TY - JOUR
T1 - Validation of In Vivo Nodal Assessment of Solid Malignancies with USPIO-Enhanced MRI
T2 - A Workflow Protocol
AU - Driessen, Daphne A.J.J.
AU - de Gouw, Didi J.J.M.
AU - Stijns, Rutger C.H.
AU - Litjens, Geke
AU - Israël, Bas
AU - Philips, Bart W.J.
AU - Hermans, John J.
AU - Dijkema, Tim
AU - Klarenbeek, Bastiaan R.
AU - van der Post, Rachel S.
AU - Nagtegaal, Iris D.
AU - van Engen-Van Grunsven, Adriana C.H.
AU - Brosens, Lodewijk A.A.
AU - Veltien, Andor
AU - Zámecnik, Patrik
AU - Scheenen, Tom W.J.
N1 - Funding Information:
Funding: The data were selected from five scientific trials that received different funding: (1) VALIN-ODE study: Radboud Oncology Fund; (2) 7TNANO1 study: KWF grant granted to the Department of Medical Imaging of the Radboudumc; (3) NANO-PANC study: anonymous funder; (4) PRECIES study: internal funding; (5) USPIO-NECK study: Radboud Institute for Health Sciences junior research grant. The funding bodies had no role in the design of the study and collection, analysis, and interpretation of data and in the writing of the manuscript.
Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2022/3/7
Y1 - 2022/3/7
N2 - Background: In various cancer types, the first step towards extended metastatic disease is the presence of lymph node metastases. Imaging methods with sufficient diagnostic accuracy are required to personalize treatment. Lymph node metastases can be detected with ultrasmall superpara-magnetic iron oxide (USPIO)-enhanced magnetic resonance imaging (MRI), but this method needs validation. Here, a workflow is presented, which is designed to compare MRI-visible lymph nodes on a node-to-node basis with histopathology. Methods: In patients with prostate, rectal, periampullary, esophageal, and head-and-neck cancer, in vivo USPIO-enhanced MRI was performed to detect lymph nodes suspicious of harboring metastases. After lymphadenectomy, but before histopathological assessment, a 7 Tesla preclinical ex vivo MRI of the surgical specimen was performed, and in vivo MR images were radiologically matched to ex vivo MR images. Lymph nodes were annotated on the ex vivo MRI for an MR-guided pathological examination of the specimens. Results: Matching lymph nodes of ex vivo MRI to pathology was feasible in all cancer types. The annotated ex vivo MR images enabled a comparison between USPIO-enhanced in vivo MRI and histopathology, which allowed for analyses on a nodal, or at least on a nodal station, basis. Conclusions: A workflow was developed to validate in vivo USPIO-enhanced MRI with histopathology. Guiding the pathologist towards lymph nodes in the resection specimens during histopathological work-up allowed for the analysis at a nodal basis, or at least nodal station basis, of in vivo suspicious lymph nodes with corresponding histopathology, providing direct information for validation of in vivo USPIO-enhanced, MRI-detected lymph nodes.
AB - Background: In various cancer types, the first step towards extended metastatic disease is the presence of lymph node metastases. Imaging methods with sufficient diagnostic accuracy are required to personalize treatment. Lymph node metastases can be detected with ultrasmall superpara-magnetic iron oxide (USPIO)-enhanced magnetic resonance imaging (MRI), but this method needs validation. Here, a workflow is presented, which is designed to compare MRI-visible lymph nodes on a node-to-node basis with histopathology. Methods: In patients with prostate, rectal, periampullary, esophageal, and head-and-neck cancer, in vivo USPIO-enhanced MRI was performed to detect lymph nodes suspicious of harboring metastases. After lymphadenectomy, but before histopathological assessment, a 7 Tesla preclinical ex vivo MRI of the surgical specimen was performed, and in vivo MR images were radiologically matched to ex vivo MR images. Lymph nodes were annotated on the ex vivo MRI for an MR-guided pathological examination of the specimens. Results: Matching lymph nodes of ex vivo MRI to pathology was feasible in all cancer types. The annotated ex vivo MR images enabled a comparison between USPIO-enhanced in vivo MRI and histopathology, which allowed for analyses on a nodal, or at least on a nodal station, basis. Conclusions: A workflow was developed to validate in vivo USPIO-enhanced MRI with histopathology. Guiding the pathologist towards lymph nodes in the resection specimens during histopathological work-up allowed for the analysis at a nodal basis, or at least nodal station basis, of in vivo suspicious lymph nodes with corresponding histopathology, providing direct information for validation of in vivo USPIO-enhanced, MRI-detected lymph nodes.
KW - 7 Tesla
KW - Lymph node
KW - Magnetic resonance imaging
KW - Nodal staging
KW - Node-to-node correlation
KW - Pathology
KW - magnetic resonance imaging
KW - pathology
KW - lymph node
KW - node-to-node correlation
KW - nodal staging
UR - http://www.scopus.com/inward/record.url?scp=85126785896&partnerID=8YFLogxK
U2 - 10.3390/mps5020024
DO - 10.3390/mps5020024
M3 - Article
C2 - 35314661
AN - SCOPUS:85126785896
VL - 5
SP - 1
EP - 13
JO - Methods and Protocols
JF - Methods and Protocols
IS - 2
M1 - 24
ER -