Basic research on photoacoustic sensing and imaging system for detecting sentinel lymph node in breast cancer

Jiaxian ZHAO; Daohuai JIANG; Binbin CONG; Fei GAO; Yongsheng WANG

doi:10.19401/j.cnki.1007-3639.2022.02.002

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Basic research on photoacoustic sensing and imaging system for detecting sentinel lymph node in breast cancer

更新时间：2025-12-31

- Basic research on photoacoustic sensing and imaging system for detecting sentinel lymph node in breast cancer
- China Oncology Vol. 32, Issue 2, Pages: 106-117(2022)
- 作者机构：
  
  1. 山东第一医科大学（山东省医学科学院）, 山东济南 250062
  2. 山东省肿瘤防治研究院（山东省肿瘤医院）乳腺病中心,山东济南 250117
  3. 上海科技大学,信息科学与技术学院,混合成像系统实验室,上海 201210
  4. 中国科学院上海微系统所与信息技术研究所,上海 200050
  5. 中国科学院大学,北京 100049
- 作者简介：
  
  GAO Fei E-mail: gaofei@shanghaitech.edu.cn;
- 基金信息：
- DOI：10.19401/j.cnki.1007-3639.2022.02.002
  CLC： R737.9
- Received：24 December 2021，
  
  Published：28 February 2022
- 稿件说明：
移动端阅览
Jiaxian ZHAO, Daohuai JIANG, Binbin CONG, et al. Basic research on photoacoustic sensing and imaging system for detecting sentinel lymph node in breast cancer[J]. China Oncology, 2022, 32(2): 106-117.
DOI：

Jiaxian ZHAO, Daohuai JIANG, Binbin CONG, et al. Basic research on photoacoustic sensing and imaging system for detecting sentinel lymph node in breast cancer[J]. China Oncology, 2022, 32(2): 106-117. DOI： 10.19401/j.cnki.1007-3639.2022.02.002.

摘要

背景与目的：

前哨淋巴结活检（sentinel lymph node biopsy

SLNB）是临床淋巴结（lymph nodes

LN）阴性早期乳腺癌患者的标准分期技术

蓝染法联合核素法作为SLNB的标准方法仍有一定的局限性。应用新型荧光靶向示踪剂吲哚菁绿（indocyanine green

ICG）与利妥昔单抗（rituximab

RIT）偶联物（indocyanine green-rituximab

ICG-RIT）

搭建手持式光声信号传感系统（photoacoustic signal sensing s

ystem

PASS）及手持式光声成像（photoacoustic imaging

PAI）系统

探索其探测富集ICG-RIT的淋巴组织穿透深度

研究其定位前哨淋巴结的可行性。

方法

为探索PASS及PAI的组织穿透能力及定位能力

通过仿体实验将鸡胸组织覆盖于ICG-RIT染色的明胶仿体上模拟体内LN

通过PASS探测不同深度下ICG-RIT仿体的光声信号强度;同时设计人体组织试验—术前于患乳外上象限注射ICG-RIT

取荧光显像的LN于腋窝脂肪下

对比PASS、PAI及超声成像深度区别。通过SD大鼠后肢淋巴引流模型探索该技术作为SLNB的可行性

在SD大鼠后肢足垫皮下注射ICG-RIT

比较SD大鼠腘LN及髂LN的PASS及PAI定位区别。

结果

仿体实验结果显示

PASS探测鸡胸组织下ICG-RIT仿体呈现特征性单峰信号

且信号强度与组织深度成反比

最大探测深度平均达52.42 mm。人体组织试验结果显示

PASS探测腋窝脂肪下ICG-RIT染色LN最大探测深度达32.72 mm

对比鸡胸组织下6.25%浓度ICG-RIT染色仿体最大探测深度达39.72 mm;PAI探测腋窝脂肪下ICG-RIT染色LN深度达25 mm。SD大鼠模型结果显示

ICG-RIT停留于SD大鼠腘LN

在PASS中光声信号呈现特征性单峰曲线

PAI呈现特征性

#x0201C;热点

#x0201D;图

而髂LN未见明显光声信号

对比亚甲蓝则同时染色腘LN及髂LN。

结论

利用ICG-RIT的光声效应及靶向LN特性

通过手持式PASS及手持式PAI能准确定位SLN

同时有良好的组织穿透深度

具备良好的应用前景

但仍需进一步临床试验数据证实。

Abstract

Background and purpose:

Sentinel lymph node biopsy (SLNB) is a standard staging technique for patients with clinical lymph nodes (LNs) negative early breast cancer. Blue staining combined with radionuclide method as the standard method of SLNB still has certain limitations. In this study

a new fluorescent targeted tracer indocyanine green-rituximab (ICG-RIT) was applied

and a handheld photoacoustic signal sensing (PASS) system and a handheld photoacoustic imaging (PAI) system were built to explore the tissue penetration depth of LNs enriched with ICG-RIT

and to study the feasibility of the new system locating LNs.

Methods:

In order to study the tissue penetration ability of ICG-RIT and localization ability of PASS and PAI

three experiments were designed. For the phantom experiment

the PASS was used to detect the ICG-RIT dyed gelatin phantom which was covered with chicken breast tissue to simulate LNs

in vivo

. For the human tissue experiment

after ICG-RIT was injected into the breast before operation

the LNs enriched with ICG-RIT were excised during the surgery and detected by the fluorescence imaging system and gamma

probe detection system. The axillary LNs were covered with the axillary fat and detected by PASS

PAI and ultrasound imaging in sequence to compare the performance. For the rat lymph drainage model experiment

ICG-RIT was subcutaneously injected into the hind paw pad of SD rats to compare the PASS and PAI detection differences between popliteal LNs and iliac LNs.

Results:

The results of phantom experiment showed that ICG-RIT phantom under PASS detection showed the characteristic single-peak signal

and the signal amplitude was inversely proportional to the tissue depth

and the maximum detection depth was 52.42 mm on average. The human tissue experiment results showed that the maximum detection depth of ICG-RIT stained LNs under axillary fat detected by PASS was 32.72 mm

and the maximum detection depth of ICG-RIT stained phantom under 6.25% concentration of chicken breast tissue was 39.72 mm. The PAI detected ICG-RIT stained LNs in axillary fat up to 25 mm in depth. The results of SD rat model showed that ICG-RIT was collected by the popliteal LNs of SD rats

showing a monopolar curve on the PASS and a characteristic ‘hot spot’ on the PAI

and no obvious photoacoustic signal was found in iliac LNs. On the contrary

the methylene blue simultaneously stained popliteal LNs and iliac LNs.

Conclusion:

Taking advantage of the photoacoustic effect and targeting LNs characteristics of ICG-RIT

SLN can be accurately located by handheld PASS and handheld PAI with good penetration depth in tissue

showing potentials in clinical application. However

further clinical trial data are still needed to validate its clinical values.

关键词

Keywords

references

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