Evaluating the Feasibility and Efficacy of a Dual-Modality Nanoparticle Contrast Agent (Nanotrast-CF800) for Image-Guided Sentinel Lymph Node Mapping in the Oral Cavity of Healthy Dogs

Abstract

A combination of pre and intraoperative sentinel lymph node (SLN) mapping techniques have been suggested to optimize SLN detection. A novel liposomal nanoparticle, Nanotrast-CF800 (CF800), utilizes computed tomography lymphography (CTL) and near infrared fluorescence imaging (NIRF) for image-guided surgery and SLN mapping. This novel tracer agent has not been evaluated in companion animals. The objective of this study was to evaluate the feasibility and efficacy of CF800 for SLN mapping in the oral cavity of healthy dogs and to report any local adverse effects. Six healthy adult purpose-bred research dogs randomly received either 1 mL (group 1) or 2 mL (group 2) of CF800 injected into the submucosa at the level of the right canine maxillary tooth. CTL and percutaneous NIRF were performed at 1, 3, and 10 min, then 1, 2, 4, 7, and 10 days post-injection (p.i). Overall, both CTL and NIRF identified SLNs in all dogs. The overall peak mean contrast enhancement of the SLNs was 73.98 HU (range 63.45–86.27 HU) at 2 days p.i. Peak fluorescence of the SLN occurred at 1 day p.i. The agent was retained within the SLN for at least 7 days for CTL and 4 days for percutaneous NIRF. No adverse effects were observed. Local administration of CF800 was simple and feasible for the detection of SLNs using CTL+NIRF in the head and neck of healthy dogs and was not associated with significant local adverse events.

Comparison of indirect computed tomographic lymphography and near‐infrared fluorescence sentinel lymph node mapping for integumentary canine mast cell tumors

“…Therefore, these imaging techniques are not mutually exclusive rather they complement each other, by potentially detecting additional SLN. This finding is similar to the results of other studies stating that the combination of SLN mapping modalities may allow the detection of different SLN 17,18,39 …”

“…This finding is similar to the results of other studies stating that the combination of SLN mapping modalities may allow the detection of different SLN. 17,18,39 The ALN-SLN discrepancy reported herein was less than previously reported. 6,11,13 Specifically, in 6/20 (30%) and 5/20 (25%) dogs for ICTL and NIRF, respectively.…”

CT Lymphography Using Lipiodol® for Sentinel Lymph Node Biopsy in Early-Stage Oral Cancer

“…Even so, modifications of oil-based iodinated contrast media could increase the degree of lymphatic drainage while still allowing for long-term retention in lymph nodes, potentially improving SLN detection by CTL [ 16 , 31 ]. Alternatively, other radiocontrast agents (e.g., Nanotrast-CF800 entrapped gold nanoparticles) have shown their potential for SLN mapping using CTL in animal studies [ 32 , 33 , 34 ]. These modified radiocontrast agents may enhance the utility of CTL for SLN mapping but have yet to be investigated in human studies.…”

Effect of volume and methylene blue on fluorescence intensity and transit of indocyanine green for sentinel lymph node mapping in a simulated feline tumor model

“…AJVR higher SLN detection rates (91%) are seen compared to using CTL (42%) or MB (50%). [13][14][15][16] While the use of these dyes (ICG and MB) has been reported independently, it has yet to be known whether adding MB to an ICG solution will impact its fluorescence intensity, either positively or negatively.…”

“…18,19 Using ICG NIRF has been proven safe and effective in healthy dogs and dogs with neoplastic disease for SLN mapping of the oral cavity, popliteal, and inguinal regions. 13,14,16 In addition, ICG NIRF has been utilized in cats for vascular visualization during reconstructive surgery with no adverse events. 20 The objectives of this study were to compare the transit time and degree of percutaneous fluorescence intensity (FI) between 2 different volumes of ICG solution in a simulated tumor model and to determine the effect on FI when using a combination of ICG and MB.…”