In the United States, the annual incidence of oral squamous cell carcinoma (OSCC) exceeds 50,000 cases. Primary tumor resection remains the first line of treatment in these patients yet follow up neck dissection and chemoradiation treatment may be indicated if cancer has spread to tumor draining lymph nodes. There is a push to minimize morbidity from neck dissection by sentinel lymph node biopsy, where only the first lymph node(s) draining the primary tumor are excised and evaluated for cancer spread. However, with current pathology methods, results are not available to surgeons until patients have been sent home. In response, we are developing a method to rapidly stain and image whole excised lymph nodes in less than 30 min, so surgeons can react to positive cases while patients are still on the operating table. Here we present a human head and neck cancer spheroid model implanted in porcine lymph nodes as a means evaluating the potential for our staining and imaging protocols to rapidly identify cancer burden in lymph nodes.
An increasing number of cancer surgery protocols are including sentinel lymph node biopsies on the day of resection to stage for non-palpable spread of cancer through tumor draining lymph nodes. The challenge is that often a tumor-positive node will make it necessary to perform an enhanced resection of the lymphatic network, and if lymph node processing is not completed within the timeframe of surgery, then patients may have to be called back for additional surgery or have to undergo amplified chemo or radiation therapy. Our group is working on a rapid lymph node staining and fluorescence tomography system that we call ADEPT to provide surgeons with lymph node biopsy results within 15 min. The aim is to minimize the number of callback surgery or amplified therapy procedures to minimize stress to patients and reduce health care costs. This work predicts, using Monte Carlo photon propagation modeling simulations, that ADEPT has the potential to yield greater than 95% accuracy in detecting the smallest amount of cancer considered clinically relevant withing 15 min of tissue processing and imaging.
Access to the requested content is limited to institutions that have purchased or subscribe to SPIE eBooks.
You are receiving this notice because your organization may not have SPIE eBooks access.*
*Shibboleth/Open Athens users─please
sign in
to access your institution's subscriptions.
To obtain this item, you may purchase the complete book in print or electronic format on
SPIE.org.
INSTITUTIONAL Select your institution to access the SPIE Digital Library.
PERSONAL Sign in with your SPIE account to access your personal subscriptions or to use specific features such as save to my library, sign up for alerts, save searches, etc.