Sentinel Lymph Node Mapping with the Quest Spectrum™ Platform

The Quest Spectrum™ Platform can be used for visualization of the sentinel lymph nodes. The sentinel lymph nodes are the first lymph nodes or group of nodes that drain tumors. Therefore, these nodes are particularly important since primary tumors might spread through the lymphatic system to other organs. The sentinel lymph node procedure consists of three steps. In the first step, the sentinel lymph node is mapped, in the second step a biopsy is taken of the nodes and in the last step analysis is performed upon the biopsy to determine whether the primary tumor has spread. The Quest Spectrum™ Platform is used in the first step of the procedure; mapping of the sentinel lymph node.

Sentinel lymph node mapping is performed by using fluorescent imaging in open or laparoscopic surgery. The patient is injected with a fluorescent tracer such as Indo Cyanine Green (ICG). This traces is injected near the tumor, to assure that the lymphatic system that is directly connected to the tumor drains the ICG-rich fluid. The ICG fluid that flows through the lymphatic nodes can be visualized with the Quest Spectrum™ Platform.

Sentinel lymph node mapping

Example of Sentinel Lymph Nodes Mapping

Visualization of the sentinel lymph node is shown in the image above. The left image shows an image that is similar to what surgeon can see with the naked eye. This image shows minimal contrast between the structures surrounding the sentinel lymph node and the sentinel lymph node itself.  The right image shows the fluorescent response of the tracer. This image shows a strong signal in the middle of the fluorescent image, but lacks a reference point. The image shown in the middle is the overlay between the natural image and the fluorescent image. The sentinel lymph node is visualized in green and refers to the fluorescent response. This image shows the advantage of using the Quest Spectrum™ Platform. Our system is capable of capturing the natural image and the fluorescent image simultaneously which allows the surgeon to directly asses the location of the sentinel lymph node.

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