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Article

Combination of an Integrin-Targeting NIR Tracer and an Ultrasensitive Spectroscopic Device for Intraoperative Detection of Head and Neck Tumor Margins and Metastatic Lymph Nodes

1
Department of Radiology and Imaging Science, Emory University School of Medicine, Atlanta, GA 30322, USA
2
Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, GA 30332, USA
3
Department of Pharmaceutical Sciences, University of Nebraska Medical Center, Omaha, NE 68198, USA
4
Winship Cancer Institute, Emory University, Atlanta, GA 30322, USA
*
Author to whom correspondence should be addressed.
Tomography 2016, 2(3), 215-222; https://doi.org/10.18383/j.tom.2016.00253
Submission received: 11 June 2016 / Revised: 6 July 2016 / Accepted: 2 August 2016 / Published: 1 September 2016

Abstract

Despite major advances in targeted drug therapy and radiation therapy, surgery remains the most effective treatment for most solid tumors. The single most important predictor of patient survival is a complete surgical resection of the primary tumor, draining lymph nodes, and metastatic lesions. Presently, however, 20%–30% of patients with head and neck cancer who undergo surgery still leave the operating room without complete resection because of missed lesions. Thus, major opportunities exist to develop advanced imaging tracers and intraoperative instrumentation that would allow surgeons to visualize microscopic tumors during surgery. The cell adhesion molecule integrin αvβ3 is specifically expressed by tumor neovasculature and invading tumor cells, but not by quiescent vessels or normal cells. Here we report the combined use of an integrin-targeting near-infrared tracer (RGD-IRDye800CW) and a handheld spectroscopic device, an integrated point spectroscopy with wide-field imaging system, for highly sensitive detection of integrin overexpression on infiltrating cancer cells. By using an orthotopic head and neck cancer animal model, we show that this tracer–device combination allows intraoperative detection of not only invasive tumor margins but also metastatic lymph nodes. Correlated histological analysis further reveals that microscopic clusters of 50–100 tumor cells can be detected intraoperatively with high sensitivity and specificity, raising new possibilities in guiding surgical resection of microscopic tumors and metastatic lymph nodes.
Keywords: intraoperative guidance; near-infrared; RGD; infiltrative; metastatic; head and neck cancer; tumor margins; lymph nodes intraoperative guidance; near-infrared; RGD; infiltrative; metastatic; head and neck cancer; tumor margins; lymph nodes

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MDPI and ACS Style

Yoon, Y.; Mohs, A.M.; Mancini, M.C.; Nie, S.; Shim, H. Combination of an Integrin-Targeting NIR Tracer and an Ultrasensitive Spectroscopic Device for Intraoperative Detection of Head and Neck Tumor Margins and Metastatic Lymph Nodes. Tomography 2016, 2, 215-222. https://doi.org/10.18383/j.tom.2016.00253

AMA Style

Yoon Y, Mohs AM, Mancini MC, Nie S, Shim H. Combination of an Integrin-Targeting NIR Tracer and an Ultrasensitive Spectroscopic Device for Intraoperative Detection of Head and Neck Tumor Margins and Metastatic Lymph Nodes. Tomography. 2016; 2(3):215-222. https://doi.org/10.18383/j.tom.2016.00253

Chicago/Turabian Style

Yoon, Younghyoun, Aaron M. Mohs, Michael C. Mancini, Shuming Nie, and Hyunsuk Shim. 2016. "Combination of an Integrin-Targeting NIR Tracer and an Ultrasensitive Spectroscopic Device for Intraoperative Detection of Head and Neck Tumor Margins and Metastatic Lymph Nodes" Tomography 2, no. 3: 215-222. https://doi.org/10.18383/j.tom.2016.00253

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