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Fluorescent Silica Nanoparticle–Guided Sentinel Lymph Node Biopsy in Melanoma

Accurate localization of tumor-draining lymph nodes and nodal micrometastases is crucial to staging and treating melanoma.

Researchers have developed a new optical imaging probe to enable high-contrast real-time identification of sentinel lymph nodes in head and neck melanoma.

This procedure video illustrates

(A) Probe injection into a scalp melanoma in a man in his 50s, and

(B) A postauricular sentinel lymph node fluoresces through the patient's intact skin under near-infrared (NIR) imaging in an area more focal than the planned broader non–image-guided dissection site noted by the purple marker line.

Then

(C) Focused incision,

(D) Limited surgical dissection and resection cavity, and

(E) Progressive dissection

retrieves the node. Postbiopsy,

(F) The node continues to fluoresce ex vivo with

(G) Minimal residual wound.

The probe uses new, ultrasmall, core-shell silica nanoparticles (Cornell prime dots [or C′ dots]), which fluoresce under handheld NIR light, linked via polyethylene glycol chains (PEGs) to peptides (cyclic arginine-glycine–aspartic acid–tyrosine [cRGDY] peptides) that target the C′ dots to integrins expressed on the surface of the melanoma cells.

Click the Related Article link for additional images, examples, and complete details.

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