Bimodal inguinal sentinel lymph node imaging using a radiation-free fluorescent magnetic hybrid tracer in penile cancer patients
Invasive lymph node (LN) staging is crucial for survival in penile cancer (PeCa) patients. To lower patient morbidity associated with radical inguinal lymphadenectomy, sentinel node biopsy (SNB) is recommended. Application of conventional radioactive/fluorescent tracers for sentinel node (SN) labell...
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Frontiers Media S.A.
2025-05-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2025.1523038/full |
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| author | Bianca Michalik Svenja Engels Maximilian C. Otterbach Martin H. Maurer Friedhelm Wawroschek Alexander Winter |
| author_facet | Bianca Michalik Svenja Engels Maximilian C. Otterbach Martin H. Maurer Friedhelm Wawroschek Alexander Winter |
| author_sort | Bianca Michalik |
| collection | DOAJ |
| description | Invasive lymph node (LN) staging is crucial for survival in penile cancer (PeCa) patients. To lower patient morbidity associated with radical inguinal lymphadenectomy, sentinel node biopsy (SNB) is recommended. Application of conventional radioactive/fluorescent tracers for sentinel node (SN) labelling is limited to centers with nuclear medicine or lacks pre-operative imaging. We introduce a radiation-free fluorescent magnetic hybrid tracer for bimodal inguinal SN imaging in PeCa patients. In three consecutive PeCa patients, the fluorescent magnetic hybrid tracer (50 µl indocyanine green, 5 mg/ml, in 1 ml superparamagnetic iron oxide nanoparticles) was peritumorally injected. SNs were visualized by magnetic resonance imaging (MRI). Intra-operatively, SNs were detected using a handheld magnetometer and a fluorescence camera. Concordance was determined between MRI and magnetometer-guided SNB and between magnetic and fluorescent SN labelling. MRI revealed 29 SNs (median 4.5, range 0–8 SNs/groin). Twenty-five LNs (median 4.5, range 0–9 LNs/groin) were resected, including 16 magnetically active and 17 fluorescent SNs (median 3, range 0–6 SNs/groin, either mode). MRI and magnetometer-guided SNB had 66% concordance, magnetic and fluorescence SN labelling 96%. The diagnostic accuracy of our approach has to be evaluated in larger patient cohorts. Our radiation-free SNB technique is feasible without the need for nuclear medicine, its associated additional effort and regulations. |
| format | Article |
| id | doaj-art-27fda50a1f894e6ebe13ca144081187a |
| institution | OA Journals |
| issn | 2234-943X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Oncology |
| spelling | doaj-art-27fda50a1f894e6ebe13ca144081187a2025-08-20T02:28:16ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-05-011510.3389/fonc.2025.15230381523038Bimodal inguinal sentinel lymph node imaging using a radiation-free fluorescent magnetic hybrid tracer in penile cancer patientsBianca Michalik0Svenja Engels1Maximilian C. Otterbach2Martin H. Maurer3Friedhelm Wawroschek4Alexander Winter5University Hospital for Urology, Klinikum Oldenburg, Department of Human Medicine, School of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Oldenburg, GermanyUniversity Hospital for Urology, Klinikum Oldenburg, Department of Human Medicine, School of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Oldenburg, GermanyUniversity Institute for Diagnostic and Interventional Radiology, Klinikum Oldenburg, Department of Human Medicine, School of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Oldenburg, GermanyUniversity Institute for Diagnostic and Interventional Radiology, Klinikum Oldenburg, Department of Human Medicine, School of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Oldenburg, GermanyUniversity Hospital for Urology, Klinikum Oldenburg, Department of Human Medicine, School of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Oldenburg, GermanyUniversity Hospital for Urology, Klinikum Oldenburg, Department of Human Medicine, School of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Oldenburg, GermanyInvasive lymph node (LN) staging is crucial for survival in penile cancer (PeCa) patients. To lower patient morbidity associated with radical inguinal lymphadenectomy, sentinel node biopsy (SNB) is recommended. Application of conventional radioactive/fluorescent tracers for sentinel node (SN) labelling is limited to centers with nuclear medicine or lacks pre-operative imaging. We introduce a radiation-free fluorescent magnetic hybrid tracer for bimodal inguinal SN imaging in PeCa patients. In three consecutive PeCa patients, the fluorescent magnetic hybrid tracer (50 µl indocyanine green, 5 mg/ml, in 1 ml superparamagnetic iron oxide nanoparticles) was peritumorally injected. SNs were visualized by magnetic resonance imaging (MRI). Intra-operatively, SNs were detected using a handheld magnetometer and a fluorescence camera. Concordance was determined between MRI and magnetometer-guided SNB and between magnetic and fluorescent SN labelling. MRI revealed 29 SNs (median 4.5, range 0–8 SNs/groin). Twenty-five LNs (median 4.5, range 0–9 LNs/groin) were resected, including 16 magnetically active and 17 fluorescent SNs (median 3, range 0–6 SNs/groin, either mode). MRI and magnetometer-guided SNB had 66% concordance, magnetic and fluorescence SN labelling 96%. The diagnostic accuracy of our approach has to be evaluated in larger patient cohorts. Our radiation-free SNB technique is feasible without the need for nuclear medicine, its associated additional effort and regulations.https://www.frontiersin.org/articles/10.3389/fonc.2025.1523038/fullfluorescence imaginghybrid tracerICGpenile cancersentinel lymph nodesSPION |
| spellingShingle | Bianca Michalik Svenja Engels Maximilian C. Otterbach Martin H. Maurer Friedhelm Wawroschek Alexander Winter Bimodal inguinal sentinel lymph node imaging using a radiation-free fluorescent magnetic hybrid tracer in penile cancer patients Frontiers in Oncology fluorescence imaging hybrid tracer ICG penile cancer sentinel lymph nodes SPION |
| title | Bimodal inguinal sentinel lymph node imaging using a radiation-free fluorescent magnetic hybrid tracer in penile cancer patients |
| title_full | Bimodal inguinal sentinel lymph node imaging using a radiation-free fluorescent magnetic hybrid tracer in penile cancer patients |
| title_fullStr | Bimodal inguinal sentinel lymph node imaging using a radiation-free fluorescent magnetic hybrid tracer in penile cancer patients |
| title_full_unstemmed | Bimodal inguinal sentinel lymph node imaging using a radiation-free fluorescent magnetic hybrid tracer in penile cancer patients |
| title_short | Bimodal inguinal sentinel lymph node imaging using a radiation-free fluorescent magnetic hybrid tracer in penile cancer patients |
| title_sort | bimodal inguinal sentinel lymph node imaging using a radiation free fluorescent magnetic hybrid tracer in penile cancer patients |
| topic | fluorescence imaging hybrid tracer ICG penile cancer sentinel lymph nodes SPION |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2025.1523038/full |
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