PT  - JOURNAL ARTICLE
AU  - Michael A. Liss
AU  - Salman Farshchi-Heydari
AU  - Zhengtao Qin
AU  - Sean A. Hickey
AU  - David J. Hall
AU  - Christopher J. Kane
AU  - David R. Vera
TI  - Preclinical Evaluation of Robotic-Assisted Sentinel Lymph Node Fluorescence Imaging
AID  - 10.2967/jnumed.114.140871
DP  - 2014 Sep 01
TA  - Journal of Nuclear Medicine
PG  - 1552--1556
VI  - 55
IP  - 9
4099  - http://jnm.snmjournals.org/content/55/9/1552.short
4100  - http://jnm.snmjournals.org/content/55/9/1552.full
SO  - J Nucl Med2014 Sep 01; 55
AB  - An ideal substance to provide convenient and accurate targeting for sentinel lymph node (SLN) mapping during robotic-assisted surgery has yet to be found. We used an animal model to determine the ability of the FireFly camera system to detect fluorescent SLNs after administration of a dual-labeled molecular imaging agent. Methods: We injected the footpads of New Zealand White rabbits with 1.7 or 8.4 nmol of tilmanocept labeled with 99mTc and a near-infrared fluorophore, IRDye800CW. One and 36 h after injection, popliteal lymph nodes, representing the SLNs, were dissected with the assistance of the FireFly camera system, a fluorescence-capable endoscopic imaging system. After excision of the paraaortic lymph nodes, which represented non-SLNs, we assayed all lymph nodes for radioactivity and fluorescence intensity. Results: Fluorescence within all popliteal lymph nodes was easily detected by the FireFly camera system. Fluorescence within the lymph channel could be imaged during the 1-h studies. When compared with the paraaortic lymph nodes, the popliteal lymph nodes retain greater than 95% of the radioactivity at both 1 and 36 h after injection. At both doses (1.7 and 8.4 nmol), the popliteal nodes had higher (P < 0.050) optical fluorescence intensity than the paraaortic nodes at the 1- and 36-h time points. Conclusion: The FireFly camera system can easily detect tilmanocept labeled with a near-infrared fluorophore at least 36 h after administration. This ability will permit image acquisition and subsequent verification of fluorescence-labeled SLNs during robotic-assisted surgery.