence: 99%

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160. Optimising magnetic sentinel lymph node biopsy in an in vivo porcine model

Ahmed

Anninga

Pouw

et al. 2014

European Journal of Surgical Oncology (EJSO)

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The magnetic technique for sentinel lymph node biopsy (SLNB) has been evaluated in several clinical trials, albeit under proscribed conditions. An in vivo porcine model was therefore developed to optimise the magnetic technique by evaluating the effect of differing volume of magnetic tracer and time of injection. A total of 48 sentinel node procedures were undertaken and 423 nodes (109 sentinel nodes) retrieved. There was a significant correlation between magnetometer counts and the tracer content of excised sentinel lymph nodes (SLNs) (r=0.82; p<0.001). Total numbers of tracer-containing SLNs increased with increasing volumes of tracer (p<0.001). Transcutaneous magnetometer counts increased with increasing time from injection of tracer (p<0.0001) and reached a plateau within 60 minutes. A non-statistically significant trend was observed between volume of tracer injected and tracer content of SLNs (p=0.07). We infer that increasing tracer volume and injecting prior to surgery improves transcutaneous 'hotspot' identification, but that very high injection volumes lead to an increase in the number of nodes excised.3

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“…They found that whilst 100 % of patients with macrometastases were successfully identified on SPIOenhanced MRI, this figure dropped to 40 % for patients with micrometastases. Johnson et al [33] administered USPIO periareolarly and performed standard SLNB. The 13 nodes containing metastases had variable quantities of iron within them, but the iron was not present in the area of the node containing the metastasis.…”

Section: The Future Role Of Mnps In the Management Of The Axilla In Bmentioning

confidence: 99%

What is the future of magnetic nanoparticles in the axillary management of breast cancer?

Ahmed

Douek

2013

Breast Cancer Res Treat

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Magnetic nanoparticles (MNPs) possess unique properties, which make them highly attractive for medical applications. The use of MNPs in surgery has mainly been focused on their role in the identification of metastatic lymph node involvement. There have been developments within this field, including ongoing and newly conducted clinical trials. The current published evidence for the use of MNPs in assessing metastatic lymph node spread using sentinel lymph node biopsy and non-invasive imaging modalities is reviewed and future applications considered.

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Deposition of superparamagnetic iron‐oxide nanoparticles in axillary sentinel lymph nodes following subcutaneous injection

Cited by 71 publications

References 9 publications

Comparison of three magnetic nanoparticle tracers for sentinel lymph node biopsy in an in vivo porcine model

Comparison of three magnetic nanoparticle tracers for sentinel lymph node biopsy in an in vivo porcine model

160. Optimising magnetic sentinel lymph node biopsy in an in vivo porcine model

What is the future of magnetic nanoparticles in the axillary management of breast cancer?

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Deposition of superparamagnetic iron‐oxide nanoparticles in axillary sentinel lymph nodes following subcutaneous injection

Cited by 71 publications

References 9 publications

Comparison of three magnetic nanoparticle tracers for sentinel lymph node biopsy in an in&nbsp;vivo porcine model

Comparison of three magnetic nanoparticle tracers for sentinel lymph node biopsy in an in&nbsp;vivo porcine model

160. Optimising magnetic sentinel lymph node biopsy in an in vivo porcine model

What is the future of magnetic nanoparticles in the axillary management of breast cancer?

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Comparison of three magnetic nanoparticle tracers for sentinel lymph node biopsy in an in vivo porcine model

Comparison of three magnetic nanoparticle tracers for sentinel lymph node biopsy in an in vivo porcine model