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Imaging prostate cancer lymph node metastases with a multimodality contrast agent
Author(s) -
Hall Mary A.,
Kwon Sunkuk,
Robinson Holly,
Lachance PierAnne,
Azhdarinia Ali,
Ranganathan Ranjani,
Price Roger E.,
Chan Wenyaw,
SevickMuraca Eva M.
Publication year - 2011
Publication title -
the prostate
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.295
H-Index - 123
eISSN - 1097-0045
pISSN - 0270-4137
DOI - 10.1002/pros.21413
Subject(s) - prostate cancer , medicine , metastasis , lymph node , positron emission tomography , prostatectomy , pathology , molecular imaging , prostate , lymph , imaging agent , fluorescence lifetime imaging microscopy , nuclear medicine , cancer , radiology , in vivo , fluorescence , physics , microbiology and biotechnology , quantum mechanics , biology
BACKGROUND Methods to detect lymph node (LN) metastases in prostate cancer (PCa) are limited. Pelvic LN dissection is commonly performed during prostatectomy, but often followed by morbid complications. More refined methods for detecting LN invasion are needed. METHODS We developed a dual‐labeled targeting agent having a near‐infrared (NIR) fluorophore for intraoperative guidance, and a conventional radiotracer for detection of LN metastasis. Nu/Nu mice were orthotopically implanted with DsRed‐expressing human PCa (PC3) cells. Antibody (Ab) specific for epithelial cell adhesion molecule was conjugated to DOTA, IRDye 800CW, and radiolabeled with 64 Cu. Dual‐labeled Ab was administered intravenously at 10–12 weeks post‐implantation, and positron emission tomography/computed tomography (PET/CT) and fluorescence imaging were performed within 18–24 hr. RESULTS Metastasis to lumbar LNs was detected by DsRed fluorescence imaging, as well as pathology, in 75% of mice having pathology‐confirmed primary prostate tumors. These metastases were also detected by NIR fluorescence imaging. In some cases, metastases to sciatic, medial, renal, and axillary nodes were also detected. For all LNs examined, no significant differences were found between the percentages of metastases detected by NIR imaging (63%) and µPET/CT (64%) ( P = 0.93), or between those detected by DsRed imaging (25%) and pathological examination (19%) ( P = 0.12). CONCLUSION This study demonstrates that a multimodality contrast agent is useful for early detection of metastatic disease, and has applications for intraoperative PCa treatment. Further agent optimization is necessary to enhance specificity, and provide validation for prostate and other LN metastasizing epithelial cancers. Prostate 72:129–146, 2012. © 2011 Wiley Periodicals, Inc.