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Sample records for sentinel node passing

  1. Sentinel node biopsy (image)

    MedlinePlus

    Sentinel node biopsy is a technique which helps determine if a cancer has spread (metastasized), or is contained locally. When a ... is closest to the cancer site. Sentinel node biopsy is used to stage many kinds of cancer, ...

  2. Black sentinel lymph node and 'scary stickers'.

    PubMed

    Yang, Arthur S; Creagh, Terrence A

    2013-04-01

    An unusual case is presented of a young adult patient with two black-stained, radio-nucleotide tracer-active sentinel lymph nodes biopsied following her primary cutaneous melanoma treatment. This was subsequently confirmed to be secondary to cutaneous tattoos, averting the need of an elective regional node dissection. History of tattooing and tattoo removal should therefore be obtained as a routine in all melanoma patients considered for sentinel node biopsy (SLN). SLN biopsy and any subsequent completion node dissection should be strictly staged so that proper histologic diagnosis of the sentinel node is available for correct decision making and treatment. PMID:23010587

  3. Contrast enhanced ultrasound of sentinel lymph nodes

    PubMed Central

    Cui, XinWu; Ignee, Andre; Nielsen, Michael Bachmann; Schreiber-Dietrich, Dagmar; De Molo, Chiara; Pirri, Clara; Jedrzejczyk, Maciej

    2013-01-01

    Sentinel lymph nodes are the first lymph nodes in the region that receive lymphatic drainage from a primary tumor. The detection or exclusion of sentinel lymph node micrometastases is critical in the staging of cancer, especially breast cancer and melanoma because it directly affects patient's prognosis and surgical management. Currently, intraoperative sentinel lymph node biopsies using blue dye and radioisotopes are the method of choice for the detection of sentinel lymph node with high identification rate. In contrast, conventional ultrasound is not capable of detecting sentinel lymph nodes in most cases. Contrast enhanced ultrasound with contrast specific imaging modes has been used for the evaluation and diagnostic work-up of peripherally located suspected lymphadenopathy. The method allows for real-time analysis of all vascular phases and the visualization of intranodal focal “avascular” areas that represent necrosis or deposits of neoplastic cells. In recent years, a number of animal and human studies showed that contrast enhanced ultrasound can be also used for the detection of sentinel lymph node, and may become a potential application in clinical routine. Several contrast agents have been used in those studies, including albumin solution, hydroxyethylated starch, SonoVue®, Sonazoid® and Definity®. This review summarizes the current knowledge about the use of ultrasound techniques in detection and evaluation of sentinel lymph node. PMID:26675994

  4. Sentinel lymph node biopsy in breast cancer

    PubMed Central

    Alsaif, Abdulaziz A.

    2015-01-01

    Objectives: To report our experience in sentinel lymph node biopsy (SLNB) in early breast cancer. Methods: This is a retrospective study conducted at King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia between January 2005 and December 2014. There were 120 patients who underwent SLNB with frozen section examination. Data collected included the characteristics of patients, index tumor, and sentinel node (SN), SLNB results, axillary recurrence rate and SLNB morbidity. Results: There were 120 patients who had 123 cancers. Sentinel node was identified in 117 patients having 120 tumors (97.6% success rate). No SN was found intraoperatively in 3 patients. Frozen section results showed that 95 patients were SN negative, those patients had no immediate axillary lymph node dissection (ALND), whereas 25 patients were SN positive and subsequently had immediate ALND. Upon further examination of the 95 negative SN’s by hematoxylin & eosin (H&E) and immunohistochemical staining for doubtful H&E cases, 10 turned out to have micrometastases (6 had delayed ALND and 4 had no further axillary surgery). Median follow up of patients was 35.5 months and the mean was 38.8 months. There was one axillary recurrence observed in the SN negative group. The morbidity of SLNB was minimal. Conclusion: The obtainable results from our local experience in SLNB in breast cancer, concur with that seen in published similar literature in particular the axillary failure rate. Sentinel lymph node biopsy resulted in minimal morbidity. PMID:26318461

  5. Sentinel node techniques in cancer of the vulva.

    PubMed

    de Hullu, Joanne A; van der Zee, Ate G J

    2003-02-01

    The sentinel lymph node procedure, with the combined technique (preoperative lymphoscintigraphy with (99m)Technetium-labeled Nanocolloid and Patente Blue V ), is a promising staging technique for patients with vulvar cancer. The clinical implementation of the sentinel lymph node procedure and the role of additional histopathologic techniques of the sentinel lymph nodes are under investigation. PMID:12521546

  6. Lymphatic mapping of the breast: locating the sentinel lymph nodes.

    PubMed

    Uren, R F; Howman-Giles, R; Renwick, S B; Gillett, D

    2001-06-01

    When the concept of sentinel lymph node biopsy was described in patients with melanoma, researchers quickly started to use lymphatic mapping techniques in breast cancer patients in an attempt to locate the sentinel node in the axilla. We have been performing mammary lymphoscintigraphy in this role for 6 years and have now studied 159 patients. Like others, we have found that most breast cancers (93%) have lymphatic drainage that includes the axilla, and we have found an average of 1.4 axillary sentinel nodes in these patients. Surgical biopsy of the axillary sentinel nodes accurately staged the node field in 96% of patients. We have also found, however, that the pattern of lymphatic drainage from the cancer site is unpredictable; and in 49% of patients lymphatic drainage occurred across the center line of the breast to axillary or internal mammary sentinel nodes. In more than half of our patients (56%) lymphatic drainage occurred to lymph nodes outside the axilla including the internal mammary (45%), supraclavicular (13%), and interpectoral and intramammary interval nodes (12%). These nodes are also sentinel nodes, and their presence indicates that a sentinel node biopsy procedure that stages only the status of the axillary lymph nodes has the potential to understage about half the patients with breast cancer. High quality lymphoscintigraphy allows accurate mapping of peritumoral lymphatic drainage in most patients with breast cancer. It is possible that in the future accurate nodal staging in each individual will involve biopsy of all sentinel lymph nodes, regardless of their location. PMID:11376417

  7. Sentinel Node Biopsy Interpretation: The Milan Experience.

    PubMed

    Galimberti, Viviana; Zurrida, Stefano; Intra, Mattia; Monti, Simonetta; Arnone, Paolo; Pruneri, Giancarlo; De Cicco, Concetta

    2000-10-01

    From March 1996 to December 1999 we performed 1,266 sentinel node biopsies (SNBs) in patients with small breast cancers. The technique is to inject technetium 99m-labeled albumin particles close to the tumor, locate the sentinel node (SN) scintigraphically, and use a handheld gamma-detecting probe to guide its removal via a small incision during breast surgery. Our experience was divided into three phases. In the first phase, complete axillary dissection was performed to assess the accuracy of SNB in predicting axillary status. We also assessed safety, perfected tracer injection technique, determined optimal particle size and radioactivity levels, optimized lymphoscintigraphic scanning, and perfected the surgical technique. The SN was identified and removed in 98.7% of cases. Comparison with complete axillary dissection showed that the SN predicted axillary status in 96.8% of cases. However, use of an intraoperative frozen section method predicted axillary status in only 86.5% of cases. In the second phase we developed a new method for intraoperative histologic analysis. Extensive sampling (up to 60 sections/SN) and an experienced pathologist proved more important than use of antikeratin immunostaining in identifying tumor cells, and the new method has the accuracy of a definitive histologic examination. The third phase, a randomized trial, closed at the end of 1999. Trial objectives were to confirm that the SN predicts axillary status, to determine the number of axillary relapses, and to assess overall and disease-free survival. Patients were randomized in the operating room to complete axillary dissection or SNB. If the SN was positive, complete axillary dissection was performed; if the SN was negative, no further axillary treatment was given. We expect the trial to confirm our clinical experience that SNB is a safe and accurate procedure for staging patients with early breast cancer and a clinically negative axilla. PMID:11348387

  8. Penile lymphoscintigraphy for sentinel node identification.

    PubMed

    Valdés Olmos, R A; Tanis, P J; Hoefnagel, C A; Jansen, L; Nieweg, O E; Meinhardt, W; Horenblas, S

    2001-05-01

    Lymphoscintigraphy for sentinel node (SN) identification has been extensively validated in breast cancer and melanoma. The aim of this study was to evaluate the findings of lymphoscintigraphy for SN identification in carcinoma of the penis. Lymphoscintigraphy was performed in 74 consecutive patients (mean age 62.2 years, range 28-87 years) with clinically lymph node-negative squamous cell carcinoma of the penis (stage T2 or greater). Following local anaesthesia by xylocaine 10% spray, technetium-99m nanocolloid (mean dose 64.8 MBq, range 40-131 MBq) in a volume of 0.3-0.4 ml was injected intradermally around the tumour. Shortly after injection, a 20-min dynamic study was performed with a dual-head gamma camera; subsequently, static anterior and lateral images were obtained at 30 min and 2 h using simultaneous cobalt-57 flood source transmission scanning. 57Co-assisted skin marking defined SN location for gamma probe/blue dye-guided biopsy, which was performed the next day. The SN visualization rate was 97% (72/74). Lymphatic drainage was bilateral in 81% of the cases (58/72), exclusively to the left groin in 13% (9/72) and only to the right groin in 6%. Bilateral lymph node drainage was synchronous in 38% (22/58) and asynchronous in 62% (in 18 patients the initial route was the left groin, and in the other 18, the right groin). Visualization before 30 min occurred in 66 patients (93%), in 64 of them (88%) already during the dynamic study. A total of 173 SNs were visualized (85 in the right groin, 88 in the left groin). Pitfalls were caused by inguinal skin contamination during injection (four patients) and intracavernous administration (one patient). At surgery, a total of 161 SNs were identified and removed. Sixteen patients (22%) had a tumour-positive SN and underwent standard regional lymph node dissection subsequently. During follow-up (median 28 months, range 3-74 months), two patients with a negative SN developed lymph node metastases in the mapped basin. It

  9. Axillary lymph node management in breast cancer with positive sentinel lymph node biopsy.

    PubMed

    Voutsadakis, Ioannis A; Spadafora, Silvana

    2015-02-10

    The surgical treatment of localized breast cancer has become progressively less aggressive over the years. The management of the axillary lymph nodes has been modified by the introduction of sentinel lymph node biopsy. Axillary dissection can be avoided in patients with sentinel lymph node negative biopsies. Based on randomized trials data, it has been proposed that no lymph node dissection should be carried out even in certain patients with sentinel lymph node positive biopsies. This commentary discusses the basis of such recommendations and cautions against a general omission of lymph node dissection in breast cancer patients with positive sentinel lymph node biopsies. Instead, an individualized approach based on axillary tumor burden and biology of the cancer should be considered. PMID:25667909

  10. [Intraoperative detection of the sentinel lymph nodes in lung cancer].

    PubMed

    Akopov, A L; Papayan, G V; Chistyakov, I V

    2015-01-01

    An analysis of the scientific data was made. It was used the literature devoted to the intraoperative visualization of the sentinel lymph nodes in patients with lung cancer. Correct detection of such lymph nodes with following pathologic investigation allowed limiting the volume of lympho-dissection in a number of patients. There is the possibility of maximal in-depth study of the sentinel lymph nodes by purposeful application of most sensible pathologic and molecular methods for detection their micrometastatic lesions. At the same time the treatment strategy and prognosis could be determined. The authors present the results of an application of dye techniques, radioactive preparation and fluorescence imaging for sentinel lymph node detection. Advantages and disadvantages of the methods are shown in the article. There are validated the prospects of technical development, study of information value of new applications and the most perspective method of fluorescence indocyanine green visualization by lymph outflow. PMID:25962306

  11. Tattoo-pigmented cervical lymph node that masqueraded as the sentinel lymph node in oral squamous cell carcinoma.

    PubMed

    Pinto, Amith; Wieshmann, Hulya; Triantafyllou, Asterios; Shaw, Richard

    2015-11-01

    We describe a case of a pigmented cervical lymph node mimicking the sentinel node during sentinel lymph node biopsy (SLNB) on a patient with oral squamous cell carcinoma (OSCC). The patient had extensive tattoos on his neck. This pigmented lymph node was not identified to be the sentinel lymph node using static and dynamic lymphoscintigraphy. Subsequent histological analysis revealed tattoo pigment within this lymph node. It is important during cervical SLNB to be aware that cutaneous tattoos can pigment lymph nodes. PMID:26188933

  12. Application of Sentinel Lymph Node Biopsy in Cutaneous Basosquamous Carcinoma

    PubMed Central

    Kovacevic, Predrag; Visnjic, Milan; Jankovic, Dimitrije; Binic, Ivana; Jankovic, Aleksandar; Ilic, Ivan

    2011-01-01

    Basosquamous carcinoma of the skin is a relatively rare cutaneous neoplasm that has significant metastatic potential and a metastatic rate greater than that of basal cell and squamous cell carcinoma. We describe the use of lymphatic mapping and sentinel lymph node biopsy in a 63-year-old man after identification of basosquamous carcinoma. Sentinel lymph node biopsy, which is a standard tool to detect regional lymphatic metastasis in cutaneous melanoma, has been rarely employed to detect lymphatic metastasis of basosquamous carcinoma. The approach was successful in detecting a regional lymphatic metastasis of two nodal basins with minor morbidity. Sentinel lymph node biopsy may be useful for certain high-risk lesions of basosquamous carcinoma. PMID:22028558

  13. Treatment plan for breast cancer with sentinel node metastasis

    PubMed Central

    Abreu, Efrén Bolívar; Martinez, Pedro; Betancourt, Luis; Romero, Gabriel; Godoy, Ali; Bergamo, Laura

    2014-01-01

    Lymph node involvement is considered to be one of the most important independent prognostic factors in breast cancer. In patients without palpable lymphadenopathies, the method of choice for determining this involvement is the sentinel lymph node biopsy. In the presence of macrometastases, the current standard is to perform axillary lymph node dissection in spite of the knowledge that the involvement of non-sentinel lymph nodes is approximately 50%. When lymph node involvement is micrometastasic, the decision as to whether or not to proceed with lymphadenectomy remains in dispute. We set out, on the basis of the current scientific evidence and our own experience, to create guidelines that allow us to individualise each case and decide whether or not to perform a lymphadenectomy. We will discuss the arguments that support our position. PMID:24478806

  14. [The validity of the sentinel node concept in gastrointestinal cancers].

    PubMed

    Kitagawa, Y; Fujii, H; Mukai, M; Ando, N; Kubota, T; Ikeda, T; Ohgami, M; Watanabe, M; Otani, Y; Ozawa, S; Hasegawa, H; Furukawa, T; Nakahara, T; Kubo, A; Kumai, K; Kitajima, M

    2000-03-01

    Although the sentinel node concept has been validated and clinically applied to breast cancer and malignant melanoma, its clinical significance in other solid tumors has not been thoroughly investigated. With regard to gastrointestinal (GI) cancers in particular, our surgeons have been cautious because of the high frequency of skip metastasis and the complicated lymphatic system in the GI tract. We would like to emphasize that so-called skip metastasis has been defined according to anatomic classification of regional lymph nodes and that the lymphatic drainage route must be patient or lesion specific. To test the validity and feasibility of this concept in GI cancers, we have established a radio-guided intraoperative sentinel node navigation system using preoperative endoscopic submucosal injection of radioactive tracer followed by intra-operative gamma-probing. In 131 patients with GI cancers (esophagus: 22, stomach: 71, colorectum: 38), the detection rate of sentinel nades was 91% and overall diagnostic accuracy of lymph node metastasis by sentinel node status was 97%. Initial results suggest further investigation of this procedure as an accurate staging and a minimally invasive approach to early GI cancers. PMID:10774000

  15. Credentialing issues with sentinel lymph node staging for breast cancer.

    PubMed

    Tafra, L; McMasters, K M; Whitworth, P; Edwards, M J

    2000-10-01

    Sentinel lymphadenectomy (SL) is a minimally invasive approach for staging patients with breast cancer. SL, when performed in lieu of axillary dissection, is associated with less morbidity and is potentially more cost effective and more accurate than the historical axillary dissection in the detection of regional nodal metastases. The credentialing and privileging of SL, as with any surgical procedure, is by the policies of the local hospital or institution. The suggested credentialing criteria for local hospitals has been an area of controversy. Herein the authors outline the credentialing controversy and suggest criteria for the implementation of sentinel lymph node staging for breast cancer. PMID:11113433

  16. Internal mammary sentinel lymph node biopsy: abandon or persist?

    PubMed Central

    Qiu, Peng-Fei; Liu, Yan-Bing; Wang, Yong-Sheng

    2016-01-01

    Although the 2009 American Joint Committee on Cancer incorporated the internal mammary sentinel lymph node biopsy (IM-SLNB) concept, there has been little change in surgical practice patterns due to the low visualization rate of internal mammary sentinel lymph nodes with the traditional injection technique. Meanwhile, as internal mammary lymph nodes (IMLN) metastases are mostly found concomitantly with axillary lymph nodes (ALN) metastases, previous IM-SLNB clinical trials fail to evaluate the status of IMLN in patients who are really in need (only in clinically ALN negative patients). Our modified injection technique (periareolar intraparenchymal, high volume, and ultrasonographic guidance) significantly improved the visualization rate of internal mammary sentinel lymph nodes, making the routine IM-SLNB possible in daily practice. IM-SLNB could provide individual minimally invasive staging, prognosis, and decision-making for breast cancer patients, especially for patients with clinically positive ALN. Moreover, IMLN radiotherapy should be tailored and balanced between the potential benefit and toxicity, and IM-SLNB-guided IMLN radiotherapy could achieve this goal. In the era of effective adjuvant therapy, within the changing treatment approach – more systemic therapy, less loco-regional therapy – clinicians should deliberate the application of regional IMLN therapy. PMID:27390528

  17. Internal mammary sentinel lymph node biopsy: abandon or persist?

    PubMed

    Qiu, Peng-Fei; Liu, Yan-Bing; Wang, Yong-Sheng

    2016-01-01

    Although the 2009 American Joint Committee on Cancer incorporated the internal mammary sentinel lymph node biopsy (IM-SLNB) concept, there has been little change in surgical practice patterns due to the low visualization rate of internal mammary sentinel lymph nodes with the traditional injection technique. Meanwhile, as internal mammary lymph nodes (IMLN) metastases are mostly found concomitantly with axillary lymph nodes (ALN) metastases, previous IM-SLNB clinical trials fail to evaluate the status of IMLN in patients who are really in need (only in clinically ALN negative patients). Our modified injection technique (periareolar intraparenchymal, high volume, and ultrasonographic guidance) significantly improved the visualization rate of internal mammary sentinel lymph nodes, making the routine IM-SLNB possible in daily practice. IM-SLNB could provide individual minimally invasive staging, prognosis, and decision-making for breast cancer patients, especially for patients with clinically positive ALN. Moreover, IMLN radiotherapy should be tailored and balanced between the potential benefit and toxicity, and IM-SLNB-guided IMLN radiotherapy could achieve this goal. In the era of effective adjuvant therapy, within the changing treatment approach - more systemic therapy, less loco-regional therapy - clinicians should deliberate the application of regional IMLN therapy. PMID:27390528

  18. Aggressive Digital Papillary Adenocarcinoma: Case Report of a Positive Sentinel Lymph Node and Discussion of Utility of Sentinel Lymph Node Biopsy.

    PubMed

    Kempton, Steve J; Navarrete, Andrew D; Salyapongse, A Neil

    2015-07-01

    Aggressive digital papillary adenocarcinoma (ADPA) is an uncommon eccrine sweat gland tumor of the distal extremities that is associated with a high rate of local recurrence and distant metastasis. Current opinion suggests that sentinel lymph node evaluation should be done for high-risk tumors where lymph node spread is a concern. Despite documented spread to regional lymph nodes, information on sentinel lymph node status in ADPA is reported infrequently, with only 1 documented case of positive findings. We report on a case of ADPA of the right long finger where sentinel lymph node biopsy was done and positive for metastases in the axilla, resulting in a subsequent completion lymphadenectomy. To determine the benefit of sentinel lymph node biopsy in ADPA, there is a need for more cases of sentinel lymph node evaluation along with data on local recurrence and distant metastasis in those with positive and negative findings. PMID:25954845

  19. [Sentinel node in melanoma and breast cancer. Current considerations].

    PubMed

    Vidal-Sicart, S; Vilalta Solsona, A; Alonso Vargas, M I

    2015-01-01

    The main objectives of sentinel node (SN) biopsy is to avoid unnecessary lymphadenectomies and to identify the 20-25% of patients with occult regional metastatic involvement. This technique reduces the associated morbidity from lymphadenectomy and increases the occult lymphatic metastases identification rate by offering the pathologist the or those lymph nodes with the highest probability of containing metastatic cells. Pre-surgical lymphoscintigraphy is considered a "road map" to guide the surgeon towards the sentinel nodes and to localize unpredictable lymphatic drainage patterns. The SPECT/CT advantages include a better SN detection rate than planar images, the ability to detect SNs in difficult to interpret studies, better SN depiction, especially in sites closer to the injection site and better anatomic localization. These advantages may result in a change in the patient's clinical management both in melanoma and breast cancer. The correct SN evaluation by pathology implies a tumoral load stratification and further prognostic implication. The use of intraoperative imaging devices allows the surgeon a better surgical approach and precise SN localization. Several studies reports the added value of such devices for more sentinel nodes excision and a complete monitoring of the whole procedure. New techniques, by using fluorescent or hybrid tracers, are currently being developed. PMID:25455506

  20. Three Different Locations of a Sentinel Node Highlight the Importance of Performing a Sentinel Node Biopsy in Breast Cancer Recurrence

    PubMed Central

    Albert, Adrien; Huyghe, Ivan; Stroobants, Sigrid; Tjalma, Wiebren A.A.

    2016-01-01

    A local breast cancer recurrence or a new breast cancer in the previously treated breast is a staging challenge. Staging is important to tailor the local and the systemic treatment. Earlier treatment(s) can disrupt the primary lymphatic drainage. After the disruption, new lymphatic drainage pathways are often created. The identification of these new pathways together with their sentinel node(s) (SN) is important for retreatment. A fluorodeoxyglucose positron emission tomography-computerized tomography could be useful to identify the involved node(s), but, unfortunately, there is no evidence to support this. Ideally, in the case of a recurrence, an SN biopsy should be performed in order to identify the “new” draining lymph node(s). This new draining SN(s) can be located in unexpected places, and tumor invasion will lead to a change in the management. PMID:26792995

  1. Dendronized iron oxide colloids for imaging the sentinel lymph node

    NASA Astrophysics Data System (ADS)

    Jouhannaud, J.; Garofalo, A.; Felder-Flesch, D.; Pourroy, G.

    2015-03-01

    Various methods have been used in medicine for more than one century to explore the lymphatic system. Radioactive colloids (RuS labelled with 99mTc) or/and Vital Blue dye are injected around the primary tumour and detected by means of nuclear probe or visual colour inspection respectively. The simultaneous clinical use of both markers (dye and radionuclide) improves the sensitivity of detection close to 100%. Superparamagnetic iron oxides (SPIOs) are currently receiving much attention as strong T2 weighted magnetic resonance imaging contrast agents that can be potentially used for preoperative localization of sentinel nodes, but also for peroperative detection of sentinel node using hand-held probes. In that context, we present the elaboration of dendronized iron oxide nanoparticles elaborated at the Institute of Physics and Chemistry of Materials of Strasbourg.

  2. Axillary web syndrome following sentinel node biopsy for breast cancer.

    PubMed

    Nieves Maldonado, S M; Pubul Núñez, V; Argibay Vázquez, S; Macías Cortiñas, M; Ruibal Morell, Á

    2016-01-01

    A 49 year-old woman diagnosed with infiltrating lobular breast carcinoma, underwent a right mastectomy and sentinel node biopsy (SLNB). The resected sentinel lymph nodes were negative for malignancy, with an axillary lymphadenectomy not being performed. In the early post-operative period, the patient reported an axillary skin tension sensation, associated with a painful palpable cord. These are typical manifestations of axillary web syndrome (AWS), a poorly known axillary surgery complication, from both invasive and conservative interventions. By presenting this case we want to focus the attention on a pathological condition, for which its incidence may be underestimated by not including it in SLNB studies. It is important for nuclear medicine physicians to be aware of AWS as a more common complication than infection, seroma, or lymphoedema, and to discuss this possible event with the patient who is consenting to the procedure. PMID:27246290

  3. Impact of non-axillary sentinel node biopsy on staging and treatment of breast cancer patients

    PubMed Central

    Tanis, P J; Nieweg, O E; Valdés Olmos, R A; Peterse, J L; Rutgers, E J Th; Hoefnagel, C A; Kroon, B B R

    2002-01-01

    The purpose of this study was to evaluate the occurrence of lymphatic drainage to non-axillary sentinel nodes and to determine the implications of this phenomenon. A total of 549 breast cancer patients underwent lymphoscintigraphy after intratumoural injection of 99mTc-nanocolloid. The sentinel node was intraoperatively identified with the aid of intratumoural administered patent blue dye and a gamma-ray detection probe. Histopathological examination of sentinel nodes included step-sectioning at six levels and immunohistochemical staining. A sentinel node outside level I or II of the axilla was found in 149 patients (27%): internal mammary sentinel nodes in 86 patients, other non-axillary sentinel nodes in 44 and both internal mammary and other non-axillary sentinel nodes in nineteen patients. The intra-operative identification rate was 80%. Internal mammary metastases were found in seventeen patients and metastases in other non-axillary sentinel nodes in ten patients. Staging improved in 13% of patients with non-axillary sentinel lymph nodes and their treatment strategy was changed in 17%. A small proportion of clinically node negative breast cancer patients can be staged more precisely by biopsy of sentinel nodes outside level I and II of the axilla, resulting in additional decision criteria for postoperative regional or systemic therapy. British Journal of Cancer (2002) 87, 705–710. doi:10.1038/sj.bjc.6600359 www.bjcancer.com © 2002 Cancer Research UK PMID:12232750

  4. Internal Mammary Sentinel Lymph Node Biopsy With Modified Injection Technique

    PubMed Central

    Qiu, Peng-Fei; Cong, Bin-Bin; Zhao, Rong-Rong; Yang, Guo-Ren; Liu, Yan-Bing; Chen, Peng; Wang, Yong-Sheng

    2015-01-01

    Abstract Although the 2009 American Joint Committee on Cancer incorporated the internal mammary sentinel lymph node biopsy (IM-SLNB) concept, there has been little change in surgical practice patterns because of the low visualization rate of internal mammary sentinel lymph nodes (IMSLN) with the traditional radiotracer injection technique. In this study, various injection techniques were evaluated in term of the IMSLN visualization rate, and the impact of IM-SLNB on the diagnostic and prognostic value were analyzed. Clinically, axillary lymph nodes (ALN) negative patients (n = 407) were divided into group A (traditional peritumoral intraparenchymal injection) and group B (modified periareolar intraparenchymal injection). Group B was then separated into group B1 (low volume) and group B2 (high volume) according to the injection volume. Clinically, ALN-positive patients (n = 63) were managed as group B2. Internal mammary sentinel lymph node biopsy was performed for patients with IMSLN visualized. The IMSLN visualization rate was significantly higher in group B than that in group A (71.1% versus 15.5%, P < 0.001), whereas the axillary sentinel lymph nodes were reliably identified in both groups (98.9% versus 98.3%, P = 0.712). With high injection volume, group B2 was found to have higher IMSLN visualization rate than group B1 (75.1% versus 45.8%, P < 0.001). The IMSLN metastasis rate was only 8.1% (12/149) in clinically ALN-negative patients with successful IM-SLNB, and adjuvant treatment was altered in a small proportion. The IMSLN visualization rate was 69.8% (44/63) in clinically ALN-positive patients with the IMSLN metastasis rate up to 20.5% (9/44), and individual radiotherapy strategy could be guided with the IM-SLNB results. The modified injection technique (periareolar intraparenchymal, high volume, and ultrasound guidance) significantly improved the IMSLN visualization rate, making the routine IM-SLNB possible in daily practice. Internal

  5. The role of sentinel lymph-node biopsy (SLNB) in the treatment of breast cancer.

    PubMed

    Marrazzo, Antonio; Taormina, Pietra; David, Massimo; Casà, Luigi; Lo Gerfo, Domenico; Noto, Antonio; Riili, Ignazio; Ficola, Umberto; Russo, Leila

    2006-01-01

    Sentinel lymph-node biopsy is an innovative method for axillary staging in breast cancer patients, based on the concept that information about the status of the entire lymphatic drainage from a tumour site could be obtained by identification and sampling of a "sentinel node". The aim of the study was to evaluate the impact of sentinel lymph-node biopsy in the management of patients with early invasive breast carcinoma. Three hundred and forty-one patients with primary invasive breast carcinoma measuring less than 2 cm (less than 3 cm from January 2001) and clinically negative axillary nodes were recruited into the study. Sentinel lymph-nodes were positive for metastases in 108/341 cases (31.7%). Micrometastases were found in 22 patients and isolated tumour cells in 1 case. The mean number of sentinel lymph-nodes removed was 1.8 per patient. The sentinel lymph-node was the only positive node in 57 of 108 patients (52.8%). The percentage of axillary recurrence in sentinel lymph-node-negative patients was 0%. The accuracy of sentinel lymph-node biopsy for axillary staging has been confirmed in many studies. Axillary recurrences after sentinel lymph-node biopsy range from 0 to 1.6% in many series, while axillary recurrence after axillary lymph-node dissection is about 0-3%. In our experience we observed no axillary recurrences in 233 patients with sentinel lymph-node biopsy alone, with a median follow-up of 33 months, confirming the accuracy of the procedure, and sentinel lymph-node-negative patients with sentinel lymph-node biopsy alone are no more at risk for axillary recurrences than those undergoing axillary lymph-node dissection. PMID:16845865

  6. Breast cancer recurrence after sentinel lymph node biopsy

    PubMed Central

    AlSaif, Abdulaziz

    2015-01-01

    Objective: To look into the pattern of breast cancer recurrence following mastectomy, breast conservative surgery and radiotherapy or chemotherapy after SLNB at our institution. Methods: Between January 2005 and December 2014, all patients diagnosed with breast cancer with clinically negative axilla, underwent SLNB. We reviewed their medical records to identify pattern of cancer recurrence. Results: The median follow-up was 35.5 months. Eighty five patients (70.8%) had a negative sentinel lymph node (SLN) and subsequently had no further axillary treatment, one of them (1.2%) developed axillary recurrence 25 months postoperatively. Twenty five patients (20.8%) had a positive SLN (macrometastases) and subsequently had immediate axillary lymph node dissection (ALND). Ten patients (8.3%) had a positive SLN (micrometastases). In the positive SLN patients (macrometastases and micrometastases), there were two ipsilateral breast recurrences (5.7%), seen three and four years postoperatively. Also in this group, there was one (2.9%) distant metastasis to bone three years postoperatively. Conclusion: In this series, the clinical axillary false negative rate for SLNB was 1.2% which is in accordance with the published literature. This supports the use of SLNB as the sole axillary staging procedure in breast cancer patients with negative SLNB. Axillary lymph node dissection can be safely omitted in patients with micrometastases in their sentinel lymph node(s). PMID:26870109

  7. Clinical utilities and biological characteristics of melanoma sentinel lymph nodes

    PubMed Central

    Han, Dale; Thomas, Daniel C; Zager, Jonathan S; Pockaj, Barbara; White, Richard L; Leong, Stanley PL

    2016-01-01

    An estimated 73870 people will be diagnosed with melanoma in the United States in 2015, resulting in 9940 deaths. The majority of patients with cutaneous melanomas are cured with wide local excision. However, current evidence supports the use of sentinel lymph node biopsy (SLNB) given the 15%-20% of patients who harbor regional node metastasis. More importantly, the presence or absence of nodal micrometastases has been found to be the most important prognostic factor in early-stage melanoma, particularly in intermediate thickness melanoma. This review examines the development of SLNB for melanoma as a means to determine a patient’s nodal status, the efficacy of SLNB in patients with melanoma, and the biology of melanoma metastatic to sentinel lymph nodes. Prospective randomized trials have guided the development of practice guidelines for use of SLNB for melanoma and have shown the prognostic value of SLNB. Given the rapidly advancing molecular and surgical technologies, the technical aspects of diagnosis, identification, and management of regional lymph nodes in melanoma continues to evolve and to improve. Additionally, there is ongoing research examining both the role of SLNB for specific clinical scenarios and the ways to identify patients who may benefit from completion lymphadenectomy for a positive SLN. Until further data provides sufficient evidence to alter national consensus-based guidelines, SLNB with completion lymphadenectomy remains the standard of care for clinically node-negative patients found to have a positive SLN. PMID:27081640

  8. Sentinel node navigation surgery for gastroduodenal neuroendocrine tumors

    PubMed Central

    Arigami, Takaaki; Uenosono, Yoshikazu; Yanagita, Shigehiro; Okubo, Keishi; Kijima, Takashi; Matsushita, Daisuke; Amatatsu, Masahiko; Hagihara, Takahiko; Haraguchi, Naoto; Mataki, Yuko; Ehi, Katsuhiko; Ishigami, Sumiya; Natsugoe, Shoji

    2016-01-01

    Abstract The percentage of gastroduodenal neuroendocrine tumors (NETs) among all gastroenteropancreatic (GEP) NETs has gradually increased worldwide. Sentinel node navigation surgery (SNNS) has been developed as a personalized approach in the surgical strategy for early gastrointestinal tract cancers. We herein report 2 cases of gastroduodenal NETs treated with SNNS. 99m Technetium-tin colloid including indocyanine green was endoscopically injected into the submucosa around a tumor the day before surgery. Basin dissection including the sentinel nodes (SNs), which were identified by Navigator GPS and near-infrared fluorescence imaging, was performed during laparoscopic surgery. SNs were intraoperatively examined using hematoxylin–eosin (HE) staining. SNs were detected in 2 patients. Lymph node metastasis was intraoperatively identified in 1 of the 2 patients. Consequently, 1 patient with metastatic SNs underwent laparoscopic gastrectomy with lymphadenectomy. Pathological findings identified submucosal NET measuring 6.0 mm × 5.0 mm. Our results suggest that SNNS is a promising surgical tool for detecting subclinical lymph node metastasis in patients with gastroduodenal NETs. PMID:27368046

  9. Role of dynamic sentinel node biopsy in carcinoma penis with or without palpable nodes

    PubMed Central

    Kathiresan, N.; Raja, Anand; Ramachandran, Krishna Kumar; Sundersingh, Shirley

    2016-01-01

    Introduction: We aimed to evaluate the role of dynamic sentinel node biopsy (DSLNB) in patients diagnosed with carcinoma penis and clinically N0 disease using superficial inguinal dissection as the standard staging modality. Materials and Methods: Twenty consecutive men (40 groins) with carcinoma penis having clinically N0 status were enrolled in the study. Patients underwent DSLNB if fine needle aspiration cytology from the groin nodes was negative, followed by injection of radiocolloid and blue dye. The sentinel lymph node(s) were harvested. The inguinal incision was then extended and a modified superficial inguinal dissection was performed and all nodes were labeled separately and sent for frozen section. A completion deep inguinal with pelvic dissection was performed if any of the nodes were reported positive for malignancy. Results: The median age of the patients was 52.5 years. Ten patients were smokers. Phimosis was present in five patients. Lesions were present over the glans penis and shaft in 18 and two patients, respectively. Wide local excision, partial penectomy and total penectomy were performed in one, 15 and four patients, respectively. Clinically palpable nodes were found in 19 groins. Median follow-up was 26 months. Nodes were positive in 10 groins. DSLNB missed the sentinel node in one groin. The accuracy and false-negative rate of DSLNB was 97.5% and 10%, respectively. Conclusion: DSLNB is a useful and reliable technique to identify the involved node(s) in patients diagnosed as having carcinoma penis with clinical N0 status (with or without palpable nodes). It helps to avoid the morbidity associated with a staging inguinal dissection in these patients. PMID:26941496

  10. Update on sentinel lymph node evaluation in gynecologic malignancies

    PubMed Central

    Robison, Katina; Holman, Laura L.; Moore, Richard G.

    2016-01-01

    Purpose of review Sentinel lymph node (SLN) dissections have been shown to be sensitive for the evaluation of nodal basins for metastatic disease and are associated with decreased short-term and long-term morbidity when compared with complete lymph node dissection. There has been increasing interest in the use of SLN technology in gynecologic cancers. This review assesses the current evidence-based literature for the use of SLN dissections in gynecologic malignancies. Recent findings Recent literature continues to support the safety and feasibility of SLN biopsy for early-stage vulvar cancer with negative predictive value approaching 100% and low false-negative rates. Alternatively, for endometrial cancer most studies have reported low false-negative rates, with variable sensitivities and have reported low detection rates of the sentinel node. Studies examining the utility of SLN biopsy in early-stage cervical cancer remain promising with detection rates, sensitivities, and false-negative rates greater than 90% for stage 1B1 tumors. Summary SLN dissections have been shown to be effective and safe in certain, select vulvar cancer patients and can be considered an alternative surgical approach for these patients. For endometrial and cervical cancer, SLN dissection continues to have encouraging results and however needs further investigation. PMID:21235023

  11. Current status of sentinel lymph node biopsy in patients with melanoma.

    PubMed

    Nieweg, O E

    2014-10-01

    The sentinel node is defined as a lymph node on a direct lymphatic drainage pathway from the primary tumour. The sentinel node biopsy is an invasive and potentially complex diagnostic test that requires considerable skill and experience from nuclear medicine physicians, surgeons and pathologists involved in the process. The procedure provides important staging information. The tumour bearing status of a regional lymph node basin is the most important prognostic factor for patients with a clinically localised melanoma. The recently published final report of the first Multicenter Selective Lymphadenectomy Trial (MSLT-1) shows that sentinel node biopsy with subsequent regional node dissection improves the survival rate in patients with nodal metastases from an intermediate Breslow thickness melanoma (1.23.5 mm). The false negative rate is substantial but can be limited by experience, a meticulous technique and close cooperation of the specialists involved. The surgical procurement of the sentinel nodes is associated with minor morbidity. Sentinel node biopsy is now part of the standard work-up in patients with intermediate thickness melanoma and can be considered in patients with a thinner or thicker melanoma. New lymph node tracers and innovative imaging techniques are likely to improve the sensitivity of the procedure further. Now that the results of MSLT-1 are available, the next question is whether sentinel node-positive patients require further surgery. This issue is addressed by EORTCs Minitub study and the MSLT-2. Until these studies yield results, regional node dissection is recommended for patients with sentinel node metastases. PMID:25340862

  12. Photoacoustic image-guided needle biopsy of sentinel lymph nodes

    NASA Astrophysics Data System (ADS)

    Kim, Chulhong; Erpelding, Todd N.; Akers, Walter J.; Maslov, Konstantin; Song, Liang; Jankovic, Ladislav; Margenthaler, Julie A.; Achilefu, Samuel; Wang, Lihong V.

    2011-03-01

    We have implemented a hand-held photoacoustic and ultrasound probe for image-guided needle biopsy using a modified clinical ultrasound array system. Pulsed laser light was delivered via bifurcated optical fiber bundles integrated with the hand-held ultrasound probe. We photoacoustically guided needle insertion into rat sentinel lymph nodes (SLNs) following accumulation of indocyanine green (ICG). Strong photoacoustic image contrast of the needle was achieved. After intradermal injection of ICG in the left forepaw, deeply positioned SLNs (beneath 2-cm thick chicken breast) were easily indentified in vivo and in real time. Further, we confirmed ICG uptake in axillary lymph nodes with in vivo and ex vivo fluorescence imaging. These results demonstrate the clinical potential of this hand-held photoacoustic system for facile identification and needle biopsy of SLNs for cancer staging and metastasis detection in humans.

  13. Sentinel lymph node biopsy in paediatric melanoma. A case series.

    PubMed

    Sánchez Aguilar, M; Álvarez Pérez, R M; García Gómez, F J; Fernández Ortega, P; Borrego Dorado, I

    2015-01-01

    The incidence of melanoma in children is uncommon, being particularly rare in children under 10 years-old. However, this disease is increasing by a mean of 2% per year. As in adults, the lymph node status is the most important prognostic factor, crucial to performing the selective sentinel lymph node biopsy (SLNB). We report 3 cases of paediatric patients of 3, 4 and 8 years-old, in which SLNB was performed for malignant melanoma. Paediatric age implies greater technical difficulty to the scintigraphy scan due to poor patient cooperation, with mild sedation required in some cases, and only being able to acquire planar images in other cases. SPECT/CT was only performed in the oldest patient. In our cases, SLNB was useful for selecting the least invasive surgery in order to reduce morbidity. PMID:25595513

  14. Sentinel lymph node biopsy for conjunctival malignant melanoma: surgical techniques

    PubMed Central

    Wainstein, Alberto JA; Drummond-Lage, Ana P; Kansaon, Milhem JM; Bretas, Gustavo O; Almeida, Rodrigo F; Gloria, Ana LF; Figueiredo, Ana RP

    2015-01-01

    Background The purpose of this report is to examine the viability and safety of preoperative lymphoscintigraphy and radio guided sentinel lymph node (SLN) biopsy for conjunctival melanoma, and to identify the best technique to perform this procedure. Methods Three patients diagnosed with malignant melanoma of the conjunctiva underwent lymphoscintigraphy and SLN biopsy using a dual technique comprising isosulfan blue dye and technetium Tc 99m sulfur colloid. Each patient was anesthetized and the conjunctival melanoma was excised. SLNs were localized by a gamma probe, identified according to radioactivity and sentinel blue printing, and dissected, along with drainage of the associated lymphatic basins. The SLNs were evaluated by a pathologist using hematoxylin-eosin staining following serial sectioning and immunohistochemistry using a triple melanoma cocktail (S-100, Melan-A, and HMB-45 antigens). Results Two SLNs were stained in the jugular chain during preoperative lymphoscintigraphy in the first patient, two SLNs were identified in the preauricular and submandibular areas in the second patient, and two SLNs were identified in the submandibular and parotid areas in the third patient. All lymph nodes identified by lymphoscintigraphy were dissected and identified at surgery with 100% accuracy in all three patients. All SLNs were histologically and immunohistochemically negative. Patients had good cosmetic and functional results, and maintained their visual acuity and ocular motility. Conclusion Patients with conjunctival melanoma can undergo preoperative lymphoscintigraphy and SLN biopsy safely using radioactive technetium and isosulfan blue dye. PMID:25565762

  15. Ex Vivo Sentinel Node Mapping in Colon Cancer Combining Blue Dye Staining and Fluorescence Imaging

    PubMed Central

    Schaafsma, Boudewijn E.; Verbeek, Floris P.R.; van der Vorst, Joost R.; Hutteman, Merlijn; Kuppen, Peter J.K.; Frangioni, John V.; van de Velde, Cornelis J.H.; Vahrmeijer, Alexander L.

    2013-01-01

    Background The sentinel lymph node procedure has been proposed to improve nodal staging in colon cancer patients. The aim of this study was to assess the added value of near-infrared fluorescence imaging to conventional blue dye staining for ex vivo sentinel lymph node mapping. Materials and Methods Twenty-two consecutive patients undergoing surgery for colon cancer were included. After tumor resection, a premixed cocktail of the near-infrared lymphatic tracer HSA800 and blue dye was submucosally injected around the tumor for detection of sentinel lymph nodes. The Mini-FLARE imaging system was used for fluorescence imaging. Results In 95% of the patients, at least one sentinel lymph node was identified. Overall, a total of 77 sentinel lymph nodes were identified, of which 77 were fluorescent (100%) and 70 (91%) were blue. Sentinel lymph nodes that were located deeper in the mesenteric fat could easily be located by NIR fluorescence. In 4 out of 5 patients with lymph node metastases, tumor cells were present in at least 1 of the sentinel lymph nodes. Conclusions This study shows the successful use and added value of the near-infrared fluorescence tracer HSA800 to conventional blue dye for the ex vivo sentinel lymph node procedure in colon cancer. PMID:23391167

  16. Review of the role of sentinel node biopsy in cutaneous head and neck melanoma.

    PubMed

    Roy, Jennifer M; Whitfield, Robert J; Gill, P Grantley

    2016-05-01

    Sentinel node biopsy (SNB) is recommended for selected melanoma patients in many parts of the world. This review examines the evidence surrounding the accuracy and prognostic value of SNB and completion neck dissection in head and neck melanoma. Sentinel nodes were identified in an average of 94.7% of head and neck cases compared with 95.3-100% in all melanoma cases. More false-negative sentinel nodes were found in head and neck cases. A positive sentinel node was associated with both lower disease-free survival (53.4 versus 83.2%) and overall survival (40 versus 84%). We conclude that SNB should be offered to all patients with intermediate and high-risk melanomas in the head and neck area. To date, evidence does not exist to demonstrate the safety of avoiding completion lymph node dissection in sentinel node-positive patients with head and neck melanoma. PMID:26362016

  17. Sentinel node in ovarian cancer: study protocol for a phase 1 study

    PubMed Central

    2013-01-01

    Background The concept of sentinel lymph node surgery is to determine whether the cancer has spread to the very first lymph node or sentinel node. If the sentinel node does not contain cancer, then there is a high likelihood that the cancer has not spread to other lymph nodes. The sentinel node technique has been proven to be effective in different types of cancer. In this study we want to determine whether a sentinel node procedure in patients with ovarian cancer is feasible when the tracers are injected into the ovarian ligaments. Methods/Design Patients with a high likelihood of having an ovarian malignancy in whom a median laparotomy and a frozen section analysis is planned and patients with endometrial cancer in whom a staging laparotomy is planned will be included. Before starting the surgical staging procedure, blue dye and radioactive colloid will be injected into the ligamentum ovarii proprium and the ligamentum infundibulo-pelvicum. In the analysis we calculate the percentage of patients in whom it is feasible to identify sentinel nodes. Other study parameters are the anatomical localization of the sentinel node(s) and the incidence of false negative lymph nodes. Trial registration Approval number: NL40323.068.12 Name: Medical Ethical Committee Maastricht University Hospital, University of Maastricht Affiliation: Maastricht University Hospital Board Chair Name: Medisch Ethische Commissie azM/UM PMID:23414057

  18. Lymphangiogenesis in breast cancer is associated with non-sentinel lymph node metastases in sentinel node positive patients

    PubMed Central

    Lv, Lin; Ma, Rui-Min; Yang, Fan; Zhang, Xiao-Hua; Huang, Du-Ping

    2015-01-01

    Axillary lymph node dissection (ALND) is not suggested in breast cancer patients with negative sentinel lymph node (SLN) biopsies, and SLN is the only positive node in 40-70% of the remaining cases. To distinguish a subgroup in which ALND would be omitted, we investigated the role of lymphangiogenesis in primary breast cancer as a risk factor for distal lymph node involvements in patients with positive SLNs. 86 patients were included in this study. The frequency of proliferative lymphatic endothelial cells (LECP%) was evaluated in each specimen after immunohistochemical double staining for D2-40 and Ki-67. Larger primary tumor size, increased number of positive SLNs, lymphatic vessel invasion and LECP% were significantly associated with non-SLN metastases in the univariate analysis, but only LECP% retained significance in the multivariate model. A positive correlation between LECP% and lymphatic vessel invasion was also revealed. Our study confirmed the important role of lymphangiogenesis in tumor spread, and suggested that LECP% is a promising predictor for additional axillary lymph node involvements. PMID:26617838

  19. Importance of sentinel lymph nodes in colorectal cancer: a pilot study.

    PubMed

    Köksal, Hande; Bostanci, Hasan; Mentes, B Bülent

    2007-01-01

    Accurate identification of lymph nodes involved in metastases is vitally important for predicting survival, and it facilitates decision making with regard to adjuvant therapy. The study described here, which was undertaken to evaluate the role of sentinel lymph node mapping in refining the staging of colorectal cancer, was performed prospectively in 19 patients with colorectal cancer who underwent surgery from January to July 2005. Sentinel lymph node sampling was performed during each operation with isosulfan blue dye. Additional immunohistochemical staining was performed only if the sentinel nodes were negative for metastasis. In 18 of 19 patients, at least 1 sentinel node was identified. In 5 of 18 patients, sentinel nodes were positive for metastasis, and in 3 of 5, the sentinel node was the only node containing metastasis that was detected by immunohistochemical staining. In 3 patients, metastases in nonsentinel lymph nodes were detected by hematoxylin and eosin staining; these were determined to be false-negative results. Upstaging associated with sentinel lymph node mapping may reveal disease that might otherwise remain undetected by conventional methods. Patients who are upstaged may benefit from adjuvant therapies that have been shown to improve survival. PMID:17660167

  20. First Robotic SPECT for Minimally Invasive Sentinel Lymph Node Mapping.

    PubMed

    Fuerst, Bernhard; Sprung, Julian; Pinto, Francisco; Frisch, Benjamin; Wendler, Thomas; Simon, Hervé; Mengus, Laurent; van den Berg, Nynke S; van der Poel, Henk G; van Leeuwen, Fijs W B; Navab, Nassir

    2016-03-01

    In this paper we present the usage of a drop-in gamma probe for intra-operative Single-Photon Emission Computed Tomography (SPECT) imaging in the scope of minimally invasive robot-assisted interventions. The probe is designed to be inserted and reside inside the abdominal cavity during the intervention. It is grasped during the procedure using a robotic laparoscopic gripper enabling full six degrees of freedom handling by the surgeon. We demonstrate the first deployment of the tracked probe for intra-operative in-patient robotic SPECT enabling augmented-reality image guidance. The hybrid mechanical- and image-based in-patient probe tracking is shown to have an accuracy of 0.2 mm. The overall system performance is evaluated and tested with a phantom for gynecological sentinel lymph node interventions and compared to ground-truth data yielding a mean reconstruction accuracy of 0.67 mm. PMID:26561283

  1. Compact intraoperative imaging device for sentinel lymph node mapping

    NASA Astrophysics Data System (ADS)

    Liu, Yang; Bauer, Adam Q.; Akers, Walter; Sudlow, Gail; Liang, Kexian; Shen, Duanwen; Berezin, Mikhail; Culver, Joseph P.; Achilefu, Samuel

    2011-03-01

    We have developed a novel real-time intraoperative fluorescence imaging device that can detect near-infrared (NIR) fluorescence and map sentinel lymph nodes (SLNs). In contrast to conventional imaging systems, this device is compact, portable, and battery-operated. It is also wearable and thus allows hands-free operation of clinicians. The system directly displays the fluorescence in its goggle eyepiece, eliminating the need for a remote monitor. Using this device in murine lymphatic mapping, the SLNs stained with indocyanine green (ICG) can be readily detected. Fluorescence-guided SLN resection under the new device was performed with ease. Ex vivo examination of resected tissues also revealed high fluorescence level in the SLNs. Histology further confirmed the lymphatic nature of the resected SLNs.

  2. Nanoparticles in Sentinel Lymph Node Assessment in Breast Cancer

    PubMed Central

    Johnson, Laura; Charles-Edwards, Geoff; Douek, Michael

    2010-01-01

    The modern management of the axilla in breast cancer relies on surgery for accurate staging of disease and identifying those patients at risk who would benefit from adjuvant chemotherapy. The introduction of sentinel lymph node biopsy has revolutionized axillary surgery, but still involves a surgical procedure with associated morbidity in many patients with no axillary involvement. Nanotechnology encompasses a broad spectrum of scientific specialities, of which nanomedicine is one. The potential use of dual-purpose nanoprobes could enable imaging the axilla simultaneous identification and treatment of metastatic disease. Whilst most applications of nanomedicine are still largely in the laboratory phase, some potential applications are currently undergoing clinical evaluation for translation from the bench to the bedside. This is an exciting new area of research where scientific research may become a reality. PMID:24281206

  3. [Anaphylactic shock after injection of patent blue for sentinel lymph node biopsy].

    PubMed

    van der Horst, J C; de Bock, M J; Klinkenbijl, J H

    2001-10-27

    After being diagnosed with a melanoma, an 18-year-old woman developed anaphylactic shock following an intracutaneous injection of patent blue during a sentinel lymph node biopsy procedure. Intracutaneous allergy tests revealed positive reactions with patent blue (Bleu patenté V 'Guerbet') as well as with several anaesthetics and morphine. It was concluded that patent blue was the most probable causative agent for the anaphylactic reaction and that the possibility of such a reaction should be taken into consideration during sentinel node procedures. After a few days the operation was completed under epidural anaesthesia with technetium Tc 99m sulphur colloid being used to detect the sentinel node. PMID:11715597

  4. Sentinel lymph node biopsy: technique validation at the Setúbal Medical Centre, Portugal

    PubMed Central

    Ferreira, P; Baía, R; António, A; Almeida, J; Simões, J; Amaro, JC; Quintana, C; Branco, L; Rigueira, MV; Gonçalves, M; Pereira, EV; Ferreira, LM

    2009-01-01

    Aims: To evaluate the accuracy of sentinel lymph node biopsy in breast cancer patients at this institution, using combined technetium-99m (99mTc) sulphur colloid and patent blue vital dye. Methods: From March 2007 to July 2008, 50 patients with a tumour of less than 3 cm and with clinically negative axillary lymph nodes underwent sentinel lymph node biopsy (SLNB), followed by axillary lymph node dissection (ALND). Sub-areolar 99mTc sulphur colloid injection was performed the day before surgery, and patent blue vital dye was also injected sub-areolarly at least 5 minutes before surgery. Sentinel lymph node was identified during the surgical procedure, using a gamma probe and direct vision. All sentinel nodes underwent frozen section analysis. Later haematoxylin and eosin staining and immunohistochemical analysis were performed. Finally, SLNB was compared with standard ALND for its ability to accurately reflect the final pathological status of the axillary nodes. Results: The sentinel lymph node (SLN) was identified in 48 of 50 patients (96%). The number of sentinel lymph nodes ranged from one to four (mean 1.48) and non-sentinel nodes ranged from seven to 27 (mean 14.33). Of the 48 patients with successfully identified SLNs, 29.17% (14/48) were histologically positive. Sensivity of the SLN to predict axilla was 93.75%; accuracy was 97.96%. The SLN was falsely negative in one patient—6.25% (1/16). Conclusions: The SLNB represents a major advance in the surgical treatment of breast cancer as a minimally invasive procedure predicting the axillary lymph node status. This validation study demonstrates the accuracy of the SLNB and its reasonable false negative rate when performed in our institute. It can now be used as the standard method of staging in patients with early breast cancer at this institution. PMID:22275996

  5. Sentinel Lymph Node Occult Metastases Have Minimal Survival Effect in Some Breast Cancer Patients

    Cancer.gov

    Detailed examination of sentinel lymph node tissue from breast cancer patients revealed previously unidentified metastases in about 16% of the samples, but the difference in 5-year survival between patients with and without these metastases was very small

  6. Dextran-based fluorescent nanoprobes for sentinel lymph node mapping.

    PubMed

    Dai, Tingting; Zhou, Shuyan; Yin, Chuyang; Li, Shengli; Cao, Weigang; Liu, Wei; Sun, Kang; Dou, Hongjing; Cao, Yilin; Zhou, Guangdong

    2014-09-01

    Biopsy of sentinel lymph node (SLN) has become a common practice to predict whether tumor metastasis has occurred, so proper SLN positioning tracers are highly required. Due to many drawbacks of SLN tracers currently used, developing ideal, biosafe SLN imaging agents is always an urgent issue. The current study designed a novel fluorescent nanoprobe for accurate SLN mapping. Dextran-based nanogel (DNG) was prepared through a highly efficient self-assembly assisted approach and serves as a multi-functional platform for conjugating wide spectra emitting fluorescent agents. The newly fabricated fluorescent DNG (FDNG) could be designed with optimum size and stable fluorescent intensity for specific SLN imaging. Furthermore, a long-term dynamic course in vivo (from 1 min to 72 h) revealed the satisfactory specificity, sensitivity, and stability for SLN mapping. Most importantly, both in vitro and in vivo evaluations indicated that FDNG had fine biosafety and biocompatibility with lymphatic endothelial cells. All these results supported that FDNG could be used as highly efficient molecular imaging probes for specific, sensitive, stable, non-invasive, and safe SLN mapping, which provides efficient and accurate location for SLN biopsy and thus predicts tumor metastasis as well as directs therapies. Besides, our recent studies further demonstrated that DNG could also serve as a specific and controllable drug carrier, indicating a potential application for specific therapies of various lymph-associated diseases. PMID:24957293

  7. Optimization of Coded Aperture Radioscintigraphy for Sentinel Lymph Node Mapping

    PubMed Central

    Fujii, Hirofumi; Idoine, John D.; Gioux, Sylvain; Accorsi, Roberto; Slochower, David R.; Lanza, Richard C.; Frangioni, John V.

    2011-01-01

    Purpose Radioscintigraphic imaging during sentinel lymph node (SLN) mapping could potentially improve localization; however, parallel-hole collimators have certain limitations. In this study, we explored the use of coded aperture (CA) collimators. Procedures Equations were derived for the six major dependent variables of CA collimators (i.e., masks) as a function of the ten major independent variables, and an optimized mask was fabricated. After validation, dual-modality CA and near-infrared (NIR) fluorescence SLN mapping was performed in pigs. Results Mask optimization required the judicious balance of competing dependent variables, resulting in sensitivity of 0.35%, XY resolution of 2.0 mm, and Z resolution of 4.2 mm at an 11.5 cm FOV. Findings in pigs suggested that NIR fluorescence imaging and CA radioscintigraphy could be complementary, but present difficult technical challenges. Conclusions This study lays the foundation for using CA collimation for SLN mapping, and also exposes several problems that require further investigation. PMID:21567254

  8. Nodal Basin Recurrence After Sentinel Lymph Node Biopsy for Melanoma

    PubMed Central

    Kretschmer, Lutz; Bertsch, Hans Peter; Zapf, Antonia; Mitteldorf, Christina; Satzger, Imke; Thoms, Kai-Martin; Völker, Bernward; Schön, Michael Peter; Gutzmer, Ralf; Starz, Hans

    2015-01-01

    Abstract The objective of this study was to analyze different types of nodal basin recurrence after sentinel lymph node biopsy (SLNB) for melanoma. Patients and Methods: Kaplan–Meier estimates and the Cox proportional hazards model were used to study 2653 patients from 3 German melanoma centers retrospectively. The estimated 5-year negative predictive value of SLNB was 96.4%. The estimated false-negative (FN) rates after 1, 2, 3, 5, and 10 years were 2.5%, 4.6%, 6.4%, 8.7%, and 12.6%, respectively. Independent factors associated with false negativity were older age, fewer SLNs excised, and head or neck location of the primary tumor. Compared with SLN-positive patients, the FNs had a significantly lower survival. In SLN-positive patients undergoing completion lymphadenectomy (CLND), the 5-year nodal basin recurrence rate was 18.3%. The recurrence rates for axilla, groin, and neck were 17.2%, 15.5%, and 44.1%, respectively. Significant factors predicting local relapse after CLND were older age, head, or neck location of the primary tumor, ulceration, deeper penetration of the metastasis into the SLN, tumor-positive CLND, and >2 lymph node metastases. All kinds of nodal relapse were associated with a higher prevalence of in-transit metastases. The FN rate after SLNB steadily increases over the observation period and should, therefore, be estimated by the Kaplan–Meier method. False-negativity is associated with fewer SLNs excised. The beneficial effect of CLND on nodal basin disease control varies considerably across different risk groups. This should be kept in mind about SLN-positive patients when individual decisions on prophylactic CLND are taken. PMID:26356697

  9. Sentinel node biopsy in melanoma using technetium-99m rhenium colloid: the London experience.

    PubMed

    Temple, C L; Scilley, C G; Engel, C J; Shum, D T; Lohmann, R C; Mattar, A G; Zabel, P L

    2000-11-01

    Nodal metastases in patients with melanoma identify a reduction of survival by 50%; however, elective lymph node dissection (ELND) has not been shown clearly to improve survival. Morton's technique of sentinel node biopsy, using preoperative lymphoscintigraphy and intraoperative blue dye, addresses elegantly the controversy regarding ELND. Sentinel node biopsy has been shown to stage the patient accurately because metastases from melanoma follow an orderly progression from the sentinel node to the remainder of the basin. Fifty-six consecutive patients with American Joint Committee on Cancer stage 1b or 2 melanoma seen at the London Health Sciences Center between July 1998 and January 2000 were enrolled prospectively to undergo sentinel node biopsy. Preoperative lymphoscintigraphy was conducted in the nuclear medicine department. A total of 10 to 15 MBq (0.27-0.41 mCi) of technetium 99m (99mTc) rhenium colloid or filtered sulfur colloid was injected intradermally around the biopsy scar. Images were obtained to localize all draining nodal basins. The location of the sentinel node was marked on the skin. The patient was taken to the operating room and anesthetized. Isosulfan blue dye was injected intradermally around the biopsy scar. A hand-held gamma probe was used intraoperatively as a guide to the first draining node. Blue-stained lymphatic channels aided in the dissection. Sentinel node localization was successful in 55 of 56 patients, for an overall success rate of 98%. Preoperative lymphoscintigraphy identified a sentinel node in an unpredictable location in 32% of patients. On average, 2.3 sentinel nodes per patient were identified on the initial scan, and 2.2 sentinel nodes per patient were recovered at surgery. Both 99mTc rhenium and filtered sulfur colloid showed no substantial differences in tracer uptake and retention in the sentinel node. Twelve patients had a positive sentinel node on routine histology, and 11 patients subsequently underwent completion

  10. Sentinel Lymph Node in Breast Cancer: Review Article from a Pathologist’s Point of View

    PubMed Central

    Apple, Sophia K.

    2016-01-01

    Breast cancer staging, in particular N-stage changed most significantly due to the advanced technique of sentinel lymph node biopsy two decades ago. Pathologists have more thoroughly examined and scrutinized sentinel lymph node and found increased number of small volume metastases. While pathologists use the strict criteria from the Tumor Lymph Node Metastasis (TNM) Classification, studies have shown poor reproducibility in the application of American Joint Committee on Cancer and International Union Against Cancer/TNM guidelines for sentinel lymph node classification in breast cancer. In this review article, a brief history of TNM with a focus on N-stage is described, followed by innate problems with the guidelines, and why pathologists may have difficulties in assessing lymph node metastases uniformly. Finally, clinical significance of isolated tumor cells, micrometastasis, and macrometastasis is described by reviewing historical retrospective data and significant prospective clinical trials. PMID:26757203

  11. Distribution of Prostate Sentinel Nodes: A SPECT-Derived Anatomic Atlas

    SciTech Connect

    Ganswindt, Ute; Schilling, David; Mueller, Arndt-Christian; Bares, Roland; Bartenstein, Peter; Belka, Claus

    2011-04-01

    Purpose: The randomized Radiation Therapy Oncology Group 94-13 trial revealed that coverage of the pelvic lymph nodes in high-risk prostate cancer confers an advantage (progression-free survival and biochemical failure) in patients with {>=}15% risk of lymph node involvement. To facilitate an improved definition of the adjuvant target volume, precise knowledge regarding the location of the relevant lymph nodes is necessary. Therefore, we generated a three-dimensional sentinel lymph node atlas. Methods and Materials: In 61 patients with high-risk prostate cancer, a three-dimensional visualization of sentinel lymph nodes was performed using a single photon emission computed tomography system after transrectal intraprostatic injection of 150 to 362 (median 295) mega becquerel (MBq) {sup 99m}Technetium-nanocolloid (1.5-3h after injection) followed by an anatomic functional image fusion. Results: In all, 324 sentinel nodes in 59 of 61 patients (96.7%) were detected, with 0 to 13 nodes per patient (median 5, mean 5.3). The anatomic distribution of the sentinel nodes was as follows: external iliac 34.3%, internal iliac 17.9%, common iliac 12.7%, sacral 8.6%, perirectal 6.2%, left paraaortic 5.3%, right paraaortic 5.3%, seminal vesicle lymphatic plexus 3.1%, deep inguinal 1.5%, superior rectal 1.2%, internal pudendal 1.2%, perivesical 0.9%, inferior rectal 0.9%, retroaortic 0.3%, superficial inguinal 0.3%, and periprostatic 0.3%. Conclusions: The distribution of sentinel nodes as detected by single photon emission computed tomography imaging correlates well with the distribution determined by intraoperative gamma probe detection. A lower detection rate of sentinels in close proximity to the bladder and seminal vesicles is probably caused by the radionuclide accumulation in the bladder. In regard to intensity-modulated radiotherapy techniques, the presented anatomic atlas may allow optimized target volume definitions.

  12. Novel Handheld Magnetometer Probe Based on Magnetic Tunnelling Junction Sensors for Intraoperative Sentinel Lymph Node Identification

    PubMed Central

    Cousins, A.; Balalis, G. L.; Thompson, S. K.; Forero Morales, D.; Mohtar, A.; Wedding, A. B.; Thierry, B.

    2015-01-01

    Using magnetic tunnelling junction sensors, a novel magnetometer probe for the identification of the sentinel lymph node using magnetic tracers was developed. Probe performance was characterised in vitro and validated in a preclinical swine model. Compared to conventional gamma probes, the magnetometer probe showed excellent spatial resolution of 4.0 mm, and the potential to detect as few as 5 μg of magnetic tracer. Due to the high sensitivity of the magnetometer, all first-tier nodes were identified in the preclinical experiments, and there were no instances of false positive or false negative detection. Furthermore, these preliminary data encourage the application of the magnetometer probe for use in more complex lymphatic environments, such as in gastrointestinal cancers, where the sentinel node is often in close proximity to other non-sentinel nodes, and high spatial resolution detection is required. PMID:26038833

  13. Novel handheld magnetometer probe based on magnetic tunnelling junction sensors for intraoperative sentinel lymph node identification.

    PubMed

    Cousins, A; Balalis, G L; Thompson, S K; Forero Morales, D; Mohtar, A; Wedding, A B; Thierry, B

    2015-01-01

    Using magnetic tunnelling junction sensors, a novel magnetometer probe for the identification of the sentinel lymph node using magnetic tracers was developed. Probe performance was characterised in vitro and validated in a preclinical swine model. Compared to conventional gamma probes, the magnetometer probe showed excellent spatial resolution of 4.0 mm, and the potential to detect as few as 5 μg of magnetic tracer. Due to the high sensitivity of the magnetometer, all first-tier nodes were identified in the preclinical experiments, and there were no instances of false positive or false negative detection. Furthermore, these preliminary data encourage the application of the magnetometer probe for use in more complex lymphatic environments, such as in gastrointestinal cancers, where the sentinel node is often in close proximity to other non-sentinel nodes, and high spatial resolution detection is required. PMID:26038833

  14. Sentinel node biopsy in breast cancer using infrared laser system first experience with PDE camera

    PubMed Central

    Polom, Karol; Murawa, Dawid; Michalak, Michał; Murawa, Paweł

    2011-01-01

    Background Sentinel node biopsy (SNB) is a gold standard in staging of early breast cancer. Nowadays, routine mapping of lymphatic tract is based on two tracers: human albumin with radioactive technetium, with or without blue dye. Recent years have seen a search for new tracers to examine sentinel node as well as lymphatic network. One of them is indocyanine green (ICG) visible in infrared light. Aim The aim of this study is to evaluate clinical usage of ICG in comparison with standard tracer, i.e. nanocoll, in SNB of breast cancer patients. Materials and methods In the 1st Department of Surgical Oncology and General Surgery, Greater Poland Cancer Centre, Poznań, 13 female breast cancer patients have benn operated since September 2010. All these patients had sentinel node biopsy with nanocoll (human albumin with radioactive technetium), and with indocyanine green. The feasibility of this new method was assessed in comparison with the standard nanocoll. Results A lymphatic network between the place of injection of ICG and sentinel node was seen in infrared light. An area where a sentinel node was possibly located was confirmed by gamma probe. Sensitivity of this method was 100%. Conclusion SNB using ICG is a new, promising diagnostics technique. This procedure is not without drawbacks; nevertheless it opens new horizons in lymphatic network diagnostics. PMID:24376962

  15. Application of novel iron core/iron oxide shell nanoparticles to sentinel lymph node identification

    NASA Astrophysics Data System (ADS)

    Cousins, Aidan; Howard, Douglas; Henning, Anna M.; Nelson, Melanie R. M.; Tilley, Richard D.; Thierry, Benjamin

    2015-12-01

    Current `gold standard' staging of breast cancer and melanoma relies on accurate in vivo identification of the sentinel lymph node. By replacing conventional tracers (dyes and radiocolloids) with magnetic nanoparticles and using a handheld magnetometer probe for in vivo identification, it is believed the accuracy of sentinel node identification in nonsuperficial cancers can be improved due to increased spatial resolution of magnetometer probes and additional anatomical information afforded by MRI road-mapping. By using novel iron core/iron oxide shell nanoparticles, the sensitivity of sentinel node mapping via MRI can be increased due to an increased magnetic saturation compared to traditional iron oxide nanoparticles. A series of in vitro magnetic phantoms (iron core vs. iron oxide nanoparticles) were prepared to simulate magnetic particle accumulation in the sentinel lymph node. A novel handheld magnetometer probe was used to measure the relative signals of each phantom, and determine if clinical application of iron core particles can improve in vivo detection of the sentinel node compared to traditional iron oxide nanoparticles. The findings indicate that novel iron core nanoparticles above a certain size possess high magnetic saturation, but can also be produced with low coercivity and high susceptibility. While some modification to the design of handheld magnetometer probes may be required for particles with large coercivity, use of iron core particles could improve MRI and magnetometer probe detection sensitivity by up to 330 %.

  16. New approach to anal cancer: Individualized therapy based on sentinel lymph node biopsy

    PubMed Central

    De Nardi, Paola; Carvello, Michele; Staudacher, Carlo

    2012-01-01

    Oncological treatment is currently directed toward a tailored therapy concept. Squamous cell carcinoma of the anal canal could be considered a suitable platform to test new therapeutic strategies to minimize treatment morbidity. Standard of care for patients with anal canal cancer consists of a combination of radiotherapy and chemotherapy. This treatment has led to a high rate of local control and a 60% cure rate with preservation of the anal sphincter, thus replacing surgical abdominoperineal resection. Lymph node metastases represent a critical independent prognostic factor for local recurrence and survival. Mesorectal and iliac lymph nodes are usually included in the radiation field, whereas the inclusion of inguinal regions still remains controversial because of the subsequent adverse side effects. Sentinel lymph node biopsies could clearly identify inguinal node-positive patients eligible for therapeutic groin irradiation. A sentinel lymph node navigation procedure is reported here to be a feasible and effective method for establishing the true inguinal node status in patients suffering from anal canal cancer. Based on the results of sentinel node biopsies, a selective approach could be proposed where node-positive patients could be selected for inguinal node irradiation while node-negative patients could take advantage of inguinal sparing irradiation, thus avoiding toxic side effects. PMID:23197880

  17. Sentinel lymph-node biopsy after previous wide local excision for melanoma

    PubMed Central

    McCready, David R.; Ghazarian, Danny M.; Hershkop, Marlon S.; Walker, Janet A.; Ambus, Ulo; Quirt, Ian C.

    2001-01-01

    Objective To document experience with sentinel lymph-node biopsy in patients who have already undergone a wide local excision for melanoma because in many centres previous wide excision has been a contraindication for sentinel lymph-node biopsy. Design A prospective cohort study. Setting A tertiary care academic cancer centre. Patients One hundred patients who presented with cutaneous melanoma (depth >1 mm or Clark level IV) after having undergone wide local excision of the primary lesion that was not situated in the head or neck. The follow-up was 3 years. Interventions Sentinel lymph-node biopsy. Patients with truncal melanoma had preoperative lymphoscintigraphy to document the nodal basins at risk. Technetium-99m sulfur colloid (0.5–1 mCi in 0.5 mL) was injected intradermally around the scar, and the sentinel lymph node was excised with the aid of a hand-held gamma detector. Outcome measures Accuracy of the biopsy and false-negative rates in this setting. Results Of the 100 patients, 44 had truncal and 56 had extremity lesions. The average tumour depth was 3.47 mm and 3.07 mm respectively. Thirty-one patients had a sentinel lymph node positive for melanoma metastasis. Biopsies were positive for melanoma in 18 (41%) truncal lesions and 13 (23%) extremity lesions. There were 3 (9%) false-negative sentinel lymph-node biopsies as diagnosed by clinically evident nodal disease subsequently appearing in the nodal basin subjected to biopsy. Two occurred in patients after large rotation flap closures of truncal lesions. The third patient had a subungual melanoma of the great toe. No disease was found in the 2 nodes dissected. Two of the 3 false-negative biopsy results were obtained before serial sections and immunohistochemical staining were used to examine the sentinel lymph nodes. Conclusions Sentinel lymph-node biopsies can successfully identify clinically occult nodal metastases in patients who have had previous wide local excision of a melanoma, but the false

  18. Comparison between one day and two days protocols for sentinel node mapping of breast cancer patients.

    PubMed

    Ali, Jangijoo; Alireza, Rezapanah; Mostafa, Mehrabibahar; Naser, Forghani Mohammad; Bahram, Memar; Ramin, Sadeghi

    2011-01-01

    Sentinel node biopsy can decrease the morbidity of breast cancer treatment significantly by sparing many patients of axillary lymph node dissection and resulting arm lymphedema. Despite widespread use of sentinel node mapping for breast cancer patients almost all aspects of this procedure are controversial; such as: type of the radiotracer, eligibility, time of injection, etc. One of these controversial issues is the efficacy of 2 days protocol (injection of the tracer on one day and sentinel node mapping and surgery on the following day). The main reason to perform 2 days protocol is the ease of operation room scheduling the patient does not need to complete injection and imaging in the nuclear medicine department. Despite widespread use of 2 days protocol for sentinel node mapping, very few studies have specifically evaluated this protocol in comparison to 1 day protocol and also the false negative rate which is the better index of sentinel node mapping success. Most of the above studies used tracers with large particle size such as (99m)Tc-sulfur colloid. Tracers with small particle size can theoretically be washed out from the real sentinel nodes and move to the second echelon nodes, so some recommended using large particle size radiotracers for the 2 days protocol. In this study, we compared the false negative rate of sentinel node mapping between 1 and 2 days protocols using intradermal injection of (99m)Tc-antimony sulfide colloid ((99m)Tc-SbSC) which has very small particle size. Eighty patients with early stage breast cancer (clinical stages of I and II) were evaluated. The diagnosis of the breast cancer was established by either excisional or core needle biopsy. The patients didn't take any chemotherapeutic drug before surgery and were divided into two groups: 1 day (Group I) and 2 days (Group II) protocols (45 in Group I and 35 in Group II). For Group I, periareolar intradermal injections of 0.5Bq/0.2mL (99m)Tc-SbSC were applied for patients without

  19. Sentinel lymph node mapping in melanoma in the twenty-first century.

    PubMed

    Doepker, Matthew P; Zager, Jonathan S

    2015-04-01

    The incidence of melanoma is increasing faster than any other cancer. The status of the regional nodal basin remains the most important prognostic factor. Sentinel lymph node biopsy (SLNB) is recommended for staging in patients diagnosed with intermediate-thickness melanoma (1.01-4.0 mm). SLNB is considered somewhat controversial, especially when used to stage thin (1 mm), thick (>4 mm), or desmoplastic melanoma. This article reviews the current literature regarding SLNB in thin, intermediate, thick, and desmoplastic melanoma. Data supporting the use of newer radiopharmaceuticals in sentinel lymph node mapping along with newer imaging modalities are also reviewed. PMID:25769710

  20. The Utility of Sentinel Lymph Node Biopsy in Papillary Thyroid Carcinoma with Occult Lymph Nodes

    PubMed Central

    Yan, Xingqiang; Zeng, Ruichao; Ma, Zhaosheng; Chen, Chengze; Chen, Endong; Zhang, Xiaohua; Cao, Feilin

    2015-01-01

    Background The sentinel lymph node (SLN) is defined as the first draining node from the primary lesion, and it has proven to be a good indicator of the metastatic status of regional lymph nodes in solid tumors. The aim of this study was to evaluate the clinical application of SLN biopsy (SLNB) in papillary thyroid carcinoma (PTC) with occult lymph nodes. Methods From April 2006 to October 2012, 212 consecutive PTC patients were treated with SLNB using carbon nanoparticle suspension (CNS). Then, the stained nodes defined as SLN were collected, and prophylactic central compartment neck dissection (CCND) followed by total thyroidectomy or subtotal thyroidectomy were performed. All the samples were sent for pathological examination. Results There were 78 (36.8%) SLN metastasis (SLNM)-positive cases and 134 (63.2%) SLNM-negative cases. The sensitivity, specificity, positive and negative predictive values, and false-positive and false-negative rates of SLNB were 78.8%, 100%, 100%, 84.3%, 0%, and 21.2%, respectively. The PTC patients with SLNM were more likely to be male (48.2% vs. 32.7%, p = 0.039) and exhibited multifocality (52.6% vs. 33.3%, p = 0.025) and extrathyroidal extension (56.7% vs. 33.5%, p = 0.015). A greater incidence of non-SLN metastases in the central compartment was found in patients with SLNM (41/78, 52.6%) than in those without SLNM (21/134, 15.7%; p < 0.05). However, the SLNM-negative PTC patients with non-SLN metastases were more likely to be male (37.9% vs. 9.5%, p < 0.05). Conclusions The application of SLNB using CNS is technically feasible, safe, and useful, especially for male patients with co-existing multifocality and extrathyroidal extension. However, the sensitivity of SLNB must be improved and its false-negative rate reduced before it can be a routine procedure and replace prophylactic CCND. More attention should be paid to PTC patients (especially males) without SLNM for signs of non-SLN metastases. PMID:26046782

  1. Sentinel lymph nodes detection with an imaging system using Patent Blue V dye as fluorescent tracer

    NASA Astrophysics Data System (ADS)

    Tellier, F.; Steibel, J.; Chabrier, R.; Rodier, J. F.; Pourroy, G.; Poulet, P.

    2013-03-01

    Sentinel lymph node biopsy is the gold standard to detect metastatic invasion from primary breast cancer. This method can help patients avoid full axillary chain dissection, thereby decreasing the risk of morbidity. We propose an alternative to the traditional isotopic method, to detect and map the sentinel lymph nodes. Indeed, Patent Blue V is the most widely used dye in clinical routine for the visual detection of sentinel lymph nodes. A Recent study has shown the possibility of increasing the fluorescence quantum yield of Patent Blue V, when it is bound to human serum albumin. In this study we present a preclinical fluorescence imaging system to detect sentinel lymph nodes labeled with this fluorescent tracer. The setup is composed of a black and white CCD camera and two laser sources. One excitation source with a laser emitting at 635 nm and a second laser at 785 nm to illuminate the region of interest. The prototype is operated via a laptop. Preliminary experiments permitted to determine the device sensitivity in the μmol.L-1 range as regards the detection of PBV fluorescence signals. We also present a preclinical evaluation performed on Lewis rats, during which the fluorescence imaging setup detected the accumulation and fixation of the fluorescent dye on different nodes through the skin.

  2. Small field of view, high-resolution, portable γ-camera for axillary sentinel node detection

    NASA Astrophysics Data System (ADS)

    Soluri, A.; Massari, R.; Trotta, C.; Tofani, A.; Di Santo, G.; Di Pietro, B.; Di Paolo, M. L.; Roncacci, A.; Amanti, C.; Scopinaro, F.

    2006-12-01

    Sentinel node (SN) biopsy is an established method for breast cancer staging. Many authors suggested lymphoscintigraphy (LS) in order to indicate the sentinel node; others adopted the vital dye method together with radiocolloids, but only with γ-probe detection during operation without preliminary Anger camera LS. The second method is more simple and fast when compared with LS plus radioguided surgery. The Imaging Probe (IP) is a portable, hand held, high-resolution mini γ-camera studied by our group since 1998. Initial studies on sentinel node biopsy were carried out by us with IP on small series of patients to validate and to demonstrate the effectiveness and usefulness of IP against conventional probes. The aim of the present study is to show that surgeon removes the mammary sentinel node quicker and safer when using IP and conventional γ-probe together than conventional probe only. The results of our study not only show that our device makes quicker and safer SN biopsy, but also that the number of detected nodes is larger with our method than with conventional diagnostic and surgical techniques.

  3. History, present status and future of sentinel node biopsy in breast cancer. The Mary Béves Lecture.

    PubMed

    Mansel, R E; Khonji, N I; Clarke, D

    2000-01-01

    The word Sentinel' is defined in The Oxford English Dictionary as 'a guard, one who keeps watch or a sentry'. When translated to the concept of a tumour and its lymph node drainage, the sentinel node could be interpreted to mean the lymph node that guards or keeps watch over a tumour. The sentinel lymph node can thus be defined as the first lymph node that drains a primary tumour within the regional lymphatic basin of that tumour. We know that tumour progression in breast cancer often occurs in an orderly, progressive fashion. So in theory, if the sentinel node is tumour free then the rest of the nodes in the lymphatic basin should also be uninvolved by the tumour. PMID:10987219

  4. Handheld array-based photoacoustic probe for guiding needle biopsy of sentinel lymph nodes

    NASA Astrophysics Data System (ADS)

    Kim, Chulhong; Erpelding, Todd N.; Maslov, Konstantin; Jankovic, Ladislav; Akers, Walter J.; Song, Liang; Achilefu, Samuel; Margenthaler, Julie A.; Pashley, Michael D.; Wang, Lihong V.

    2010-07-01

    By modifying a clinical ultrasound array system, we develop a novel handheld photoacoustic probe for image-guided needle biopsy. The integration of optical fiber bundles for pulsed laser light delivery enables photoacoustic image-guided insertion of a needle into rat axillary lymph nodes with accumulated indocyanine green (ICG). Strong photoacoustic contrast of the needle is achieved. After subcutaneous injection of the dye in the left forepaw, sentinel lymph nodes are easily detected, in vivo and in real time, beneath 2-cm-thick chicken breast overlaying the axillary region. ICG uptake in axillary lymph nodes is confirmed with fluorescence imaging both in vivo and ex vivo. These results demonstrate the clinical potential of this handheld photoacoustic system for facile identification and needle biopsy of sentinel lymph nodes for cancer staging and metastasis detection in humans.

  5. Diagnostic value of preoperative axillary lymph node ultrasound assessment in patients with breast cancer qualified for sentinel lymph node biopsy

    PubMed Central

    Nowak, Adam; Wiśniewska, Magdalena; Wiśniewski, Michał; Zegarski, Wojciech

    2015-01-01

    Introduction Sentinel lymph node biopsy (SLNB) is a standard procedure in the therapeutic management of patients with non-advanced breast cancer. Aim To analyse the utility of ultrasound scan (USS) examination in the process of patient qualification for SLNB and to estimate the optimal time to perform USS in the clinical preoperational assessment of axillary lymph nodes. Material and methods A prospective analysis of 702 patients with invasive breast cancer treated with SLNB between 7.03.2012 and 27.05.2013 was performed. The patients were divided into three groups: I (USS < 8 weeks before SLNB), II (USS > 8 weeks before SLNB and another one on the day before SLNB) and III (USS > 8 weeks before SLNB without perioperative USS). In these patients the percentage of metastases in the sentinel lymph node and the clinical factors influencing the diagnostic value of preoperative ultrasound scan were assessed. Results Metastatic lesions in sentinel lymph nodes were found in 154 (21.9%) patients. The highest percentage of metastases was noted in patients operated on in the second and third month from the beginning of preoperative diagnostics. None of the factors tested (size of the original tumour, histological malignancy grading, kind of preoperative diagnostics, Ki-67 value, biological type of the tumour, age) had a statistically significant influence on the diagnostic value of perioperative USS examination in the analysed time span. Conclusions The lowest percentage of metastases in the sentinel lymph node was noted in the patients qualified for SLNB who had the ultrasound performed directly before the surgical procedure (not more than 4 weeks before the surgery). PMID:26240616

  6. Histological pattern of Merkel cell carcinoma sentinel lymph node metastasis improves stratification of Stage III patients.

    PubMed

    Ko, Jennifer S; Prieto, Victor G; Elson, Paul J; Vilain, Ricardo E; Pulitzer, Melissa P; Scolyer, Richard A; Reynolds, Jordan P; Piliang, Melissa P; Ernstoff, Marc S; Gastman, Brian R; Billings, Steven D

    2016-02-01

    Sentinel lymph node biopsy is used to stage Merkel cell carcinoma, but its prognostic value has been questioned. Furthermore, predictors of outcome in sentinel lymph node positive Merkel cell carcinoma patients are poorly defined. In breast carcinoma, isolated immunohistochemically positive tumor cells have no impact, but in melanoma they are considered significant. The significance of sentinel lymph node metastasis tumor burden (including isolated tumor cells) and pattern of involvement in Merkel cell carcinoma are unknown. In this study, 64 Merkel cell carcinomas involving sentinel lymph nodes and corresponding immunohistochemical stains were reviewed and clinicopathological predictors of outcome were sought. Five metastatic patterns were identified: (1) sheet-like (n=38, 59%); (2) non-solid parafollicular (n=4, 6%); (3) sinusoidal, (n=11, 17%); (4) perivascular hilar (n=1, 2%); and (5) rare scattered parenchymal cells (n=10, 16%). At the time of follow-up, 30/63 (48%) patients had died with 21 (33%) attributable to Merkel cell carcinoma. Patients with pattern 1 metastases had poorer overall survival compared with patients with patterns 2-5 metastases (P=0.03), with 22/30 (73%) deaths occurring in pattern 1 patients. Three (10%) deaths occurred in patients showing pattern 5, all of whom were immunosuppressed. Four (13%) deaths occurred in pattern 3 patients and 1 (3%) death occurred in a pattern 2 patient. In multivariable analysis, the number of positive sentinel lymph nodes (1 or 2 versus >2, P<0.0001), age (<70 versus ≥70, P=0.01), sentinel lymph node metastasis pattern (patterns 2-5 versus 1, P=0.02), and immune status (immunocompetent versus suppressed, P=0.03) were independent predictors of outcome, and could be used to stratify Stage III patients into three groups with markedly different outcomes. In Merkel cell carcinoma, the pattern of sentinel lymph node involvement provides important prognostic information and utilizing this data with other

  7. Sentinel lymph node biopsy using indigo carmine blue dye and the validity of '10% rule' and '4 nodes rule'.

    PubMed

    Nagao, Tomoya; Kinoshita, Takayuki; Hojo, Takashi; Kurihara, Hiroaki; Tsuda, Hitoshi

    2012-08-01

    This is the study which assessed sentinel lymph node biopsy (SNB) using indigo carmine blue dye and the validity of the '10% rule' and '4 nodes rule'. Patients (302) were performed SNB using the combined radioisotope (RI)/indigo carmine dye method. Excised SLNs were confirmed whether they were stained and numbered in order of RI count and the percentage of radioactivity as compared to the hottest node was calculated. The relationship between histological diagnosis, dyeing and RI count was assessed. All the patients were detected SLN. Positive nodes were identified in 84 (27.8%) patients and were identified up to the third degree of hottest. All the hottest positive nodes were stained by indigo carmine. From the results, removing the three most radioactive SLNs identified all cases of nodal metastasis without complications. These stopping rules were valid and useful under indigo carmine use too. PMID:22119457

  8. Inappropriate Intra-cervical Injection of Radiotracer for Sentinel Lymph Node Mapping in a Uterine Cervix Cancer Patient: Importance of Lymphoscintigraphy and Blue Dye Injection

    PubMed Central

    Kadkhodayan, Sima; Farahabadi, Elham Hosseini; Yousefi, Zohreh; Hasanzadeh, Malihe; Sadeghi, Ramin

    2014-01-01

    Herein, we report a case of sentinel lymph node mapping in a uterine cervix cancer patient, referring to the nuclear medicine department of our institute. Lymphoscintigraphy images showed inappropriate intra-cervical injection of radiotracer. Blue dye technique was applied for sentinel lymph node mapping, using intra-cervical injection of methylene blue. Two blue/cold sentinel lymph nodes, with no pathological involvement, were intra-operatively identified, and the patient was spared pelvic lymph node dissection. The present case underscores the importance of lymphoscintigraphy imaging in sentinel lymph node mapping and demonstrates the added value of blue dye injection in selected patients. It is suggested that pre-operative lymphoscintigraphy imaging be considered as an integral part of sentinel lymph node mapping in surgical oncology. Detailed results of lymphoscintigraphy images should be provided for surgeons prior to surgery, and in case the sentinel lymph nodes are not visualized, use of blue dye for sentinel node mapping should be encouraged.

  9. Inappropriate Intra-cervical Injection of Radiotracer for Sentinel Lymph Node Mapping in a Uterine Cervix Cancer Patient: Importance of Lymphoscintigraphy and Blue Dye Injection.

    PubMed

    Kadkhodayan, Sima; Farahabadi, Elham Hosseini; Yousefi, Zohreh; Hasanzadeh, Malihe; Sadeghi, Ramin

    2014-01-01

    Herein, we report a case of sentinel lymph node mapping in a uterine cervix cancer patient, referring to the nuclear medicine department of our institute. Lymphoscintigraphy images showed inappropriate intra-cervical injection of radiotracer. Blue dye technique was applied for sentinel lymph node mapping, using intra-cervical injection of methylene blue. Two blue/cold sentinel lymph nodes, with no pathological involvement, were intra-operatively identified, and the patient was spared pelvic lymph node dissection. The present case underscores the importance of lymphoscintigraphy imaging in sentinel lymph node mapping and demonstrates the added value of blue dye injection in selected patients. It is suggested that pre-operative lymphoscintigraphy imaging be considered as an integral part of sentinel lymph node mapping in surgical oncology. Detailed results of lymphoscintigraphy images should be provided for surgeons prior to surgery, and in case the sentinel lymph nodes are not visualized, use of blue dye for sentinel node mapping should be encouraged. PMID:27408871

  10. Symptomatic Lymphocele Formation After Sentinel Lymph Node Biopsy for Early Stage Cervical Cancer.

    PubMed

    Dogan, Nasuh Utku; Garagozova, Nigar; Pfiffer, Tatiana; Beier, Anna; Köhler, Christhardt; Favero, Giovanni

    2016-01-01

    In early stage cervical cancer, nodal status is the most important prognostic factor, and execution of retroperitoneal lymphadenectomy is currently an integral part of surgical therapy. Sentinel lymph node biopsy has been progressively incorporated with surgical therapy and could reduce morbidity. However, the current incidence of complications exclusively related to the procedure is unknown. We report on a 29-year-old woman affected by cervical cancer (Fédération Internationale de Gynécologie et d'Obstétrique Stage 1b1), who underwent sentinel lymph node biopsy in combination with radical vaginal trachelectomy, and who later developed a symptomatic pelvic lymphocele that required surgical therapy. Conservative procedures in the pelvic lymph nodes are not free of complications, especially with regard to the formation of symptomatic lymphoceles. This report brings to light an important discussion about the exact magnitude of the complications associated with the procedure. PMID:26260297

  11. Development of a handheld fluorescence imaging camera for intraoperative sentinel lymph node mapping

    NASA Astrophysics Data System (ADS)

    Szyc, Łukasz; Bonifer, Stefanie; Walter, Alfred; Jagemann, Uwe; Grosenick, Dirk; Macdonald, Rainer

    2015-05-01

    We present a compact fluorescence imaging system developed for real-time sentinel lymph node mapping. The device uses two near-infrared wavelengths to record fluorescence and anatomical images with a single charge-coupled device camera. Experiments on lymph node and tissue phantoms confirmed that the amount of dye in superficial lymph nodes can be better estimated due to the absorption correction procedure integrated in our device. Because of the camera head's small size and low weight, all accessible regions of tissue can be reached without the need for any adjustments.

  12. Lymphoscintigraphy in cutaneous melanoma: an updated total body atlas of sentinel node mapping.

    PubMed

    Intenzo, Charles M; Truluck, Christina A; Kushen, Medina C; Kim, Sung M; Berger, Adam; Kairys, John C

    2009-01-01

    Lymphoscintigraphy has become part of the standard of care for patients with a new or recurrent diagnosis of melanoma, in helping determine the status of regional lymph nodes. Correct identification of sentinel lymph nodes enables the surgeon to further delineate the extent of malignancy by allowing sampling of the appropriate nodal group. Performing the lymphoscintigraphy prior to the planned operation allows limited surgery with less extensive postoperative morbidity. For this reason, a thorough knowledge of the lymph node drainage patterns from the different primary tumor locations, as well as of proper lymphoscintigraphic techniques and radiopharmaceuticals, constitutes an important armamentarium in the hands of surgeons, radiologists, and nuclear medicine physicians. PMID:19605661

  13. Sentinel Node Identification Rate and Nodal Involvement in the EORTC 10981-22023 AMAROS Trial

    PubMed Central

    Meijnen, Philip; van Tienhoven, Geertjan; van de Velde, Cornelis J. H.; Mansel, Robert E.; Bogaerts, Jan; Duez, Nicole; Cataliotti, Luigi; Klinkenbijl, Jean H. G.; Westenberg, Helen A.; van der Mijle, Huub; Snoj, Marko; Hurkmans, Coen; Rutgers, Emiel J. T.

    2010-01-01

    Background The randomized EORTC 10981-22023 AMAROS trial investigates whether breast cancer patients with a tumor-positive sentinel node biopsy (SNB) are best treated with an axillary lymph node dissection (ALND) or axillary radiotherapy (ART). The aim of the current substudy was to evaluate the identification rate and the nodal involvement. Methods The first 2,000 patients participating in the AMAROS trial were evaluated. Associations between the identification rate and technical, patient-, and tumor-related factors were evaluated. The outcome of the SNB procedure and potential further nodal involvement was assessed. Results In 65 patients, the sentinel node could not be identified. As a result, the sentinel node identification rate was 97% (1,888 of 1,953). Variables affecting the success rate were age, pathological tumor size, histology, year of accrual, and method of detection. The SNB results of 65% of the patients (n = 1,220) were negative and the patients underwent no further axillary treatment. The SNB results were positive in 34% of the patients (n = 647), including macrometastases (n = 409, 63%), micrometastases (n = 161, 25%), and isolated tumor cells (n = 77, 12%). Further nodal involvement in patients with macrometastases, micrometastases, and isolated tumor cells undergoing an ALND was 41, 18, and 18%, respectively. Conclusions With a 97% detection rate in this prospective international multicenter study, the SNB procedure is highly effective, especially when the combined method is used. Further nodal involvement in patients with micrometastases and isolated tumor cells in the sentinel node was similar—both were 18%. PMID:20300966

  14. Internal Mammary Sentinel Lymph Nodes in Breast Cancer - Effects on Disease Prognosis and Therapeutic Protocols - A Case Report

    PubMed Central

    Stojanoski, Sinisa; Ristevska, Nevena; Pop-Gjorcheva, Daniela; Antevski, Borce; Petrushevska, Gordana

    2015-01-01

    BACKGROUND: The main prognostic factor in early staged breast cancer is the axillary lymph node metastatic affection. Sentinel lymph node biopsy, as a staging modality, significantly decreases surgical morbidity. The status of internal mammary lymph nodes gains an increased predictive role in grading breast carcinomas and modulation of postoperative therapeutic protocols. If positive, almost always are associated with worse disease outcome. Nevertheless, the clinical significance of internal mammary lymph node micrometastases has not been up to date precisely defined. AIM: To present a case of female patient clinically diagnosed as T1, N0, M0 (clinical TNM) ductal breast carcinoma with scintigraphic detection of internal mammary and axillary sentinel lymph nodes. METHODS: Dual method of scintigraphic sentinel lymph node detection using 99mTc-SENTI-SCINT and blue dye injection, intraoperative gamma probe detection, radioguided surgery and intraoperative ex tempore biopsy were used. CASE REPORT: We present a case of clinically T1, N0, M0 ductal breast cancer with scintigraphic detection of internal mammary and axillary sentinel lymph nodes. Intraoperative ex tempore biopsy revealed micrometastases in the internal mammary node and no metastatic involvement of the axillary sentinel lymph node. CONCLUSION: Detection of internal mammary lymph node metastases improves N (nodal) grading of breast cancer by selecting a high risk subgroup of patients that require adjuvant hormone therapy, chemotherapy and/or radiotherapy.

  15. Comparison of Positron Emission Tomography Scanning and Sentinel Node Biopsy in the Detection of Inguinal Node Metastases in Patients With Anal Cancer

    SciTech Connect

    Mistrangelo, Massimiliano; Pelosi, Ettore; Bello, Marilena; Castellano, Isabella; Cassoni, Paola; Ricardi, Umberto; Munoz, Fernando; Racca, Patrizia; Contu, Viviana; Beltramo, Giancarlo; Morino, Mario; Mussa, Antonio

    2010-05-01

    Background: Inguinal lymph node metastases in patients with anal cancer are an independent prognostic factor for local failure and overall mortality. Inguinal lymph node status can be adequately assessed with sentinel node biopsy, and the radiotherapy strategy can subsequently be changed. We compared this technique vs. dedicated 18F-fluorodeoxyglucose positron emission tomography (PET) to determine which was the better tool for staging inguinal lymph nodes. Methods and Materials: In our department, 27 patients (9 men and 18 women) underwent both inguinal sentinel node biopsy and PET-CT. PET-CT was performed before treatment and then at 1 and 3 months after treatment. Results: PET-CT scans detected no inguinal metastases in 20 of 27 patients and metastases in the remaining 7. Histologic analysis of the sentinel lymph node detected metastases in only three patients (four PET-CT false positives). HIV status was not found to influence the results. None of the patients negative at sentinel node biopsy developed metastases during the follow-up period. PET-CT had a sensitivity of 100%, with a negative predictive value of 100%. Owing to the high number of false positives, PET-CT specificity was 83%, and positive predictive value was 43%. Conclusions: In this series of patients with anal cancer, inguinal sentinel node biopsy was superior to PET-CT for staging inguinal lymph nodes.

  16. Lymphoscintigraphy in cutaneous melanoma: a total body atlas of sentinel node mapping.

    PubMed

    Intenzo, Charles M; Kim, Sung M; Patel, Jayant I; Lin, Henry C; Kairys, John C

    2002-01-01

    Lymphoscintigraphy of malignant melanoma has been a reliable method of identifying regional lymph nodes at risk for metastases and is now considered part of the standard of care in patients with melanoma. The status of the sentinel lymph node (SLN) is predictive of the metastatic status of the corresponding regional lymph node group. Lymphatic channel mapping allows identification of the SLN, thereby making selective lymph node sampling possible. Consequently, SLN identification with lymphoscintigraphy results in both less extensive surgery and more efficient pathologic examination of the lymph node specimens. Therefore, it is imperative that radiologists and nuclear medicine physicians know which radiopharmaceuticals to use, recognize different lymphatic drainage patterns from various primary tumor sites throughout the body, use proper imaging techniques, and recognize potential pitfalls in image interpretation. PMID:12006683

  17. Should Sentinel Lymph Node Biopsy for Patients with Early Breast Cancer Be Abandoned? Not So Fast

    PubMed Central

    Chu, Quyen D.; Peddi, Prakash

    2016-01-01

    As major advances are made in the management of early breast cancer, the role of sentinel lymph node biopsy (SLNBx) has been called into question. However, before abandoning SLNBx, a critical appraisal of its role should be done because we believe that it remains a critical component of care, especially when tailoring patient’s adjuvant therapy. This commentary provides cogent arguments in favor of SLNBx in the management of patients with early breast cancer. PMID:27398043

  18. Factors associated with involvement of four or more axillary nodes for sentinel lymph node-positive patients

    SciTech Connect

    Katz, Angela . E-mail: abkatz@partners.org; Niemierko, Andrzej; Gage, Irene; Evans, Sheila; Shaffer, Margaret; Smith, Frederick P.; Taghian, Alphonse; Magnant, Colette

    2006-05-01

    Purpose: Sentinel lymph node-positive (SLN+) patients who are unlikely to have 4 or more involved axillary nodes might be treated with less extensive regional nodal radiation. The purpose of this study was to define possible predictors of having 4 or more involved axillary nodes. Methods and Materials: The records of 224 patients with breast cancer and 1 to 3 involved SLNs, who underwent completion axillary dissection without neoadjuvant chemotherapy or hormonal therapy were reviewed. Factors associated with the presence of 4 or more involved axillary nodes (SLNs plus non-SLNs) were evaluated by Pearson chi-square test of association and by simple and multiple logistic-regression analysis. Results: Of 224 patients, 42 had involvement of 4 or more axillary nodes. On univariate analysis, the presence of 4 or more involved axillary nodes was positively associated with increased tumor size, lobular histology, lymphovascular space invasion (LVSI), increased number of involved SLNs, decreased number of uninvolved SLNs, and increased size of SLN metastasis. On multivariate analysis, the presence of 4 or more involved axillary nodes was associated with LVSI, increased number of involved SLNs, increased size of SLN metastasis, and lobular histology. Conclusions: Patients with 1 or more involved SLN, LVSI, or SLN macrometastasis should be treated to the supraclavicular fossa/axillary apex if they do not undergo completion axillary dissection. Other SLN+ patients might be adequately treated with less extensive radiation fields.

  19. The EANM clinical and technical guidelines for lymphoscintigraphy and sentinel node localization in gynaecological cancers.

    PubMed

    Giammarile, Francesco; Bozkurt, M Fani; Cibula, David; Pahisa, Jaume; Oyen, Wim J; Paredes, Pilar; Olmos, Renato Valdes; Sicart, Sergi Vidal

    2014-07-01

    The accurate harvesting of a sentinel node in gynaecological cancer (i.e. vaginal, vulvar, cervical, endometrial or ovarian cancer) includes a sequence of procedures with components from different medical specialities (nuclear medicine, radiology, surgical oncology and pathology). These guidelines are divided into sectione entitled: Purpose, Background information and definitions, Clinical indications and contraindications for SLN detection, Procedures (in the nuclear medicine department, in the surgical suite, and for radiation dosimetry), and Issues requiring further clarification. The guidelines were prepared for nuclear medicine physicians. The intention is to offer assistance in optimizing the diagnostic information that can currently be obtained from sentinel lymph node procedures. If specific recommendations given cannot be based on evidence from original scientific studies, referral is made to "general consensus" and similar expressions. The recommendations are designed to assist in the practice of referral to, and the performance, interpretation and reporting of all steps of the sentinel node procedure in the hope of setting state-of-the-art standards for high-quality evaluation of possible metastatic spread to the lymphatic system in gynaecological cancer. The final result has been discussed by a group of distinguished experts from the EANM Oncology Committee and the European Society of Gynaecological Oncology (ESGO). The document has been endorsed by the SNMMI Board. PMID:24609929

  20. [Place of indocyanine green coupled with fluorescence imaging in research of breast cancer sentinel node].

    PubMed

    Vermersch, Charlotte; Raia Barjat, Tiphaine; Perrot, Marianne; Lima, Suzanne; Chauleur, Céline

    2016-04-01

    The sentinel node has a fundamental role in the management of early breast cancer. Currently, the double detection of blue and radioisotope is recommended. But in common practice, many centers use a single method. However, with a single detection, the risk of false negatives and the identification failure rate increase to a significant extent and the number of sentinel lymph node detected and removed is not enough. Furthermore, the tracers used until now show inconveniences. The purpose of this work is to present a new method of detection, using the green of indocyanine coupled with fluorescence imaging, and to compare it with the already existing methods. The method combined by fluorescence and isotopic is reliable, sure, of fast learning and could constitute a good strategy of detection. The major interest is to obtain a satisfactory number of sentinel nodes. The profit could be even more important for overweight patients. The fluorescence used alone is at the moment not possible. Wide ranging studies are necessary. The FLUOTECH, randomized study of 100 patients, comparing the isotopic method of double isotope technique and fluorescence, is underway to confirm these data. PMID:26946971

  1. Hybrid Natural Orifice Transluminal Endoscopic Surgery with Sentinel Lymph Node Navigation for Deep Early Gastric Cancer in the Fundic Region

    PubMed Central

    Park, Yoon Suk; Kim, Seong Hwan; Ryu, Hee Yun; Cho, Young Kwan; Jo, Yun Ju; Son, Tae il; Hong, Young Ok

    2016-01-01

    For patients refusing surgical treatment for deep early gastric cancer, hybrid natural orifice transluminal endoscopic surgery with sentinel lymph node navigation is a potential treatment option, particularly when the anatomic location of the cancer has low probability of lymph node metastasis. We report a case of deep early gastric cancer of the fundus beyond the endoscopic submucosal dissection indication that was treated by hybrid natural orifice transluminal endoscopic surgery with sentinel lymph node navigation. In a conventional approach, a total gastrectomy would have been needed; however, the patient refused surgical intervention. In this case, since the patient showed no positivity of the sentinel lymph node on intraoperative navigation, laparoscopic basin lymph node dissection was not performed. Hybrid natural orifice transluminal endoscopic surgery might be considered for specific regions such as the safety zone where lymph node metastases are less likely to occur. PMID:27020308

  2. Sentinel Lymph Node Biopsy in Pelvic Tumors: Clinical Indications and Protocols Under Investigation.

    PubMed

    Maccauro, Marco; Lorenzoni, Alice; Crippa, Flavio; Manca, Gianpiero; Chondrogiannis, Sotirios; Giammarile, Francesco; Colletti, Patrick M; Cook, Gary J; Rubello, Domenico

    2016-06-01

    Sentinel lymph node (SLN) sampling is an attractive alternative to complete lymphadenectomy. Based on the identification and sampling of the first LN draining a primary tumor, SLN biopsy is the most accurate and the only reliable method for microscopic nodal staging for solid tumors including breast cancer and melanoma. Lymph node status in pelvic tumors remains the most important prognostic factor for recurrence and survival and a major decision criterion for adjuvant therapy. We review the clinical indications, controversies, and perspective of SLN biopsy in male and female pelvic cancers. PMID:26914577

  3. Sentinel lymph node mapping of a breast cancer of the vulva: Case report and literature review

    PubMed Central

    Cripe, James; Eskander, Ramez; Tewari, Krishnansu

    2015-01-01

    Ectopic breast tissue is rare and typically presents as an axillary mass. Previous reports have identified ectopic breast tissue in the vulva, but malignancy is exceedingly uncommon. We present a 62 years old with locally advanced breast carcinoma arising in the vulva demonstrates the utilization of sentinel lymph node mapping to identify metastatic lymph nodes previously unable to be identified via traditional surgical exploration. Our case supports the principles of adjuvant therapy for breast cancer to be applied to ectopic breast cancer arising in the vulva. A literature review highlights common key points in similar cases to guide management. PMID:25866706

  4. A dual-modal magnetic nanoparticle probe for preoperative and intraoperative mapping of sentinel lymph nodes by magnetic resonance and near infrared fluorescence imaging

    PubMed Central

    Zhou, Zhengyang; Chen, Hongwei; Lipowska, Malgorzata; Wang, Liya; Yu, Qiqi; Yang, Xiaofeng; Tiwari, Diana; Yang, Lily; Mao, Hui

    2016-01-01

    The ability to reliably detect sentinel lymph nodes for sentinel lymph node biopsy and lymphadenectomy is important in clinical management of patients with metastatic cancers. However, the traditional sentinel lymph node mapping with visible dyes is limited by the penetration depth of light and fast clearance of the dyes. On the other hand, sentinel lymph node mapping with radionucleotide technique has intrinsically low spatial resolution and does not provide anatomic details in the sentinel lymph node mapping procedure. This work reports the development of a dual modality imaging probe with magnetic resonance and near infrared imaging capabilities for sentinel lymph node mapping using magnetic iron oxide nanoparticles (10 nm core size) conjugated with a near infrared molecule with emission at 830 nm. Accumulation of magnetic iron oxide nanoparticles in sentinel lymph nodes leads to strong T2 weighted magnetic resonance imaging contrast that can be potentially used for preoperative localization of sentinel lymph nodes, while conjugated near infrared molecules provide optical imaging tracking of lymph nodes with a high signal to background ratio. The new magnetic nanoparticle based dual imaging probe exhibits a significant longer lymph node retention time. Near infrared signals from nanoparticle conjugated near infrared dyes last up to 60 min in sentinel lymph node compared to that of 25 min for the free near infrared dyes in a mouse model. Furthermore, axillary lymph nodes, in addition to sentinel lymph nodes, can be also visualized with this probe, given its slow clearance and sufficient sensitivity. Therefore, this new dual modality imaging probe with the tissue penetration and sensitive detection of sentinel lymph nodes can be applied for preoperative survey of lymph nodes with magnetic resonance imaging and allows intraoperative sentinel lymph node mapping using near infrared optical devices. PMID:23812946

  5. Localization of the sentinel lymph node in breast cancer: prospective comparison of vital staining and radioactive tracing methods.

    PubMed

    Marrazzo, Antonio; Taormina, Pietra; Noto, Antonio; Cardinale, Giovanni; Casà, Luigi; Mercadante, Sebastiano; Lo Gerfo, Domenico; David, Massimo

    2004-01-01

    The aim of the study was to evaluate possible differences in accuracy between the radioactive tracing and vital staining method in the search for sentinel nodes in patients with breast cancer. From January 1999 to December 2000, 102 patients with T1 N0 breast carcinoma were recruited into the study for localization of sentinel nodes with vital blue dye staining and radioactive tracing and were then submitted to lumpectomy and axillary dissection. For the two methods, we estimated the percentage of sentinel nodes localized, the false-negative rate, the predictive negative and positive value and the accuracy. The vital blue dye staining method permitted localization of the sentinel node in 73% of patients with a false-negative rate of 8%, a predictive negative value of 92% and 92% accuracy. The radioactive tracing method permitted localization of the sentinel node in 97% cases with a false-negative rate of 0%, a predictive negative value of 100% and 100% accuracy (P<0.0005). The method that offers the better results is radioactive tracing. Currently, many authors use both techniques, since, in common practice, staining helps to identify the sentinel node with the probe. PMID:15553432

  6. [Sentinel node biopsy and axillary clearence in early breast cancer--An algorithm with explanations and queries].

    PubMed

    Cserni, Gábor

    2016-03-01

    The introduction of sentinel lymph node biopsy in early breast cancer patients has substantially changed the approach to axillary management traditionally consisting of lymph node dissection. It has also rendered it more sophisticated. Several factors influence the decision on whether a patient should be offered sentinel lymph node biopsy or axillary lymph node dissection after the biopsy or instead of it. The potential options have been combined into an algorithm, of which each step is explained with the most important evidences in support or against summarized. PMID:26901689

  7. Near infrared imaging to identify sentinel lymph nodes in invasive urinary bladder cancer

    NASA Astrophysics Data System (ADS)

    Knapp, Deborah W.; Adams, Larry G.; Niles, Jacqueline D.; Lucroy, Michael D.; Ramos-Vara, Jose; Bonney, Patty L.; deGortari, Amalia E.; Frangioni, John V.

    2006-02-01

    Approximately 12,000 people are diagnosed with invasive transitional cell carcinoma of the urinary bladder (InvTCC) each year in the United States. Surgical removal of the bladder (cystectomy) and regional lymph node dissection are considered frontline therapy. Cystectomy causes extensive acute morbidity, and 50% of patients with InvTCC have occult metastases at the time of diagnosis. Better staging procedures for InvTCC are greatly needed. This study was performed to evaluate an intra-operative near infrared fluorescence imaging (NIRF) system (Frangioni laboratory) for identifying sentinel lymph nodes draining InvTCC. NIRF imaging was used to map lymph node drainage from specific quadrants of the urinary bladder in normal dogs and pigs, and to map lymph node drainage from naturally-occurring InvTCC in pet dogs where the disease closely mimics the human condition. Briefly, during surgery NIR fluorophores (human serum albumen-fluorophore complex, or quantum dots) were injected directly into the bladder wall, and fluorescence observed in lymphatics and regional nodes. Conditions studied to optimize the procedure including: type of fluorophore, depth of injection, volume of fluorophore injected, and degree of bladder distention at the time of injection. Optimal imaging occurred with very superficial injection of the fluorophore in the serosal surface of the moderately distended bladder. Considerable variability was noted from dog to dog in the pattern of lymph node drainage. NIR fluorescence was noted in lymph nodes with metastases in dogs with InvTCC. In conclusion, intra-operative NIRF imaging is a promising approach to improve sentinel lymph node mapping in invasive urinary bladder cancer.

  8. Sentinel lymph node biopsy in clinically detected ductal carcinoma in situ

    PubMed Central

    Al-Ameer, Ahmed Yahia; Al Nefaie, Sahar; Al Johani, Badria; Anwar, Ihab; Al Tweigeri, Taher; Tulbah, Asma; Alshabanah, Mohmmed; Al Malik, Osama

    2016-01-01

    AIM: To study the indications for sentinel lymph node biopsy (SLNB) in clinically-detected ductal carcinoma in situ (CD-DCIS). METHODS: A retrospective analysis of 20 patients with an initial diagnosis of pure DCIS by an image-guided core needle biopsy (CNB) between June 2006 and June 2012 was conducted at King Faisal Specialist Hospital. The accuracy of performing SLNB in CD-DCIS, the rate of sentinel and non-sentinel nodal metastasis, and the histologic underestimation rate of invasive cancer at initial diagnosis were analyzed. The inclusion criteria were a preoperative diagnosis of pure DCIS with no evidence of invasion. We excluded any patient with evidence of microinvasion or invasion. There were two cases of mammographically detected DCIS and 18 cases of CD-DCIS. All our patients were diagnosed by an image-guided CNB except two patients who were diagnosed by fine needle aspiration (FNA). All patients underwent breast surgery, SLNB, and axillary lymph node dissection (ALND) if the SLN was positive. RESULTS: Twenty patients with an initial diagnosis of pure DCIS underwent SLNB, 2 of whom had an ALND. The mean age of the patients was 49.7 years (range, 35-70). Twelve patients (60%) were premenopausal and 8 (40%) were postmenopausal. CNB was the diagnostic procedure for 18 patients, and 2 who were diagnosed by FNA were excluded from the calculation of the underestimation rate. Two out of 20 had a positive SLNB and underwent an ALND and neither had additional non sentinel lymph node metastasis. Both the sentinel visualization rate and the intraoperative sentinel identification rate were 100%. The false negative rate was 0%. Only 2 patients had a positive SLNB (10%) and neither had additional metastasis following an ALND. After definitive surgery, 3 patients were upstaged to invasive ductal carcinoma (3/18 = 16.6%) and 3 other patients were upstaged to DCIS with microinvasion (3/18 = 16.6%). Therefore the histologic underestimation rate of invasive disease was 33

  9. [INTRAOPERATIVE DETECTION OF SENTINEL LYMPH NODES USING INFRARED IMAGING SYSTEM IN LOCAL NON-SMALL CELL CARCINOMA OF LUNG].

    PubMed

    Akopov, A L; Papayan, G V; Chistyakov, I V; Karlson, A; Gerasin, A V; Agishev, A S

    2015-01-01

    The article presents the results of the first domestic experience of intraoperative fluorescence mapping of sentinel lymph nodes in lung cancer. The research included 10 patients, who underwent surgery over the period of time from September 2013 to May 2014. After performing thoracotomy, the solution of indocyanine green (ICG) was injected using subpleural position above the tumor in 3-4 points. Fluorescence (ICG) image guided surgery was carried out by using infrared radiation (wave length 808 nm) on lung surface, root of lung, mediastinum in real time. Fluorescence lymph nodes were mapped. In case that metastatic lesions weren't revealed in sentinel lymph nodes, they weren't noted in other nodes. Method specificity consisted of 100%. Biopsy and histological study of sentinel lymph nodes mapped during fluorescence (ICG) image guided surgery could be useful for prevention of lymphodissection in patients with non-small cell carcinoma of lung. PMID:26601511

  10. Interval sentinel lymph nodes in melanoma: a digital pathology analysis of Ki67 expression and microvascular density.

    PubMed

    Marinaccio, Christian; Giudice, Giuseppe; Nacchiero, Eleonora; Robusto, Fabio; Opinto, Giuseppina; Lastilla, Gaetano; Maiorano, Eugenio; Ribatti, Domenico

    2016-08-01

    The presence of interval sentinel lymph nodes in melanoma is documented in several studies, but controversies still exist about the management of these lymph nodes. In this study, an immunohistochemical evaluation of tumor cell proliferation and neo-angiogenesis has been performed with the aim of establishing a correlation between these two parameters between positive and negative interval sentinel lymph nodes. This retrospective study reviewed data of 23 patients diagnosed with melanoma. Bioptic specimens of interval sentinel lymph node were retrieved, and immunohistochemical reactions on tissue sections were performed using Ki67 as a marker of proliferation and CD31 as a blood vessel marker for the study of angiogenesis. The entire stained tissue sections for each case were digitized using Aperio Scanscope Cs whole-slide scanning platform and stored as high-resolution images. Image analysis was carried out on three selected fields of equal area using IHC Nuclear and Microvessel analysis algorithms to determine positive Ki67 nuclei and vessel number. Patients were divided into positive and negative interval sentinel lymph node groups, and the positive interval sentinel lymph node group was further divided into interval positive with micrometastasis and interval positive with macrometastasis subgroups. The analysis revealed a significant difference between positive and negative interval sentinel lymph nodes in the percentage of Ki67-positive nuclei and mean vessel number suggestive of an increased cellular proliferation and angiogenesis in positive interval sentinel lymph nodes. Further analysis in the interval positive lymph node group showed a significant difference between micro- and macrometastasis subgroups in the percentage of Ki67-positive nuclei and mean vessel number. Percentage of Ki67-positive nuclei was increased in the macrometastasis subgroup, while mean vessel number was increased in the micrometastasis subgroup. The results of this study suggest

  11. Scanning elastic scattering spectroscopy detects metastatic breast cancer in sentinel lymph nodes

    NASA Astrophysics Data System (ADS)

    Austwick, Martin R.; Clark, Benjamin; Mosse, Charles A.; Johnson, Kristie; Chicken, D. Wayne; Somasundaram, Santosh K.; Calabro, Katherine W.; Zhu, Ying; Falzon, Mary; Kocjan, Gabrijela; Fearn, Tom; Bown, Stephen G.; Bigio, Irving J.; Keshtgar, Mohammed R. S.

    2010-07-01

    A novel method for rapidly detecting metastatic breast cancer within excised sentinel lymph node(s) of the axilla is presented. Elastic scattering spectroscopy (ESS) is a point-contact technique that collects broadband optical spectra sensitive to absorption and scattering within the tissue. A statistical discrimination algorithm was generated from a training set of nearly 3000 clinical spectra and used to test clinical spectra collected from an independent set of nodes. Freshly excised nodes were bivalved and mounted under a fiber-optic plate. Stepper motors raster-scanned a fiber-optic probe over the plate to interrogate the node's cut surface, creating a 20×20 grid of spectra. These spectra were analyzed to create a map of cancer risk across the node surface. Rules were developed to convert these maps to a prediction for the presence of cancer in the node. Using these analyses, a leave-one-out cross-validation to optimize discrimination parameters on 128 scanned nodes gave a sensitivity of 69% for detection of clinically relevant metastases (71% for macrometastases) and a specificity of 96%, comparable to literature results for touch imprint cytology, a standard technique for intraoperative diagnosis. ESS has the advantage of not requiring a pathologist to review the tissue sample.

  12. Multiphoton microscopy as a diagnostic tool for pathological analysis of sentinel lymph nodes

    NASA Astrophysics Data System (ADS)

    Lemiere, J.; Douady, J.; Estève, F.; Salameire, D.; Lantuejoul, S.; Lorimier, P.; Ricard, C.; van der Sanden, B.; Vial, J.-C.

    2009-02-01

    Multiphoton microscopy has shown a powerful potential for biomedical in vivo and ex vivo analysis of tissue sections and explants. Studies were carried out on several animal organs such as brain, arteries, lungs, and kidneys. One of the current challenges is to transfer to the clinic the knowledge and the methods previously developed in the labs at the preclinical level. For tumour staging, physicians often remove the lymph nodes that are localized at the proximity of the lesion. In case of breast cancer or melanoma, sentinel lymph node protocol is performed: pathologists randomly realize an extensive sampling of formol fixed nodes. However, the duration of this protocol is important and its reliability is not always satisfactory. The aim of our study was to determine if multiphoton microscopy would enable the fast imaging of lymph nodes on important depths, with or without exogenous staining. Experiments were first conducted on pig lymph nodes in order to test various dyes and to determine an appropriate protocol. The same experiments were then performed on thin slices of human lymph nodes bearing metastatic melanoma cells. We obtained relevant images with both endofluorescence plus second-harmonic generation and xanthene dyes. They show a good contrast between tumour and healthy cells. Furthermore, images of pig lymph nodes were recorded up to 120μm below the surface. This new method could then enable a faster diagnosis with higher efficiency for the patient. Experiments on thicker human lymph nodes are currently underway in order to validate these preliminary results.

  13. Sentinel node navigation surgery for gastroduodenal neuroendocrine tumors: Two case reports.

    PubMed

    Arigami, Takaaki; Uenosono, Yoshikazu; Yanagita, Shigehiro; Okubo, Keishi; Kijima, Takashi; Matsushita, Daisuke; Amatatsu, Masahiko; Hagihara, Takahiko; Haraguchi, Naoto; Mataki, Yuko; Ehi, Katsuhiko; Ishigami, Sumiya; Natsugoe, Shoji

    2016-06-01

    The percentage of gastroduodenal neuroendocrine tumors (NETs) among all gastroenteropancreatic (GEP) NETs has gradually increased worldwide. Sentinel node navigation surgery (SNNS) has been developed as a personalized approach in the surgical strategy for early gastrointestinal tract cancers. We herein report 2 cases of gastroduodenal NETs treated with SNNS. Technetium-tin colloid including indocyanine green was endoscopically injected into the submucosa around a tumor the day before surgery. Basin dissection including the sentinel nodes (SNs), which were identified by Navigator GPS and near-infrared fluorescence imaging, was performed during laparoscopic surgery. SNs were intraoperatively examined using hematoxylin-eosin (HE) staining.SNs were detected in 2 patients. Lymph node metastasis was intraoperatively identified in 1 of the 2 patients. Consequently, 1 patient with metastatic SNs underwent laparoscopic gastrectomy with lymphadenectomy. Pathological findings identified submucosal NET measuring 6.0 mm × 5.0 mm.Our results suggest that SNNS is a promising surgical tool for detecting subclinical lymph node metastasis in patients with gastroduodenal NETs. PMID:27368046

  14. Spectral imaging as a potential tool for optical sentinel lymph node biopsies

    NASA Astrophysics Data System (ADS)

    O'Sullivan, Jack D.; Hoy, Paul R.; Rutt, Harvey N.

    2011-07-01

    Sentinel Lymph Node Biopsy (SLNB) is an increasingly standard procedure to help oncologists accurately stage cancers. It is performed as an alternative to full axillary lymph node dissection in breast cancer patients, reducing the risk of longterm health problems associated with lymph node removal. Intraoperative analysis is currently performed using touchprint cytology, which can introduce significant delay into the procedure. Spectral imaging is forming a multi-plane image where reflected intensities from a number of spectral bands are recorded at each pixel in the spatial plane. We investigate the possibility of using spectral imaging to assess sentinel lymph nodes of breast cancer patients with a view to eventually developing an optical technique that could significantly reduce the time required to perform this procedure. We investigate previously reported spectra of normal and metastatic tissue in the visible and near infrared region, using them as the basis of dummy spectral images. We analyse these images using the spectral angle map (SAM), a tool routinely used in other fields where spectral imaging is prevalent. We simulate random noise in these images in order to determine whether the SAM can discriminate between normal and metastatic pixels as the quality of the images deteriorates. We show that even in cases where noise levels are up to 20% of the maximum signal, the spectral angle map can distinguish healthy pixels from metastatic. We believe that this makes spectral imaging a good candidate for further study in the development of an optical SLNB.

  15. Preoperative Scintigrams to Identify the Sentinel Lymph Node in Breast Cancer: a Waste of Time?

    PubMed

    Sharma, N; Pinto, A; Notghi, A; Sintler, M

    2015-12-01

    Sentinel lymph node biopsy (SLNB) remains the gold standard for assessing axillary node status in breast cancer. Preoperative scintigrams have been used to identify the sentinel lymph node (SLN); however, their use is controversial. Studies suggest they add little to successful SLN detection in theatre, immediately prior to node excision. They have been associated with high false negatives, time expense, patient dissatisfaction, and unnecessary costs. The aim of the present study was to evaluate the diagnostic accuracy of scintigrams in comparison to intraoperative SLN identification techniques. This study included all patients undergoing a SLNB for breast cancer from April 2010 to 2011. Scintigram reports, operation notes, and histology results were analyzed. Mann-Whitney U and chi-squared tests were used for statistical analysis of data. Two hundred nineteen female patients with a median age of 59.6 years (24.0-89.9 years) were included in this study. Scintigram was performed in 185 and not in 34 patients due to time constraints. Combined γ-probe and Isosulfan blue dye for SLN detection (intraoperative methods) have an identification rate of 98.2 % (p = 0.005), compared to 92.4 % (p = 0.088) from scintigrams alone. Scintigrams confer no additional advantage to the operating surgeon for successful SLN detection and excision in theatre. Intraoperative SLN identification is more accurate and reliable. Routine scintigram use is unjustified and should be withdrawn from current practice. PMID:27011606

  16. Portable widefield imaging device for ICG-detection of the sentinel lymph node

    NASA Astrophysics Data System (ADS)

    Govone, Angelo Biasi; Gómez-García, Pablo Aurelio; Carvalho, André Lopes; Capuzzo, Renato de Castro; Magalhães, Daniel Varela; Kurachi, Cristina

    2015-06-01

    Metastasis is one of the major cancer complications, since the malignant cells detach from the primary tumor and reaches other organs or tissues. The sentinel lymph node (SLN) is the first lymphatic structure to be affected by the malignant cells, but its location is still a great challenge for the medical team. This occurs due to the fact that the lymph nodes are located between the muscle fibers, making it visualization difficult. Seeking to aid the surgeon in the detection of the SLN, the present study aims to develop a widefield fluorescence imaging device using the indocyanine green as fluorescence marker. The system is basically composed of a 780nm illumination unit, optical components for 810nm fluorescence detection, two CCD cameras, a laptop, and dedicated software. The illumination unit has 16 diode lasers. A dichroic mirror and bandpass filters select and deliver the excitation light to the interrogated tissue, and select and deliver the fluorescence light to the camera. One camera is responsible for the acquisition of visible light and the other one for the acquisition of the ICG fluorescence. The software developed at the LabVIEW® platform generates a real time merged image where it is possible to observe the fluorescence spots, related to the lymph nodes, superimposed at the image under white light. The system was tested in a mice model, and a first patient with tongue cancer was imaged. Both results showed the potential use of the presented fluorescence imaging system assembled for sentinel lymph node detection.

  17. In vivo carbon nanotube-enhanced non-invasive photoacoustic mapping of the sentinel lymph node

    NASA Astrophysics Data System (ADS)

    Pramanik, Manojit; Song, Kwang Hyun; Swierczewska, Magdalena; Green, Danielle; Sitharaman, Balaji; Wang, Lihong V.

    2009-06-01

    Sentinel lymph node biopsy (SLNB), a less invasive alternative to axillary lymph node dissection (ALND), has become the standard of care for patients with clinically node-negative breast cancer. In SLNB, lymphatic mapping with radio-labeled sulfur colloid and/or blue dye helps identify the sentinel lymph node (SLN), which is most likely to contain metastatic breast cancer. Even though SLNB, using both methylene blue and radioactive tracers, has a high identification rate, it still relies on an invasive surgical procedure, with associated morbidity. In this study, we have demonstrated a non-invasive single-walled carbon nanotube (SWNT)-enhanced photoacoustic (PA) identification of SLN in a rat model. We have successfully imaged the SLN in vivo by PA imaging (793 nm laser source, 5 MHz ultrasonic detector) with high contrast-to-noise ratio (=89) and good resolution (~500 µm). The SWNTs also show a wideband optical absorption, generating PA signals over an excitation wavelength range of 740-820 nm. Thus, by varying the incident light wavelength to the near infrared region, where biological tissues (hemoglobin, tissue pigments, lipids and water) show low light absorption, the imaging depth is maximized. In the future, functionalization of the SWNTs with targeting groups should allow the molecular imaging of breast cancer.

  18. Detection of Sentinel Lymph Nodes in Gynecologic Tumours by Planar Scintigraphy and SPECT/CT

    PubMed Central

    Kraft, Otakar; Havel, Martin

    2012-01-01

    Objective: Assess the role of planar lymphoscintigraphy and fusion imaging of SPECT/CT in sentinel lymph node (SLN) detection in patients with gynecologic tumours. Material and Methods: Planar scintigraphy and hybrid modality SPECT/CT were performed in 64 consecutive women with gynecologic tumours (mean age 53.6 with range 30-77 years): 36 pts with cervical cancer (Group A), 21 pts with endometrial cancer (Group B), 7 pts with vulvar carcinoma (Group C). Planar and SPECT/CT images were interpreted separately by two nuclear medicine physicians. Efficacy of these two techniques to image SLN were compared. Results: Planar scintigraphy did not image SLN in 7 patients (10.9%), SPECT/CT was negative in 4 patients (6.3%). In 35 (54.7%) patients the number of SLNs captured on SPECT/CT was higher than on planar imaging. Differences in detection of SLN between planar and SPECT/CT imaging in the group of all 64 patients are statistically significant (p<0.05). Three foci of uptake (1.7% from totally visible 177 foci on planar images) in 2 patients interpreted on planar images as hot LNs were found to be false positive non-nodal sites of uptake when further assessed on SPECT/CT. SPECT/CT showed the exact anatomical location of all visualised sentinel nodes. Conclusion: In some patients with gynecologic cancers SPECT/CT improves detection of sentinel lymph nodes. It can image nodes not visible on planar scintigrams, exclude false positive uptake and exactly localise pelvic and paraaortal SLNs. It improves anatomic localization of SLNs. Conflict of interest:None declared. PMID:23486989

  19. Elevated Serum Leptin Levels are Associated With an Increased Risk of Sentinel Lymph Node Metastasis in Cutaneous Melanoma

    PubMed Central

    Oba, Junna; Wei, Wei; Gershenwald, Jeffrey E.; Johnson, Marcella M.; Wyatt, Cynthia M.; Ellerhorst, Julie A.; Grimm, Elizabeth A.

    2016-01-01

    Abstract The metabolic hormone leptin has been implicated in the pathogenesis of various malignancies and may contribute to the high rate of cancer in obese individuals. We reported that leptin and its receptor are expressed by melanoma tumors and cell lines, and that leptin stimulates proliferation of cultured melanoma cells. Here, we tested the hypothesis that leptin contributes to early melanoma progression by assessing its association with sentinel node positivity in cutaneous melanoma patients. The study enrolled 72 patients who were scheduled to undergo lymphatic mapping and sentinel node biopsy. Fasting blood was obtained before surgery, and serum leptin levels were measured by enzyme-linked immunosorbent assay (ELISA) with a “raw” (assay value) and an “adjusted” value (raw value divided by body mass index). Leptin levels and other clinicopathologic parameters were compared between sentinel node positive and negative groups. Logistic regression models were used to predict sentinel node status using leptin and other relevant clinical parameters. The raw and adjusted leptin levels were significantly higher in the 15 patients with positive sentinel nodes. These findings could not be attributed to differences in body mass indices. Univariate models revealed raw leptin, adjusted leptin, Breslow thickness, and mitotic rate as significant predictors of sentinel node status. Leptin levels and Breslow thickness remained significant in multivariate models. Survival and follow-up analysis revealed more aggressive disease in diabetic patients. Elevated serum leptin levels predict sentinel node metastasis in melanoma. Validation of this finding in larger cohorts should enable better stratification of early stage melanoma patients. PMID:26986135

  20. Sentinel Node Biopsy for the Head and Neck Using Contrast-Enhanced Ultrasonography Combined with Indocyanine Green Fluorescence in Animal Models: A Feasibility Study

    PubMed Central

    Sato, Dai; Ikeda, Tetsuya; Matsumoto, Yoshifumi; Moro, Yorihisa; Kimura, Toru; Hamanoue, Yasuhiro; Nakamura, Takehiro; Yamauchi, Koichi; Saito, Koichiro; Sugasawa, Masashi; Kohno, Naoyuki

    2015-01-01

    Background Sentinel node navigation surgery is gaining popularity in oral cancer. We assessed application of sentinel lymph node navigation surgery to pharyngeal and laryngeal cancers by evaluating the combination of contrast-enhanced ultrasonography and indocyanine green fluorescence in animal models. Methods This was a prospective, nonrandomized, experimental study in rabbit and swine animal models. A mixture of indocyanine green and Sonazoid was used as the tracer. The tracer mixture was injected into the tongue, larynx, or pharynx. The sentinel lymph nodes were identified transcutaneously by infra-red camera and contrast-enhanced ultrasonography. Detection time and extraction time of the sentinel lymph nodes were measured. The safety of the tracer mixture in terms of mucosal reaction was evaluated macroscopically and microscopically. Results Sentinel lymph nodes were detected transcutaneously by contrast-enhanced ultrasonography alone. The number of sentinel lymph nodes detected was one or two. Despite observation of contrast enhancement of Sonazoid for at least 90 minutes, the number of sentinel lymph nodes detected did not change. The average extraction time of sentinel lymph nodes was 4.8 minutes. Indocyanine green fluorescence offered visual information during lymph node biopsy. The safety of the tracer was confirmed by absence of laryngeal edema both macro and microscopically. Conclusions The combination method of indocyanine green fluorescence and contrast-enhanced ultrasonography for detecting sentinel lymph nodes during surgery for head and neck cancer seems promising, especially for pharyngeal and laryngeal cancer. Further clinical studies to confirm this are warranted. PMID:26161800

  1. Biological ablation of sentinel lymph node metastasis in submucosally invaded early gastrointestinal cancer.

    PubMed

    Kikuchi, Satoru; Kishimoto, Hiroyuki; Tazawa, Hiroshi; Hashimoto, Yuuri; Kuroda, Shinji; Nishizaki, Masahiko; Nagasaka, Takeshi; Shirakawa, Yasuhiro; Kagawa, Shunsuke; Urata, Yasuo; Hoffman, Robert M; Fujiwara, Toshiyoshi

    2015-03-01

    Currently, early gastrointestinal cancers are treated endoscopically, as long as there are no lymph node metastases. However, once a gastrointestinal cancer invades the submucosal layer, the lymph node metastatic rate rises to higher than 10%. Therefore, surgery is still the gold standard to remove regional lymph nodes containing possible metastases. Here, to avoid prophylactic surgery, we propose a less-invasive biological ablation of lymph node metastasis in submucosally invaded gastrointestinal cancer patients. We have established an orthotopic early rectal cancer xenograft model with spontaneous lymph node metastasis by implantation of green fluorescent protein (GFP)-labeled human colon cancer cells into the submucosal layer of the murine rectum. A solution containing telomerase-specific oncolytic adenovirus was injected into the peritumoral submucosal space, followed by excision of the primary rectal tumors mimicking the endoscopic submucosal dissection (ESD) technique. Seven days after treatment, GFP signals had completely disappeared indicating that sentinel lymph node metastasis was selectively eradicated. Moreover, biologically treated mice were confirmed to be relapse-free even 4 weeks after treatment. These results indicate that virus-mediated biological ablation selectively targets lymph node metastasis and provides a potential alternative to surgery for submucosal invasive gastrointestinal cancer patients. PMID:25523761

  2. Sentinel lymph node biopsy in renal malignancy: The past, present and future

    PubMed Central

    Mahesan, Tharani; Coscione, Alberto; Ayres, Ben; Watkin, Nick

    2016-01-01

    Sentinel lymph node biopsy (SLNB) is now an established technique in penile and pelvic cancers, resulting in a lower mortality and morbidity when compared with the traditional lymph node dissection. In renal cancer however, despite some early successes for the SLNB technique, paucity of data remains a problem, thus lymph node dissection and extended lymph node dissection remain the management of choice in clinically node positive patients, with surveillance of lymph nodes in those who are clinically node negative. SLNB is a rapidly evolving technique and the introduction of new techniques such as near infra-red fluorescence optical imaging agents and positron emission tomography/computed tomography scans, may improve sensitivity. Evidence in support of this has already been recorded in bladder and prostate cancer. Although the lack of large multi-centre studies and issues around false negativity currently prevent its widespread use, with evolving techniques improving accuracy and the support of large-scale studies, SLNB does have the potential to become an integral part of staging in renal malignancy. PMID:26981443

  3. Biological Ablation of Sentinel Lymph Node Metastasis in Submucosally Invaded Early Gastrointestinal Cancer

    PubMed Central

    Kikuchi, Satoru; Kishimoto, Hiroyuki; Tazawa, Hiroshi; Hashimoto, Yuuri; Kuroda, Shinji; Nishizaki, Masahiko; Nagasaka, Takeshi; Shirakawa, Yasuhiro; Kagawa, Shunsuke; Urata, Yasuo; Hoffman, Robert M; Fujiwara, Toshiyoshi

    2015-01-01

    Currently, early gastrointestinal cancers are treated endoscopically, as long as there are no lymph node metastases. However, once a gastrointestinal cancer invades the submucosal layer, the lymph node metastatic rate rises to higher than 10%. Therefore, surgery is still the gold standard to remove regional lymph nodes containing possible metastases. Here, to avoid prophylactic surgery, we propose a less-invasive biological ablation of lymph node metastasis in submucosally invaded gastrointestinal cancer patients. We have established an orthotopic early rectal cancer xenograft model with spontaneous lymph node metastasis by implantation of green fluorescent protein (GFP)-labeled human colon cancer cells into the submucosal layer of the murine rectum. A solution containing telomerase-specific oncolytic adenovirus was injected into the peritumoral submucosal space, followed by excision of the primary rectal tumors mimicking the endoscopic submucosal dissection (ESD) technique. Seven days after treatment, GFP signals had completely disappeared indicating that sentinel lymph node metastasis was selectively eradicated. Moreover, biologically treated mice were confirmed to be relapse-free even 4 weeks after treatment. These results indicate that virus-mediated biological ablation selectively targets lymph node metastasis and provides a potential alternative to surgery for submucosal invasive gastrointestinal cancer patients. PMID:25523761

  4. Silica-Coated Gold Nanoplates as Stable Photoacoustic Contrast Agents for Sentinel Lymph Node Imaging

    PubMed Central

    Luke, Geoffrey P.; Bashyam, Ashvin; Homan, Kimberly A.; Makhija, Suraj; Chen, Yun-Sheng; Emelianov, Stanislav Y.

    2013-01-01

    A biopsy of the first lymph node to which a tumor drains – the sentinel lymph node (SLN) – is commonly performed to identify micrometastases. Image guidance of the SLN biopsy procedure has the potential to improve its accuracy and decrease its morbidity. We have developed a new stable contrast agent for photoacoustic image-guided SLN biopsy: silica-coated gold nanoplates (Si-AuNPs). The Si-AuNPs exhibit high photothermal stability when exposed to pulsed and continuous wave laser irradiation. This makes them well-suited for in vivo photoacoustic imaging. Furthermore, Si-AuNPs are shown to have low cytotoxicity. We tested the Si-AuNPs for SLN mapping in a mouse model where they exhibited a strong, sustained photoacoustic signal. Real-time ultrasound and photoacoustic imaging revealed that the Si-AuNPs quickly drain to the SLN gradually spreading throughout a large portion of the node. PMID:24121616

  5. Quantitative Molecular Analysis of Sentinel Lymph Node May Be Predictive of Axillary Node Status in Breast Cancer Classified by Molecular Subtypes

    PubMed Central

    Buglioni, Simonetta; Di Filippo, Franco; Terrenato, Irene; Casini, Beatrice; Gallo, Enzo; Marandino, Ferdinando; Maini, Carlo L.; Pasqualoni, Rossella; Botti, Claudio; Di Filippo, Simona; Pescarmona, Edoardo; Mottolese, Marcella

    2013-01-01

    To determine the performance of intraoperative one-step nucleic acid amplification (OSNA) assay in detecting sentinel lymph node metastases compared to postoperative histology taking into account breast cancer molecular classification and to evaluate whether the level of cytokeratin 19 mRNA copy number may be useful in predicting the likelihood of a positive axillary lymph node dissection. OSNA assay was performed in a prospective series of 903 consecutive sentinel lymph nodes from 709 breast cancer patients using 2 alternate slices of each sentinel lymph node. The remaining 2 slices were investigated by histology. Cytokeratin 19 mRNA copy number, which distinguishes negative cases (<250 copies), micrometastases (+, ≥250≤5000 copies) and macrometastases (++, >5000 copies), was compared to axillary lymph node dissection status and to the biological tumor profile. Concordance between OSNA and histopathology was 95%, specificity 95% and sensitivity 93%. Multiple Corresponce Analysis and logistic regression evidenced that positive axillary lymph node dissection was significantly associated with a higher cytokeratin 19 mRNA copy number (>5000; p<0.0001), HER2 subtype (p = 0.007) and lymphovascular invasion (p<0.0001). Conversely, breast cancer patients with cytokeratin 19 mRNA copy number <2000 mostly presented a luminal subtype and a negative axillary lymph node dissection. We confirmed that OSNA assay can provide standardized and reproducible results and that it represents a fast and quantitative tool for intraoperative evaluation of sentinel lymph node. Omission of axillary lymph node dissection could be proposed in patients presenting a sentinel lymph node with a cytokeratin 19 mRNA copy number <2000 and a Luminal tumor phenotype. PMID:23533593

  6. Sentinel lymph node biopsy in melanoma: final results of MSLT-I.

    PubMed

    Durham, Alison B; Wong, Sandra L

    2014-05-01

    In 1994 an international randomized controlled clinical trial, MSLT-I, opened to study the utility of sentinel lymph node biopsy (SLNB) for patients with clinically localized melanoma. This trial compared outcomes of patients treated with wide local excision (WLE) and SLNB (followed by immediate completion lymph node dissection [CLND] for those with a positive sentinel node [SN]) with outcomes of patients treated with WLE alone and CLND upon the development of clinically apparent disease. In February 2014 the final analysis of long-term outcomes data was published. Importantly, these data showed that the rates of nodal positivity were the same between the two arms of the trial. Although no difference in 10-year melanoma-specific survival was noted between the two arms, this was not entirely surprising as the overall rate of nodal disease within the trial was 20.8%, meaning that 79.2% of patients could not derive a benefit from SLNB. Subset analysis was performed to determine the impact of early intervention for those patients most likely to have a benefit from early detection. This analysis showed that for patients with nodal disease and intermediate-thickness melanoma (defined as 1.2-3.5-mm Breslow depth), early treatment following positive SLNB was associated with improved 10-year distant disease-free survival and improved 10-year melanoma-specific survival. PMID:24947251

  7. Prognostic significance of drainage to pelvic nodes at sentinel lymph node mapping in patients with extremity melanoma.

    PubMed

    Karakousis, Giorgos C; Pandit-Taskar, Neeta; Hsu, Meier; Panageas, Katherine; Atherton, Sonny; Ariyan, Charlotte; Brady, Mary S

    2013-02-01

    Patients undergoing sentinel lymph node (SLN) mapping for lower extremity melanoma may have drainage to pelvic nodes (DPN) in addition to superficial inguinal nodes. These nodes are not sampled routinely at SLN biopsy. Factors predicting DPN and its prognostic significance were assessed in a large cohort of patients undergoing an SLN biopsy. Three hundred and twenty five patients with single primary melanomas of the lower extremity or buttocks who underwent SLN mapping were identified from our prospective melanoma database (December 1995-October 2008). Associations of clinical and pathologic factors with DPN and time to melanoma recurrence (TTR) were analyzed by logistic and Cox regression, respectively. DPN was common, occurring in 23% of cases. Increased Breslow's thickness (P=0.007) and age (P=0.01) were associated with DPN by multivariate analysis. Patients with DPN were not more likely to have a positive SLN; however, SLN- patients with DPN showed a shorter TTR (P=0.02) in a multivariable model including thickness and ulceration. With age included in the model, DPN remained marginally associated with TTR in this group (P=0.08). The pelvic recurrence rates observed were similar in recurrent patients with DPN compared with those without DPN (39% in both groups). In conclusion, DPN occurs in almost one-quarter of patients with lower extremity melanoma and is marginally associated with a shorter TTR in SLN- patients. PMID:23250048

  8. New models and online calculator for predicting non-sentinel lymph node status in sentinel lymph node positive breast cancer patients

    PubMed Central

    Kohrt, Holbrook E; Olshen, Richard A; Bermas, Honnie R; Goodson, William H; Wood, Douglas J; Henry, Solomon; Rouse, Robert V; Bailey, Lisa; Philben, Vicki J; Dirbas, Frederick M; Dunn, Jocelyn J; Johnson, Denise L; Wapnir, Irene L; Carlson, Robert W; Stockdale, Frank E; Hansen, Nora M; Jeffrey, Stefanie S

    2008-01-01

    Background Current practice is to perform a completion axillary lymph node dissection (ALND) for breast cancer patients with tumor-involved sentinel lymph nodes (SLNs), although fewer than half will have non-sentinel node (NSLN) metastasis. Our goal was to develop new models to quantify the risk of NSLN metastasis in SLN-positive patients and to compare predictive capabilities to another widely used model. Methods We constructed three models to predict NSLN status: recursive partitioning with receiver operating characteristic curves (RP-ROC), boosted Classification and Regression Trees (CART), and multivariate logistic regression (MLR) informed by CART. Data were compiled from a multicenter Northern California and Oregon database of 784 patients who prospectively underwent SLN biopsy and completion ALND. We compared the predictive abilities of our best model and the Memorial Sloan-Kettering Breast Cancer Nomogram (Nomogram) in our dataset and an independent dataset from Northwestern University. Results 285 patients had positive SLNs, of which 213 had known angiolymphatic invasion status and 171 had complete pathologic data including hormone receptor status. 264 (93%) patients had limited SLN disease (micrometastasis, 70%, or isolated tumor cells, 23%). 101 (35%) of all SLN-positive patients had tumor-involved NSLNs. Three variables (tumor size, angiolymphatic invasion, and SLN metastasis size) predicted risk in all our models. RP-ROC and boosted CART stratified patients into four risk levels. MLR informed by CART was most accurate. Using two composite predictors calculated from three variables, MLR informed by CART was more accurate than the Nomogram computed using eight predictors. In our dataset, area under ROC curve (AUC) was 0.83/0.85 for MLR (n = 213/n = 171) and 0.77 for Nomogram (n = 171). When applied to an independent dataset (n = 77), AUC was 0.74 for our model and 0.62 for Nomogram. The composite predictors in our model were the product of angiolymphatic

  9. [Sentinel lymph node detection in breast cancer. Experience of the Institut Curie].

    PubMed

    Nos, C; Fréneaux, P; Clough, K B

    2000-05-01

    Sentinel lymph node biopsy is a recently developed, minimally invasive technique for staging the axilla in breast cancer. This new procedure of selective lymphadenectomy has been the subject of several studies, and a consensus of opinion is starting to form to define indications and methods of identification concerning the use of this technique. At the Institut Curie since 1996, we have been using the Patenté blue dye technique and from 1998 we have used the combination of blue dye and technetium labeled sulfur colloid. This article summarizes the principales aspect of this technique. PMID:10804363

  10. Sentinel lymph node detection by an optical method using scattered photons

    PubMed Central

    Tellier, Franklin; Ravelo, Rasata; Simon, Hervé; Chabrier, Renée; Steibel, Jérôme; Poulet, Patrick

    2010-01-01

    We present a new near infrared optical probe for the sentinel lymph node detection, based on the recording of scattered photons. A two wavelengths setup was developed to improve the detection threshold of an injected dye: the Patent Blue V dye. The method used consists in modulating each laser diode at a given frequency. A Fast Fourier Transform of the recorded signal separates both components. The signal amplitudes are used to compute relative Patent Blue V concentration. Results on the probe using phantoms model and small animal experimentation exhibit a sensitivity threshold of 3.2 µmol/L, which is thirty fold better than the eye visible threshold. PMID:21258517

  11. Preclinical Evaluation of Robotic-Assisted Sentinel Lymph Node Fluorescence Imaging

    PubMed Central

    Liss, Michael A.; Farshchi-Heydari, Salman; Qin, Zhengtao; Hickey, Sean A.; Hall, David J.; Kane, Christopher J.; Vera, David R.

    2015-01-01

    An ideal substance to provide convenient and accurate targeting for sentinel lymph node (SLN) mapping during robotic-assisted surgery has yet to be found. We used an animal model to determine the ability of the FireFly camera system to detect fluorescent SLNs after administration of a dual-labeled molecular imaging agent. Methods We injected the footpads of New Zealand White rabbits with 1.7 or 8.4 nmol of tilmanocept labeled with 99mTc and a near-infrared fluorophore, IRDye800CW. One and 36 h after injection, popliteal lymph nodes, representing the SLNs, were dissected with the assistance of the FireFly camera system, a fluorescence-capable endoscopic imaging system. After excision of the paraaortic lymph nodes, which represented non-SLNs, we assayed all lymph nodes for radioactivity and fluorescence intensity. Results Fluorescence within all popliteal lymph nodes was easily detected by the FireFly camera system. Fluorescence within the lymph channel could be imaged during the 1-h studies. When compared with the paraaortic lymph nodes, the popliteal lymph nodes retain greater than 95% of the radioactivity at both 1 and 36 h after injection. At both doses (1.7 and 8.4 nmol), the popliteal nodes had higher (P < 0.050) optical fluorescence intensity than the paraaortic nodes at the 1- and 36-h time points. Conclusion The FireFly camera system can easily detect tilmanocept labeled with a near-infrared fluorophore at least 36 h after administration. This ability will permit image acquisition and subsequent verification of fluorescence-labeled SLNs during robotic-assisted surgery. PMID:25024425

  12. Transaxillary breast augmentation: two breast cancer patients with successful sentinel lymph node diagnosis.

    PubMed

    Mottura, A Aldo; Del Castillo, René

    2007-01-01

    In recent years, some surgeons have been warned of possible problems with sentinel lymph node diagnosis (SLND) for patients who have undergone transaxillary breast augmentation (TBA), although no scientific studies support this warning. The authors report two additional cases of breast cancer in which the SLND was successfully performed for patients with previous TBA. The surgical anatomy of the axilla, the groups of lymph nodes, and a personal way of performing TBA are described. Five other reports concerning the same issue are thoroughly discussed. Four of these are clinical in vivo reports, and one is a cadaver study. The four in vivo studies and what we are reporting now clearly demonstrate that what was said regarding possible problems in the SLND after TBA was not founded on clinical research and contradicts these five clinical findings. PMID:17659414

  13. Sentinel lymph nodes fluorescence detection and imaging using Patent Blue V bound to human serum albumin

    PubMed Central

    Tellier, Franklin; Steibel, Jérôme; Chabrier, Renée; Blé, François Xavier; Tubaldo, Hervé; Rasata, Ravelo; Chambron, Jacques; Duportail, Guy; Simon, Hervé; Rodier, Jean-François; Poulet, Patrick

    2012-01-01

    Patent Blue V (PBV), a dye used clinically for sentinel lymph node detection, was mixed with human serum albumin (HSA). After binding to HSA, the fluorescence quantum yield increased from 5 × 10−4 to 1.7 × 10−2, which was enough to allow fluorescence detection and imaging of its distribution. A detection threshold, evaluated in scattering test objects, lower than 2.5 nmol × L−1 was obtained, using a single-probe setup with a 5-mW incident light power. The detection sensitivity using a fluorescence imaging device was in the µmol × L−1 range, with a noncooled CCD camera. Preclinical evaluation was performed on a rat model and permitted to observe inflamed nodes on all animals. PMID:23024922

  14. Intraoperative sentinel lymph node mapping guides laparoscopic-assisted distal gastrectomy for distal gastric cancer

    PubMed Central

    Liu, Naiqing; Niu, Zhengchuan; Niu, Wei; Peng, Cheng; Zou, Xueqing; Sun, Shuxiang; Shinichi, Obo; Shahbaz, Muhammad; Sun, Qinli; Jun, Niu

    2015-01-01

    Aims: The aim of this retrospective study is to explore the effects of sentinel lymph node (SLN) mapping guided laparoscopic-assisted distal gastrectomy (LADG) for distal gastric cancer. Methods: Two hundred patients were enrolled in this study. One hundred and one patients undergoing SLN guided LADG were designated as the SLN group. Ninety-nine patients having conventional LADG with D1 or D2 lymph node dissection were designated as the control group. Intraoperative and postoperative indicators such as the number of lymph nodes dissected, intraoperative and postoperative conditions, flow cytometry analysis of T lymphocyte subsets and natural killer (NK) cells, survival rates, recurrence rates and postoperative complications were investigated between these two groups. Results: The number of lymph nodes dissected in the SLN group was significantly lesser than that in the control group. Furthermore, in the SLN group, the patients achieved better immunization status, improved intraoperative and postoperative conditions and decreased postoperative complications. There were no significant differences were found in the positive lymph nodes detected, the distance between proximal and distal cutting edge, postoperative survival or recurrence rates. Conclusions: SLN guided LADG for gastric cancer is a safe and effective method and could achieve an equal clinical effect as traditional laparoscopic D1 or D2 radical operation with less operation trauma and better recovery. PMID:26131162

  15. Sentinel lymph node biopsy in breast cancer: a technical and clinical appraisal.

    PubMed

    Manca, Gianpiero; Tardelli, Elisa; Rubello, Domenico; Gennaro, Marta; Marzola, Maria Cristona; Cook, Gary J; Volterrani, Duccio

    2016-06-01

    Breast cancer is the most common type of cancer diagnosed in women worldwide. Regional lymph node status is one of the strongest predictors of long-term prognosis in primary breast cancer. Sentinel lymph node biopsy (SLNB) has replaced axillary lymph node dissection as the standard surgical procedure for staging clinically tumor-free regional nodes in patients with early-stage breast cancer. SLNB staging considerably reduces surgical morbidity in terms of shoulder dysfunction and lymphedema, without affecting diagnostic accuracy and prognostic information. Clinicians should not recommend axillary lymph node dissection for women with early-stage breast cancer who have tumor-free findings on SLNB because there is no advantage in terms of overall survival and disease-free survival. Starting from the early 1990s, SLNB has increasingly been used in breast cancer management, but its role is still debated under many clinical circumstances. Moreover, there is still a lack of standardization of the basic technical details of the procedure that is likely to be responsible for the variability found in the false-negative rate of the procedure (5.5-16.7%). In this article, we report the aspects of SLNB that are well established, those that are still debated, and the advancements that have taken place over the last 20 years. We have provided an update on the methodology from both a technical and a clinical point of view in the light of the most recent publications. PMID:26886421

  16. Sentinel Lymph Node Detection Using Laser-Assisted Indocyanine Green Dye Lymphangiography in Patients with Melanoma

    PubMed Central

    Jain, Vikalp; Phillips, Brett T.

    2013-01-01

    Introduction. Sentinel lymph node (SLN) biopsy is a vital component of staging and management of multiple cancers. The current gold standard utilizes technetium 99 (tech99) and a blue dye to detect regional nodes. While the success rate is typically over 90%, these two methods can be inconclusive or inconvenient for both patient and surgeon. We evaluated a new technique using laser-assisted ICG dye lymphangiography to identify SLN. Methods. In this retrospective analysis, we identified patients with melanoma who were candidates for SLN biopsy. In addition to tech99 and methylene blue, patients received a dermal injection of indocyanine green (ICG). The infrared signal was detected with the SPY machine (Novadaq), and nodes positive by any method were excised. Results. A total of 15 patients were evaluated, with 40 SLNs removed. Four patients were found to have nodal metastases on final pathology. 100% of these 4 nodes were identified by ICG, while only 75% (3/4) were positive for tech99 and/or methylene blue. Furthermore, none of the nodes missed by ICG (4/40) had malignant cells. Conclusion. ICG dye lymphangiography is a reasonable alternative for locating SLNs in patients with melanoma. Prospective studies are needed to better ascertain the full functionality of this technique. PMID:24382997

  17. Intraoperative mapping of sentinel lymph node metastases using a clinically translated ultrasmall silica nanoparticle.

    PubMed

    Bradbury, Michelle S; Pauliah, Mohan; Zanzonico, Pat; Wiesner, Ulrich; Patel, Snehal

    2016-07-01

    The management of regional lymph nodes in patients with melanoma has undergone a significant paradigm shift over the past several decades, transitioning from the use of more aggressive surgical approaches, such as lymph node basin dissection, to the application of minimally invasive sentinel lymph node (SLN) biopsy methods to detect the presence of nodal micrometastases. SLN biopsy has enabled reliable, highly accurate, and low-morbidity staging of regional lymph nodes in early stage melanoma as a means of guiding treatment decisions and improving patient outcomes. The accurate identification and staging of lymph nodes is an important prognostic factor, identifying those patients for whom the expected benefits of nodal resection outweigh attendant surgical risks. However, currently used standard-of-care technologies for SLN detection are associated with significant limitations. This has fueled the development of clinically promising platforms that can serve as intraoperative visualization tools to aid accurate and specific determination of tumor-bearing lymph nodes, map cancer-promoting biological properties at the cellular/molecular levels, and delineate nodes from adjacent critical structures. Among a number of promising cancer-imaging probes that might facilitate achievement of these ends is a first-in-kind ultrasmall tumor-targeting inorganic (silica) nanoparticle, designed to overcome translational challenges. The rationale driving these considerations and the application of this platform as an intraoperative treatment tool for guiding resection of cancerous lymph nodes is discussed and presented within the context of alternative imaging technologies. WIREs Nanomed Nanobiotechnol 2016, 8:535-553. doi: 10.1002/wnan.1380 For further resources related to this article, please visit the WIREs website. PMID:26663853

  18. Noninvasive photoacoustic sentinel lymph node mapping using Au nanocages as a lymph node tracer in a rat model

    NASA Astrophysics Data System (ADS)

    Song, Kwang Hyun; Kim, Chulhong; Cobley, Claire M.; Xia, Younan; Wang, Lihong V.

    2009-02-01

    Sentinel lymph node biopsy (SLNB) has been widely performed and become the standard procedure for axillary staging in breast cancer patients. In current SLNB, identification of SLNs is prerequisite, and blue dye and/or radioactive colloids are clinically used for mapping. However, these methods are still intraoperative, and especially radioactive colloids based method is ionizing. As a result, SLNB is generally associated with ill side effects. In this study, we have proposed near-infrared Au nanocages as a new tracer for noninvasive and nonionizing photoacoustic (PA) SLN mapping in a rat model as a step toward clinical applications. Au nanocages have great features: biocompatibility, easy surface modification for biomarker, a tunable surface plasmon resonance (SPR) which allows for peak absorption to be optimized for the laser being used, and capsule-type drug delivery. Au nanocage-enhanced photoacoustic imaging has the potential to be adjunctive to current invasive SLNB for preoperative axillary staging in breast cancer patients.

  19. Is sentinel lymph node biopsy more accurate than axillary dissection for staging nodal involvement in breast cancer patients?

    PubMed

    Marrazzo, Antonio; Taormina, Pietra; Gebbiab, Vittorio; David, Massimo; Riili, Ignazio; Lo Gerfo, Domenico; Casà, Luigi; Noto, Antonio

    2007-01-01

    Today evaluation of axillary involvement can be routinely performed with the technique of sentinel lymph node biopsy (SLNB). One of the greatest advantages of SLNB is the nearly total absence of local postoperative complications. It is important to understand whether SLNB is better than axillary lymph-node dissection (ALND) for staging axillary nodal involvement. The aim of the study was to evaluate the axillary staging accuracy comparing three different methods: axillary dissection, sentinel node biopsy with the traditional 4-6 sections and sentinel node biopsy with complete analysis of the lymph node. 527 consecutive patients (525 females and 2 males) with invasive breast cancer < or = 3 cm and clinically negative axillary nodes were divided into 3 different groups: group A treated with axillary dissection, group B treated with sentinel nodal biopsy analysed with 4-6 sections, and group C treated with sentinel node biopsy with analysis of the entire node. All patients underwent a quadrantectomy to treat the tumor. Group differences and statistical significance were assessed by ANOVA. The percentages of N+ in group A and group B were 25.80% and 28% respectively, while in the third group it rose to 45%, or almost half the patients. The differences among the three groups were statistically significant (p = 0.02). From our analysis of the data it emerges that axillary dissection and sentinel node biopsy with analysis of 4-6 sections have the same accuracy in staging the nodal status of the axilla; analysis of the entire sentinel lymph node revealed an increased number of patients with axillary nodal involvement, proving more powerful in predicting nodal stage. SLNB with complete examination of the SLN removed can be considered the best method for axillary staging in breast cancer patients with clinical negative nodes. In our study, the percentage of metastases encountered after complete examination of SLN was 45% compared to the accuracy of axillary dissection that

  20. Sentinel lymph node navigation surgery for gastric cancer: Does it really benefit the patient?

    PubMed Central

    Tani, Tohru; Sonoda, Hiromichi; Tani, Masaji

    2016-01-01

    Sentinel lymph node (SLN) navigation surgery is accepted as a standard treatment procedure for malignant melanoma and breast cancer. However, the benefit of reduced lymphadenectomy based on SLN examination remains unclear in cases of gastric cancer. Here, we review previous studies to determine whether SLN navigation surgery is beneficial for gastric cancer patients. Recently, a large-scale prospective study from the Japanese Society of Sentinel Node Navigation Surgery reported that the endoscopic dual tracer method, using a dye and radioisotope for SLN biopsy, was safe and effective when applied to cases of superficial and relatively small gastric cancers. SLN mapping with SLN basin dissection was preferred for early gastric cancer since it is minimally invasive. However, previous studies reported that limited gastrectomy and lymphadenectomy may not improve the patient’s postoperative quality of life (QOL). As a result, the benefit of SLN navigation surgery for gastric cancer patients, in terms of their QOL, is limited. Thus, endoscopic and laparoscopic limited gastrectomy combined with SLN navigation surgery has the potential to become the standard minimally invasive surgery in early gastric cancer. PMID:26973385

  1. Atypical Anaphylactic Reaction to Patent Blue During Sentinel Lymph Node Biopsy for Breast Cancer

    PubMed Central

    Lanitis, Sophocles; Filippakis, George; Sidhu, Virinder; Mufti, Ragheed AL; Lee, Tak H; Hadjiminas, Dimitri J

    2008-01-01

    INTRODUCTION We present an unusual case of severe anaphylaxis to Patent Blue dye with atypical clinical features during sentinel lymph node biopsy (SLNB). The medical personnel involved with sentinel node biopsies should be alert, and familiar with this unusual entity. We also present current data from the literature. CASE REPORT During a wide local excision for primary breast cancer and SLNB, and early during the operation, the patient became severely tachycardic and hypotensive without any signs of urticaria, rash, oedema, or bronchospasm. Resuscitation required the addition of noradrenaline infusion followed by an overnight admission to the intensive care unit. Raised serum tryptase levels supported the diagnosis of anaphylactic shock while skin tests showed a severe reaction to Patent Blue dye. CONCLUSIONS Severe, life-threatening anaphylaxis to Patent Blue dye may present without obvious previous exposure to the dye and without the cardinal signs of oedema, urticaria and bronchospasm making the diagnosis and management of such cases challenging. Correct diagnosis and identification of the causative factor is important and requires a specific set of laboratory tests that are not commonly requested in every-day medical practice. It is not clear from the literature whether the condition is common enough to justify pre-operative prophylactic or diagnostic measures. PMID:18492403

  2. The value of immunohistochemistry in sentinel lymph node histopathology in breast cancer

    PubMed Central

    Klevesath, M B; Bobrow, L G; Pinder, S E; Purushotham, A D

    2005-01-01

    The optimal protocol for the histopathological examination of sentinel lymph nodes (SLNs) in breast cancer has not been determined. The value of more detailed examination using immunohistochemistry (IHC) is controversial. A total of 476 SLNs from 216 patients were reviewed. Sentinel lymph nodes were sectioned at three levels at 100 μm intervals and stained with haematoxylin and eosin (H&E). If the H&E sections showed no evidence of metastasis, then the three serial sections were stained with a murine monoclonal anti-cytokeratin antibody (CAM 5.2). Metastatic deposits were classified as macrometastasis (>2.0 mm), micrometastasis (0.2–2.0 mm) or isolated tumour cells (ITC, <0.2 mm). Of the 216 patients, 56 (26%) had metastasis as identified by H&E. Immunohistochemistry detected metastatic deposits in a further nine patients (4%), of whom four (2%) had micrometastasis and five (2%) had ITC only. Those cases with micrometastases were all, on review, visible on the H&E sections. Immunohistochemistry detects only a small proportion of metastasis in SLNs. All metastatic deposits identified by IHC were either micrometastasis or ITC. Until the prognostic significance of these deposits has been determined, IHC may be of limited value in the histopathological examination of SLNs. PMID:15942633

  3. Molecular markers to complement sentinel node status in predicting survival in patients with high-risk locally invasive melanoma.

    PubMed

    Rowe, Casey J; Tang, Fiona; Hughes, Maria Celia B; Rodero, Mathieu P; Malt, Maryrose; Lambie, Duncan; Barbour, Andrew; Hayward, Nicholas K; Smithers, B Mark; Green, Adele C; Khosrotehrani, Kiarash

    2016-08-01

    Sentinel lymph node status is a major prognostic marker in locally invasive cutaneous melanoma. However, this procedure is not always feasible, requires advanced logistics and carries rare but significant morbidity. Previous studies have linked markers of tumour biology to patient survival. In this study, we aimed to combine the predictive value of established biomarkers in addition to clinical parameters as indicators of survival in addition to or instead of sentinel node biopsy in a cohort of high-risk melanoma patients. Patients with locally invasive melanomas undergoing sentinel lymph node biopsy were ascertained and prospectively followed. Information on mortality was validated through the National Death Index. Immunohistochemistry was used to analyse proteins previously reported to be associated with melanoma survival, namely Ki67, p16 and CD163. Evaluation and multivariate analyses according to REMARK criteria were used to generate models to predict disease-free and melanoma-specific survival. A total of 189 patients with available archival material of their primary tumour were analysed. Our study sample was representative of the entire cohort (N = 559). Average Breslow thickness was 2.5 mm. Thirty-two (17%) patients in the study sample died from melanoma during the follow-up period. A prognostic score was developed and was strongly predictive of survival, independent of sentinel node status. The score allowed classification of risk of melanoma death in sentinel node-negative patients. Combining clinicopathological factors and established biomarkers allows prediction of outcome in locally invasive melanoma and might be implemented in addition to or in cases when sentinel node biopsy cannot be performed. PMID:26990817

  4. Dual-Modality Photoacoustic and Ultrasound Imaging System for Noninvasive Sentinel Lymph Node Detection in Patients with Breast Cancer

    PubMed Central

    Garcia-Uribe, Alejandro; Erpelding, Todd N.; Krumholz, Arie; Ke, Haixin; Maslov, Konstantin; Appleton, Catherine; Margenthaler, Julie A.; Wang, Lihong V.

    2015-01-01

    The detection of regional lymph node metastases is important in cancer staging as it guides the prognosis of the patient and the strategy for treatment. Sentinel lymph node biopsy (SLNB) is an accurate, less invasive alternative to axillary lymph node dissection. The sentinel lymph node hypothesis states that the pathological status of the axilla can be accurately predicted by determining the status of the first lymph nodes that drain from the primary tumor. Physicians use radio-labeled sulfur colloid and/or methylene blue dye to identify the SLN, which is most likely to contain metastatic cancer cells. However, the surgical procedure causes morbidity and associated expenses. To overcome these limitations, we developed a dual-modality photoacoustic and ultrasonic imaging system to noninvasively detect SLNs based on the accumulation of methylene blue dye. Ultimately, we aim to guide percutaneous needle biopsies and provide a minimally invasive method for axillary staging of breast cancer. PMID:26510774

  5. Technique of sentinel lymph node biopsy and lymphatic mapping during laparoscopic colon resection for cancer

    PubMed Central

    Bianchi, PP; Andreoni, B; Rottoli, M; Celotti, S; Chiappa, A; Montorsi, M

    2007-01-01

    Background: The utility of lymph node mapping to improve staging in colon cancer is still under evaluation. Laparoscopic colectomy for colon cancer has been validated in multi-centric trials. This study assessed the feasibility and technical aspects of lymph node mapping in laparoscopic colectomy for colon cancer. Methods: A total of 42 patients with histologically proven colon cancer were studied from January 2006 to September 2007. Exclusion criteria were: advanced disease (clinical stage III), rectal cancer, previous colon resection and contraindication to laparoscopy. Lymph-nodal status was assessed preoperatively by computed tomography (CT) scan and intra-operatively with the aid of laparoscopic ultrasound. Before resection, 2–3 ml of Patent Blue V dye was injected sub-serosally around the tumour. Coloured lymph nodes were marked as sentinel (SN) with metal clips or suture and laparoscopic colectomy with lymphadenectomy completed as normal. In case of failure of the intra-operative procedure, an ex vivo SN biopsy was performed on the colectomy specimen after resection. Results: A total number of 904 lymph nodes were examined, with a median number of 22 lymph nodes harvested per patient. The SN detection rate was 100%, an ex vivo lymph node mapping was necessary in four patients. Eleven (26.2%) patients had lymph-nodal metastases and in five (45.5%) of these patients, SN was the only positive lymph node. There were two (18.2%) false-negative SN. In three cases (7.1%) with aberrant lymphatic drainage, lymphadenectomy was extended. The accuracy of SN mapping was 95.2% and negative predictive value was 93.9%. Conclusions: Laparoscopic lymphatic mapping and SN removal is feasible in laparoscopic colectomy for colon cancer. The ex vivo technique is useful as a salvage technique in case of failure of the intra-operative procedure. Prospective studies are justified to determine the real accuracy and false-negative rate of the technique. PMID:22275957

  6. Robotic-Assisted Fluorescence Sentinel Lymph Node Mapping Using Multi-Modal Image-Guidance in an Animal Model

    PubMed Central

    Liss, Michael A.; Stroup, Sean P.; Cand, Zhengtao Qin; Hoh, Carl; Hall, David J.; Vera, David R.; Kane, Christopher J.

    2015-01-01

    Objectives To investigate PET/CT pre-operative imaging and intraoperative detection of a fluorescent-labeled receptor-targeted radiopharmaceutical in a prostate cancer animal model. Methods Three male Beagle dogs underwent an intra-prostatic injection of fluorescent-tagged tilmanocept radio-labeled with both gallium-68 and technetium-99m. One hour after injection a pelvic PET/CT scan was performed for pre-operative sentinel lymph node (SLN) mapping. Definition of SLN was a standardized uptake value (SUV) that exceeded 5% of the lymph node with the highest SUV. Thirty-six hours later we performed robotic-assisted SLN dissection using a fluorescence-capable camera system. Fluorescent lymph nodes were clipped, the abdomen was opened, and the pelvic and retroperitoneal nodes were excised. All excised nodal packets were assayed by in vitro nuclear counting and reported as percent-of-injected dose. Results Pre-operative PET/CT imaging identified a median of three sentinel lymph nodes per animal. All sentinel lymph nodes (100%) identified by the PET/CT were fluorescent during robotic-assisted lymph node dissection. Of all fluorescent nodes visualized by the camera system, 83% (10/12) satisfied the 5%-rule defined by the PET/CT scan. The two lymph nodes that did not qualify accumulated less than 0.002% of the injected dose. Conclusions Fluorescent-labeled tilmanocept has optimal logistical properties to obtain pre-operative PET/CT and subsequent real-time intraoperative confirmation during robotic-assisted sentinel lymph node dissection. PMID:25139676

  7. Increased Angiogenesis and Lymphangiogenesis in Metastatic Sentinel Lymph Nodes Is Associated With Nonsentinel Lymph Node Involvement and Distant Metastasis in Patients With Melanoma.

    PubMed

    Pastushenko, Ievgenia; Van den Eynden, Gert G; Vicente-Arregui, Sandra; Prieto-Torres, Lucia; Alvarez-Alegret, Ramiro; Querol, Ignacio; Dirix, Luc Y; Carapeto, Francisco J; Vermeulen, Peter B; Van Laere, Steven J

    2016-05-01

    Lymph node angio- and lymphangio-genesis have been shown to play an important role in the premetastatic niche of sentinel lymph nodes. In the current study we have investigated the association of angio- and lympangio-genesis related parameters in metastatic sentinel lymph nodes of patients with melanoma with the presence of nonsentinel and distant organ metastasis. Peritumoral and intratumoral relative blood and lymphatic vessel areas (evaluated by Chalkley method), blood and lymphatic microvessel densities, and the rates of blood and lymphatic vessel proliferation were assessed in primary tumors and sentinel lymph node metastasis of 44 patients with melanoma using CD34/Ki-67 and D240/Ki-67 immunohistochemical double staining. Primary melanoma exhibited significantly higher rate of lymphatic proliferation compared with its lymph node metastasis (P < 0.05), while lymph node metastasis showed significantly higher rate of blood vessel proliferation (P < 0.05). Using multivariate logistic regression model, the rate of peritumoral lymphatic proliferation was inversely associated with positive nonsentinel lymph node status (P < 0.05), whereas the rate of intratumoral blood vessel proliferation was associated with distant organ metastasis (P < 0.05). Using multivariate Cox regression analysis, the rate of intratumoral blood vessel proliferation was also inversely associated with overall survival of patients with melanoma (P < 0.05). PMID:26909582

  8. Sentinel lymph node biopsy in bladder cancer: Systematic review and technology update

    PubMed Central

    Liss, Michael A.; Noguchi, Jonathan; Lee, Hak J.; Vera, David R.; Kader, A. Karim

    2015-01-01

    A sentinel lymph node (SLN) is the first lymph node to drain a solid tumor and likely the first place metastasis will travel. SLN biopsy has been well established as a staging tool for melanoma and breast cancer to guide lymph node dissection (LND); its utility in bladder cancer is debated. We performed a systematic search of PubMed for both human and animal studies that looked at SLN detection in cases of urothelial carcinoma of the bladder. We identified a total of nine studies that assessed a variety of imaging techniques to identify SLNs in patients with urothelial carcinoma of the bladder. Eight studies investigated human patients while one looked at animal (dog) models. Seven studies representing 156 patients noted the negative predictive value of the SLN to predict a metastasis free state was 92% (92/100). The SLN biopsy was less accurate in metastatic patients with a positive predictive value of only 77% (43/56) with a false negative range of in individual studies of 0-19%. Clinically, positive nodes routinely do not take up the pharmaceutical agent for SLN. Therefore, SLN biopsy is a promising concept with a 92% negative predictive value; however, the false negative rates are high which may be improved by standardizing populations and indications. Novel technologies are improving the detection of SLN and may provide the surgeon with an improved ability to detect micrometastasis, guide surgery, and reduce patient morbidity. PMID:26166959

  9. Use of the Sentinel Lymph Node Technique Compared to Complete Inguino-femoral Lymph Node Removal in Patients with Invasive Vulvar Cancer in Germany

    PubMed Central

    Kramer, F.; Hertel, H.; Hillemanns, P.

    2013-01-01

    In the current S2 guidelines, the standard surgical therapy for patients with vulvar cancer also includes inguino-femoral lymphadenectomy. However, in view of the severe side-effects associated with this approach such as problems with wound healing, lymphoceles and lymphoedema, the search is on for alternative treatments that could decrease treatment-associated morbidity and improve patientsʼ quality of life, particularly for node-negative patients. The sentinel lymph node technique is currently the gold standard in the treatment of unifocal breast cancer (clinically negative axilla), and studies on the use of this technique in the treatment of vulvar cancer are promising. To date, the diagnostic accuracy of this method in vulvar cancer has only been evaluated in a single, one-arm, non-randomised, multicentre study. In preparation for a multicentre study, in 2010 we surveyed 41 German hospitals to investigate how often they used the sentinel lymph node technique compared to inguino-femoral lymphadenectomy. The hospitals were grouped according to hospital size and number of patients treated for vulvar cancer. The decision criteria to determine the type of procedure performed were also investigated. Finally, the hospitals were asked whether they would be willing to participate in a prospective clinical study to evaluate the sentinel lymph node technique in patients with vulvar cancer. The majority of surgeons questioned (73 %) already had some experience with this technique in patients with vulvar cancer. In our survey, 27 % of hospitals carried out inguino-femoral lymphadenectomy, 10 % used the sentinel lymph node technique, and 63 % used both methods. In 24 % of hospitals, the standard procedure consisted of the sentinel lymph node technique supplemented by inguino-femoral lymphadenectomy. Only 20 % of the institutions surveyed in our study carried out sentinel lymph node biopsy alone in accordance with the criteria of the consensus recommendations

  10. Evaluation and localization of lymphatic drainage and sentinel lymph nodes in patients with head and neck melanomas by hybrid SPECT/CT lymphoscintigraphic imaging.

    PubMed

    Mar, Martha V; Miller, Scott A; Kim, E Edmund; Macapinlac, Homer A

    2007-03-01

    In patients with head and neck tumors, preoperative lymphoscintigraphy can be used to map lymphatic drainage patterns and identify sentinel lymph nodes. However, it is very difficult to determine the exact locations of head and neck sentinel nodes on preoperative lymphoscintigraphy without the use of anatomic landmarks. Lymph nodes in the head and neck are grouped into 7 regions, or levels, on the basis of anatomic landmarks. In patients undergoing standard lymphoscintigraphy, obtaining lateral marker images that show important anatomic landmarks can help with the localization of sentinel nodes. However, technical problems often render marker images of little or no use. Hybrid SPECT/CT lymphoscintigraphic imaging facilitates the localization of sentinel nodes by reliably showing the relationships between sentinel nodes and important anatomic structures. After reading this article, the reader should understand the lymph node level classification system for head and neck melanomas, be able to describe the technique used for the imaging of sentinel nodes in the head and neck region, and be able to demonstrate how SPECT/CT lymphoscintigraphic imaging can enable precise sentinel node localization and thus help to ensure minimal dissection. PMID:17337652

  11. Blue-dye sentinel node mapping in thyroid carcinoma: debatable results of feasibility.

    PubMed

    Peparini, N; Maturo, A; Di Matteo, F M; Tartaglia, F; Marchesi, M; Campana, E P

    2006-01-01

    The present study aims to investigate the feasibility and influence of the lymphatic mapping and sentinel node biopsy on determination of the nodal status in thyroid carcinoma using blue-dye method. Nine consecutive patients with cytological diagnosis of papillary carcinoma were included in this study. To detect the sentinel lymphnode, intra- or perinodular injection of an average quantity of 0.5 ml (range : 0.1-1.2) of Ble Patenté V was performed intraoperatively in 8 cases only, as in one case a solitary cystic nodule occupied the entire lobe and thus any injection was impossible. After an average time of 16 minutes (range : 5-25) before dissection of the thyroid , no lymphnodes and no lymphatic afferent thereto visibly coloured were evidenced, except for spread of the vital dye into adjacent tissue and disrupted blood and lymphatic vessels at the injection site. Our results evidence that : intranodular injection, does not allow proper diffusion of the dye in the adjacent parenchyma, and in nodules smaller than 1 cm it may be difficult ; and that it is hazardous in cystic nodule because of the rupture risk; perinodular injection, at the four cardinal points, is impossible when the nodule occupies the entire lobe or the isthmus; multinodular goiter complicates the identification by palpation of the neoplastic nodule in which the dye should be injected or, if perinodular injection is given, to detect the parenchyma surrounding the nodule. PMID:17168262

  12. Sentinel lymph node mapping in melanoma: the issue of false-negative findings.

    PubMed

    Manca, Gianpiero; Rubello, Domenico; Romanini, Antonella; Boni, Giuseppe; Chiacchio, Serena; Tredici, Manuel; Mazzarri, Sara; Duce, Valerio; Colletti, Patrick M; Volterrani, Duccio; Mariani, Giuliano

    2014-07-01

    Management of cutaneous melanoma has changed after introduction in the clinical routine of sentinel lymph node biopsy (SLNB) for nodal staging. By defining the nodal basin status, SLNB provides a powerful prognostic information. Nevertheless, some debate still surrounds the accuracy of this procedure in terms of false-negative rate. Several large-scale studies have reported a relatively high false-negative rate (5.6%-21%), correctly defined as the proportion of false-negative results with respect to the total number of "actual" positive lymph nodes. In this review, we identified all the technical aspects that the nuclear medicine physician, the surgeon, and the pathologist should take into account to improve accuracy of the procedure and minimize the false-negative rate. In particular, SPECT/CT imaging detects more SLNs than those found by planar lymphoscintigraphy. Furthermore, the nuclear medicine community should reach a consensus on the radioactive counting rate threshold to better guide the surgeon in identifying the lymph nodes with the highest likelihood of housing metastases ("true biologic SLNs"). Analysis of the harvested SLNs by conventional techniques is also a further potential source for error. More accurate SLN analysis (eg, molecular analysis by reverse transcriptase-polymerase chain reaction) and more extensive SLN sampling identify more positive nodes, thus reducing the false-negative rate.The clinical factors identifying patients at higher-risk local recurrence after a negative SLNB include older age at diagnosis, deeper lesions, histological ulceration, and head-neck anatomic location of the primary lesion.The clinical impact of a false-negative SLNB on the prognosis of melanoma patients remains controversial, because the majority of studies have failed to demonstrate overall statistically significant disadvantage in melanoma-specific survival for false-negative SLNB patients compared with true-positive SLNB patients.When new more effective

  13. Near infrared photoacoustic detection of sentinel lymph nodes with gold nanobeacons.

    PubMed

    Pan, Dipanjan; Pramanik, Manojit; Senpan, Angana; Ghosh, Soumojit; Wickline, Samuel A; Wang, Lihong V; Lanza, Gregory M

    2010-05-01

    Detection of sentinel lymph node (SLN) using photoacoustic imaging is an emerging technique for noninvasive axillary staging of breast cancer. Due to the absence of intrinsic contrast inside the lymph nodes, exogenous contrast agents are used for photoacoustic detection. In this work, we have demonstrated near infrared detection of SLN with gold nanobeacons (GNBs) providing the photoacoustic contrast in a rodent model. We found that size dictates the in vivo characteristics of these nanoparticles in SLN imaging. Larger nanobeacons with high payloads of gold were not as efficient as smaller size nanobeacons with lower payloads for this purpose. Colloidal GNBs were designed as a nanomedicine platform with "soft" nature that is amenable to bio-elimination, an essential feature for in vivo efficacy and safety. The GNBs were synthesized as lipid- or polymer-encapsulated colloidal particles incorporating tiny gold nanoparticles (2-4 nm) in three tunable sizes (90 nm, 150 nm and 290 nm). Smaller GNBs were noted trafficking through the lymphatic system and accumulating more efficiently in the lymph nodes in comparison to the bigger nanoagents. At 20 min, the GNBs reached the SLN and were no longer observed within the draining lymphatic vessel. Within 1 h post-injection, the contrast ratio of the lymph nodes with the surrounding blood vessels was 9:1. These findings were also supported by analytical measurements of the ex vivo tissue samples. Results indicate that cumulative nanoparticle deposition in lymph nodes is size dependent and that high payloads of gold, although offering greater contrast in vitro, may yield nanoagents with poor intradermal migration and lymphatic transport characteristics. PMID:20172607

  14. Intraoperative Imaging Guidance for Sentinel Node Biopsy in Melanoma Using a Mobile Gamma Camera

    SciTech Connect

    Dengel, Lynn T; Judy, Patricia G; Petroni, Gina R; Smolkin, Mark E; Rehm, Patrice K; Majewski, Stan; Williams, Mark B

    2011-04-01

    The objective is to evaluate the sensitivity and clinical utility of intraoperative mobile gamma camera (MGC) imaging in sentinel lymph node biopsy (SLNB) in melanoma. The false-negative rate for SLNB for melanoma is approximately 17%, for which failure to identify the sentinel lymph node (SLN) is a major cause. Intraoperative imaging may aid in detection of SLN near the primary site, in ambiguous locations, and after excision of each SLN. The present pilot study reports outcomes with a prototype MGC designed for rapid intraoperative image acquisition. We hypothesized that intraoperative use of the MGC would be feasible and that sensitivity would be at least 90%. From April to September 2008, 20 patients underwent Tc99 sulfur colloid lymphoscintigraphy, and SLNB was performed with use of a conventional fixed gamma camera (FGC), and gamma probe followed by intraoperative MGC imaging. Sensitivity was calculated for each detection method. Intraoperative logistical challenges were scored. Cases in which MGC provided clinical benefit were recorded. Sensitivity for detecting SLN basins was 97% for the FGC and 90% for the MGC. A total of 46 SLN were identified: 32 (70%) were identified as distinct hot spots by preoperative FGC imaging, 31 (67%) by preoperative MGC imaging, and 43 (93%) by MGC imaging pre- or intraoperatively. The gamma probe identified 44 (96%) independent of MGC imaging. The MGC provided defined clinical benefit as an addition to standard practice in 5 (25%) of 20 patients. Mean score for MGC logistic feasibility was 2 on a scale of 1-9 (1 = best). Intraoperative MGC imaging provides additional information when standard techniques fail or are ambiguous. Sensitivity is 90% and can be increased. This pilot study has identified ways to improve the usefulness of an MGC for intraoperative imaging, which holds promise for reducing false negatives of SLNB for melanoma.

  15. Experimental study of 99mTc-aluminum oxide use for sentinel lymph nodes detection

    NASA Astrophysics Data System (ADS)

    Chernov, V. I.; Sinilkin, I. G.; Zelchan, R. V.; Medvedeva, A. A.; Lyapunov, A. Yu.; Bragina, O. D.; Varlamova, N. V.; Skuridin, V. S.

    2016-08-01

    The purpose of the study was a comparative research in the possibility of using the radiopharmaceuticals 99mTc-Al2O3 and 99mTc-Nanocis for visualizing sentinel lymph nodes. The measurement of the sizes of 99mTc-Al2O3 and 99mTc-Nanocis colloidal particles was performed in seven series of radiopharmaceuticals. The pharmacokinetics of 99mTc-Al2O3 and 99mTc-Nanocis was researched on 50 white male rats. The possibility of the use of 99mTc-Al2O3 and 99mTc-Nanocis for lymphoscintigraphy was studied in the experiments on 12 white male rats. The average dynamic diameter of the sol particle was 52-77 nm for 99mTc-Al2O3 and 16.7-24.5 nm for 99mTc-Nanocis. Radiopharmaceuticals accumulated in the inguinal lymph node in 1 hour after administration; the average uptake of 99mTc-Al2O3 was 8.6% in it, and the accumulation of 99mTc-Nanocis was significantly lower—1.8% (p < 0.05). In all study points the average uptake of 99mTc-Al2O3 in the lymph node was significantly higher than 99mTc-Nanocis accumulation. The results of dynamic scintigraphic studies in rats showed that 99mTc-Al2O3 and 99mTc-Nanocis actively accumulated into the lymphatic system. By using 99mTc-Al2O3 inguinal lymph node was determined in 5 minutes after injection and clearly visualized in all the animals in the 15th minute, when the accumulation became more than 1% of the administered dose. Further observation indicated that the 99mTc-Al2O3 accumulation reached a plateau in a lymph node (average 10.5%) during 2-hour study and then its accumulation remained practically at the same level, slightly increasing to 12% in 24 hours. In case of 99mTc-Nanocis inguinal lymph node was visualized in all animals for 15 min when it was accumulated on the average 1.03% of the administered dose. Plateau of 99mTc-Nanocis accumulation in the lymph node (average 2.05%) occurred after 2 hours of the study and remained almost on the same level (in average 2.3%) for 24 hours. Thus, the experimental study of a new domestic

  16. Correlation between serum levels of vascular endothelial growth factor-C and sentinel lymph node status in early breast cancer.

    PubMed

    Pérez, Diego; Rohde, Alexander; Callejón, Gonzalo; Pérez-Ruiz, Elisabeth; Rodrigo, Isabel; Rivas-Ruiz, Francisco; Ramos, Belen; Medina, Francisco; Villatoro, Rosa; Redondo, Maximino; Zarcos, Irene; Maañón, Claudio; Rueda, Antonio

    2015-12-01

    Axillary lymph nodes status is the most important prognosis factor in early breast cancer. This status is known by a selective sentinel lymph node biopsy (SLNB) and/or lymphadenectomy. Immunohistochemical studies of breast cancer tumour tissue have reported a relation between the increased expression of vascular endothelial growth factor-C (VEGF-C) and the risk of lymph node metastasis. We researched whether serum levels of VEGF-C could be a predictor factor of sentinel lymph node status in these patients. A prospective analysis was performed on serum from 174 patients with early breast cancer who underwent SLNB. The level of VEGF-C was determined by enzyme-linked immunosorbent assay. Clinical-pathologic variables were collected. Univariate analysis and multivariate logistic regression were conducted, taking SLNB positivity as the segmentation variable. The predictive value of VEGF-C was assessed using ROC curves. Of the sample group of 167 patients, 64 (38.3 %) had affected lymph node. Eighteen patients (28.1 %) presented micrometastasis; there were isolated tumour cells in 11 cases (17.2 %) and macrometastasis in 35 (54.6 %). The median value of VEGF-C was 6561.5 pg/ml. These values did not correlate with any clinical variables, and there was no association between the level of VEGF-C and SLNB status (p = 0.626). In the multivariate analysis, tumour size (p = 0.009) and the presence of vascular invasion (p < 0.001) were independently associated with sentinel lymph node affected. Serum levels of VEGF-C do not appear to predict sentinel lymph node status in patients with early breast cancer who undergo SLNB. PMID:26104766

  17. Sentinel lymph node mapping in breast cancer: a critical reappraisal of the internal mammary chain issue.

    PubMed

    Manca, G; Volterrani, D; Mazzarri, S; Duce, V; Svirydenka, A; Giuliano, A; Mariani, G

    2014-06-01

    Although, like the axilla, the internal mammary nodes (IMNs) are a first-echelon nodal drainage site in breast cancer, the importance of their treatment has long been debated. Seminal randomized trials have failed to demonstrate a survival benefit from surgical IMN dissection, and several retrospective studies have shown that IMNs are rarely the first site of recurrence. However, the recent widespread adoption of sentinel lymph node (SLN) biopsy has stimulated a critical reappraisal of such early results. Furthermore, the higher proportion of screening-detected cancers, improved imaging and techniques (i.e., lymphoscintigraphy for radioguided SLN biopsy) make it possible to visualize lymphatic drainage to the IMNs. The virtually systematic application of adjuvant systemic and/or loco-regional radiotherapy encourages re-examination of the significance of IMN metastases. Moreover, randomized trials testing the value of postmastectomy irradiation and a meta-analysis of 78 randomized trials have provided high levels of evidence that local-regional tumor control is associated with long-term survival improvements. This benefit was limited to trials that used systemic chemotherapy, which was not routinely administered in the earlier studies. However, the contribution from IMN treatment is unclear. Lymphoscintigraphic studies have shown that a significant proportion of breast cancers have primary drainage to the IMNs, including approximately 30% of medial tumors and 15% of lateral tumors. In the few studies where IMN biopsy was performed, 20% of sentinel IMNs were metastatic. The risk of IMN involvement is higher in patients with medial tumors and positive axillary nodes. IMN metastasis has prognostic significance, as recognized by its inclusion in the American Joint Committee on Cancer staging criteria, and seems to have similar prognostic importance as axillary nodal involvement. Although routine IMN evaluation might be indicated, it has not been routinely performed

  18. Usefulness of sentinel lymph node biopsy for prognostic prediction in extramammary Paget's disease.

    PubMed

    Ogata, Dai; Kiyohara, Yoshio; Yoshikawa, Syusuke; Tsuchida, Tetsuya

    2016-06-01

    Complete excision of the primary lesion has long been considered the standard treatment for extramammary Paget's disease (EMPD). However, the presence of lymph node metastases has been reported as an important prognostic factor. We evaluated the association between lymph node metastasis and prognosis for EMPD using sentinel lymph node (SLN) biopsy. This retrospective study included 59 patients with histopathologically-confirmed primary EMPD. A total of 45 patients with microinvasion to the papillary dermis and deep invasion into the reticular dermis or subcutaneous tissue were included in the analysis. The survival curves of the SLN-negative group and the SLN-positive group were compared and we examined the risk factors for SLN positivity. A total of 139 SLNs were excised from one (28 patients) or both inguinal regions (31 patients). The average number of detected SLNs was 2.4. The incidence of SLN metastases was 16.9%. SLN positivity rates according to level of invasion were 0% for intraepithelial lesions, 4.1% for microinvasion, and 42.8% for dermal invasion. The five-year survival rates were 100% in the SLN-negative and 24% in the SLN-positive groups (p = 0.0001). Reticular dermis or subcutaneous tissue invasion was a significant independent risk factor for SLN positivity according to multivariate analysis. The result of SLN biopsy affected prognosis. It is extremely important to accurately ascertain the presence, i.e. the number, or absence of regional lymph node metastases in patients with EMPD. We conclude that SLN biopsy may be appropriate for cases where invasion is suspected. PMID:26985569

  19. Ultrasound of the sentinel node in melanoma patients: echo-free island is a discriminatory morphologic feature for node positivity.

    PubMed

    Voit, Christiane A; Oude Ophuis, Charlotte M C; Ulrich, Jens; van Akkooi, Alexander C J; Eggermont, Alexander M M

    2016-06-01

    Unlike breast and thyroid cancer, the use of ultrasound (US)-guided fine needle aspiration cytology (FNAC) for preoperative staging is limited in melanoma. New US morphology criteria have shown that US-FNAC can correctly identify 50% of all involved sentinel nodes (SN) in melanoma patients before surgical excision. The aim of this study was to examine a new criterion: the echo-free island (EFI). A total of 1000 consecutively staged melanoma patients (Breslow thickness>1 or<1 mm, but ulcerated, Clark IV/V or regressed) scheduled for SN staging underwent preoperative US. US morphology items were assessed: peripheral perfusion, loss of central echoes, balloon shape, and EFI. FNAC was performed in case of suspicious and malignant US patterns. All patients proceeded to undergo an SN biopsy or direct completion lymph node dissection (CLND) (in the case of positive FNAC). In all, 57% of the patients were men. The mean/median Breslow thickness was 2.58/1.57 mm. The mean/median follow-up was 56/53 months. SN was positive in 21%. EFI information was available in 95.3%. EFI was seen in 40 patients (4%). EFI sensitivity was 10.8%, specificity was 97.6%, positive predictive value was 50%, and negative predictive value was 80.2%. EFI was significantly correlated to peripheral perfusion (67.5%). There was no correlation to balloon shape or loss of central echoes. Five-year melanoma-specific survival of patients with EFI was significantly worse: 80% versus 92% when absent. The EFI can be useful in the early detection of SN melanoma metastasis. It is an early sign of involvement and thus associated with a decreased survival. PMID:26881876

  20. A dual-modality photoacoustic and ultrasound imaging system for noninvasive sentinel lymph node detection: preliminary clinical results

    NASA Astrophysics Data System (ADS)

    Erpelding, Todd N.; Garcia-Uribe, Alejandro; Krumholz, Arie; Ke, Haixin; Maslov, Konstantin; Appleton, Catherine; Margenthaler, Julie; Wang, Lihong V.

    2014-03-01

    Sentinel lymph node biopsy (SLNB) has emerged as an accurate, less invasive alternative to axillary lymph node dissection, and it has rapidly become the standard of care for patients with clinically node-negative breast cancer. The sentinel lymph node (SLN) hypothesis states that the pathological status of the axilla can be accurately predicted by determining the status of the first (i.e., sentinel) lymph nodes that drain from the primary tumor. Physicians use radio-labeled sulfur colloid and/or methylene blue dye to identify the SLN, which is most likely to contain metastatic cancer cells. However, the surgical procedure causes morbidity and associated expenses. To overcome these limitations, we developed a dual-modality photoacoustic and ultrasound imaging system to noninvasively detect SLNs based on the accumulation of methylene blue dye. Ultimately, we aim to guide percutaneous needle biopsies and provide a minimally invasive method for axillary staging of breast cancer. The system consists of a tunable dye laser pumped by a Nd:YAG laser, a commercial ultrasound imaging system (Philips iU22), and a multichannel data acquisition system which displays co-registered photoacoustic and ultrasound images in real-time. Our clinical results demonstrate that real-time photoacoustic imaging can provide sensitive and specific detection of methylene blue dye in vivo. While preliminary studies have shown that in vivo detection of SLNs by using co-registered photoacoustic and ultrasound imaging is feasible, further investigation is needed to demonstrate robust SLN detection.

  1. Axillary Dissection in Breast Cancer Patients with Metastatic Sentinel Node: To Do or Not to Do? Suggestions from Our Series

    PubMed Central

    Bortolini, M.; Genta, F.; Biacchiardi, Chiara Perono; Zanon, E.; Camanni, M.; Deltetto, F.

    2011-01-01

    Several studies have put to question and evaluated the indication and prognosis of sentinel lymph node biopsy (SNLB) as sole treatment in human breast cancer. We reviewed 1588 patients who underwent axillary surgery. In 239 patients, axillary lymph node dissection (ALND) was performed following positive fine needle aspiration cytology (FNAC), and, in 299 cases, ALND was executed after positive SNLB. The most dramatic result from our data is that patients with either micrometastasis of the sentinel lymph node (SLN) or only metastatic SLN have, respectively, an 84.5% and a 75.0% chance of having no other nodal involvement. We believe a more refined patient selection is neccessary when considering ALND. Where the primary tumor is larger than 5 cm, where radio or adjuvant therapies are not indicated, in cases of FNAC+ nodes, and in cases presenting more than one metastatic sentinel node, we prefer to carry out ALND. Having thus said, however, our data suggests that it is wise not to perform ALND in almost all cases presenting positive SLNs. PMID:22084733

  2. A mini-review on factors and countermeasures associated with false-negative sentinel lymph node biopsies in breast cancer

    PubMed Central

    Han, Chao; Yang, Li

    2016-01-01

    Sentinel lymph node biopsy (SLNB) is a new surgical technique for local axillary lymph nodes (ALNs) of breast cancer. Large-scale clinical trials have confirmed that undergoing SLNB and ALN dissection (ALND) showed no significant difference for sentinel lymph node (SLN)-negative patients in terms of disease-free survival, overall survival and recurrence-free survival. However, false-negative results are still the main concern of physicians as well as patients who undergo SLNB instead of ALND. The American Society of Breast Surgeons established a task force to suggest acceptable standards for SLNB. In 2000, the task force recommended that the identification rate for SLNB be 85% or higher and the false-negative rate be 5% or lower. This review focuses on clinical factors (tumor volume, multifocal/multi-center cancers, neoadjuvant chemotherapy and skip metastasis), tracer techniques and pathological factors affecting SLNB and explores methods for reducing the false-negative rate PMID:27478323

  3. Characterization of the Microenvironment in Positive and Negative Sentinel Lymph Nodes from Melanoma Patients

    PubMed Central

    Messaoudene, Meriem; Périer, Aurélie; Fregni, Giulia; Neves, Emmanuelle; Zitvogel, Laurence; Cremer, Isabelle; Chanal, Johan; Sastre-Garau, Xavier; Deschamps, Lydia; Marinho, Eduardo; Larousserie, Frederique; Maubec, Eve; Avril, Marie-Françoise; Caignard, Anne

    2015-01-01

    Melanomas are aggressive skin tumors characterized by high metastatic potential. Our previous results indicate that Natural Killer (NK) cells may control growth of melanoma. The main defect of blood NK cells was a decreased expression of activating NCR1/NKp46 receptor and a positive correlation of NKp46 expression with disease outcome in stage IV melanoma patients was found. In addition, in stage III melanoma patients, we identified a new subset of mature NK cells in macro-metastatic Lymph nodes (LN). In the present studies, we evaluated the numbers of NK cells infiltrating primary cutaneous melanoma and analyzed immune cell subsets in a series of sentinel lymph nodes (SLN). First, we show that NKp46+ NK cells infiltrate primary cutaneous melanoma. Their numbers were related to age of patients and not to Breslow thickness. Then, a series of patients with tumor-negative or -positive sentinel lymph nodes matched for Breslow thickness of the cutaneous melanoma was constituted. We investigated the distribution of macrophages (CD68), endothelial cells, NK cells, granzyme B positive (GrzB+) cells and CD8+ T cells in the SLN. Negative SLN (SLN-) were characterized by frequent adipose involution and follicular hyperplasia compared to positive SLN (SLN+). High densities of macrophages and endothelial cells (CD34), prominent in SLN+, infiltrate SLN and may reflect a tumor favorable microenvironment. Few but similar numbers of NK and GrzB+ cells were found in SLN- and SLN+: NK cells and GrzB+ cells were not correlated. Numerous CD8+ T cells infiltrated SLN with a trend for higher numbers in SLN-. Moreover, CD8+ T cells and GrzB+ cells correlated in SLN- not in SLN+. We also observed that the numbers of CD8+ T cells negatively correlated with endothelial cells in SLN-. The numbers of NK, GrzB+ or CD8+ T cells had no significant impact on overall survival. However, we found that the 5 year-relapse rate was higher in SLN with higher numbers of NK cells. PMID:26218530

  4. In vivo quantitative evaluation of gold nanocages' kinetics in sentinel lymph nodes by photoacoustic tomography

    NASA Astrophysics Data System (ADS)

    Cai, Xin; Li, Weiyang; Kim, Chulhong; Yuan, Yuchen; Xia, Younan; Wang, Lihong V.

    2012-02-01

    As a new class of sentinel lymph node (SLN) tracers for photoacoustic (PA) imaging, Au nanocages offer the advantages of noninvasiveness, strong optical absorption in the near-infrared region (for deep penetration), and accumulation in higher concentrations than the initial injected solution. By monitoring the amplitude changes of PA signals in an animal model, we quantified the accumulations of nanocages in SLNs over time. Based on this method, we quantitatively evaluated the kinetics of gold nanocages in SLN in terms of concentration, size, and surface modification. We could detect the SLN at an Au nanocage injection concentration of 50 pM and a dose of 100 μL in vivo. This concentration is about 40 times less than the previously reported value. We also investigated the influence of nanocages' size (50 nm and 30 nm in edge length), and the effects of surface modification (with positive, or neutral, or negative surface charges). The results are helpful to develop this AuNC-based PA imaging system for noninvasive lymph node mapping, providing valuable information about metastatic cancer staging.

  5. [Sentinel lymph node procedure in melanoma patients: a staging procedure, not a therapy].

    PubMed

    van Akkooi, Alexander C J; Kukutsch, Nicole A; Soetekouw, Patricia M M B

    2014-01-01

    The definitive results of the MSLT-1 study in melanoma patients were published recently. The sentinel lymph node (SLN) procedure shows no survival benefit compared with observation. The authors reported, however, that there was a survival benefit with "biopsy management" of patients. This statement is based on subgroup analyses that we find to be incorrect for three reasons: (a) patients with a false negative SLN were incorrectly left out of consideration; (b) accelerated failure time latent subgroup analysis is an unproven statistical hypothesis, which was developed on interim data from the MSLT-1 study, and therefore cannot be used as validation; (c) there is a significant difference in terms of the percentage of patients with affected lymph nodes between the SLN group and the observation group. This excess of "prognostic false positive" patients would have incorrectly falsely improved the survival of the SLN group. We concluded that the SLN procedure does not give a survival benefit and that its role in melanoma patients should be for staging purposes and not for therapeutic purposes. PMID:25370949

  6. Quantitative assessment of the radiation hazards and risks in sentinel node procedures.

    PubMed

    Morton, R; Horton, P W; Peet, D J; Kissin, M W

    2003-02-01

    Sentinel node localization using an injected radiopharmaceutical and a gamma probe is performed in many hospitals. Employers have a duty to give appropriate training to staff who may not have been previously formally trained to work with unsealed radioactive sources. A study was performed to assess hazards and risks at all stages of the localization procedure. Whole body doses and finger doses of imaging, surgery and pathology staff were determined. The activity remaining in the tumour specimen, excised nodes and disposable waste from the operating theatre was measured. Any radioactive contamination of the operating theatre and equipment was also ascertained. All results were then assessed in light of current UK radiation protection legislation for the protection of staff and members of the public. Results showed that radiation doses are low and no additional procedures are required for protection of staff, provided the usual procedures for biohazards are in place. However, an information sheet has been prepared for the reassurance of staff, and theatre swabs may need to be stored temporarily before disposal. Injecting and imaging on the day before surgery is preferred, compared with injecting and imaging before surgery on the same day, since this gives lower radiation doses to staff, lower activity in excised specimens and waste, and provides a higher count rate giving better image quality. PMID:12642280

  7. Current Innovations in Sentinel Lymph Node Mapping for the Staging and Treatment of Resectable Lung Cancer

    PubMed Central

    Hachey, Krista J.; Colson, Yolonda L.

    2016-01-01

    Despite surgical resectability, early stage lung cancer remains a challenge to cure. Survival outcomes are hindered by variable performance of adequate lymphadenectomy and the limitations of current pathologic nodal staging. Sentinel lymph node (SLN) mapping, a mainstay in the management of breast cancer and melanoma, permits targeted nodal sampling for efficient and accurate staging that can influence both intraoperative and adjuvant treatment decisions. Unfortunately, standard SLN identification techniques with blue dye and radiocolloid tracers have not been shown to be reproducible in lung cancer. In more recent years, intraoperative near infrared (NIR) image-guided lung SLN mapping has emerged as promising technology for the identification of the tumor-associated lymph nodes most likely to contain metastatic disease. Additionally, the clinical relevance of SLN mapping for lung cancer remains pressing, as the ability to identify micrometastatic disease in SLNs could facilitate trials to assess chemotherapeutic response and the clinical impact of occult nodal disease. This review will outline the current status of lung cancer lymphatic mapping and techniques in development that may help close the gap between translational research in this field and routine clinical practice. PMID:25527014

  8. A critical review of variables affecting the accuracy and false-negative rate of sentinel node biopsy procedures in early breast cancer.

    PubMed

    Vijayakumar, Vani; Boerner, Philip S; Jani, Ashesh B; Vijayakumar, Srinivasan

    2005-05-01

    Radionuclide sentinel lymph node localization and biopsy is a staging procedure that is being increasingly used to evaluate patients with invasive breast cancer who have clinically normal axillary nodes. The most important prognostic indicator in patients with invasive breast cancer is the axillary node status, which must also be known for correct staging, and influences the selection of adjuvant therapies. The accuracy of sentinel lymph node localization depends on a number of factors, including the injection method, the operating surgeon's experience and the hospital setting. The efficacy of sentinel lymph node mapping can be determined by two measures: the sentinel lymph node identification rate and the false-negative rate. Of these, the false-negative rate is the most important, based on a review of 92 studies. As sentinel lymph node procedures vary widely, nuclear medicine physicians and radiologists must be acquainted with the advantages and disadvantages of the various techniques. In this review, the factors that influence the success of different techniques are examined, and studies which have investigated false-negative rates and/or sentinel lymph node identification rates are summarized. PMID:15838421

  9. Establishing a Sentinel Lymph Node Mapping Algorithm for the Treatment of Early Cervical Cancer

    PubMed Central

    Cormier, Beatrice; Diaz, John P.; Shih, Karin; Sampson, Rachael M.; Sonoda, Yukio; Park, Kay J.; Alektiar, Khaled; Chi, Dennis S.; Barakat, Richard R.; Abu-Rustum, Nadeem R.

    2016-01-01

    Objective To establish an algorithm that incorporates sentinel lymph node (SLN) mapping to the surgical treatment of early cervical cancer, ensuring that lymph node (LN) metastases are accurately detected but minimizing the need for complete lymphadenectomy (LND). Methods A prospectively maintained database of all patients who underwent SLN procedure followed by a complete bilateral pelvic LND for cervical cancer (FIGO stages IA1 with LVI to IIA) from 03/2003 to 09/2010 was analyzed. The surgical algorithm we evaluated included the following: 1. SLN are removed and submitted to ultrastaging; 2. Any suspicious LN is removed regardless of mapping; 3. If only unilateral mapping is noted, a contralateral side-specific pelvic LND is performed (including inter-iliac nodes); 4. Parametrectomy en bloc with primary tumor resection is done in all cases. We retrospectively applied the algorithm to determine how it would have performed. Results One hundred twenty-two patients were included. Median SLN count was 3 and median total LN count was 20. At least one SLN was identified in 93% of cases (114/122), while optimal (bilateral) mapping was achieved in 75% (91/122). SLN correctly diagnosed 21 of 25 patients with nodal spread. When the algorithm was applied, all pts with LN metastasis were detected and bilateral pelvic LND could have been spared in the 75% of cases with optimal mapping. Conclusions In the surgical treatment of early cervical cancer, the algorithm we propose allows for comprehensive detection of all patients with nodal disease and spares complete LND in the majority of cases. PMID:21570713

  10. In vivo photoacoustic (PA) mapping of sentinel lymph nodes (SLNs) using carbon nanotubes (CNTs) as a contrast agent

    NASA Astrophysics Data System (ADS)

    Pramanik, Manojit; Song, Kwang Hyun; Swierczewska, Magdalena; Green, Danielle; Sitharaman, Balaji; Wang, Lihong V.

    2009-02-01

    Sentinel lymph node biopsy (SLNB), a less invasive alternative to axillary lymph node dissection (ALND), is routinely used in clinic for staging breast cancer. In SLNB, lymphatic mapping with radio-labeled sulfur colloid and/or blue dye helps identify the sentinel lymph node (SLN), which is most likely to contain metastatic breast cancer. Even though SLNB, using both methylene blue and radioactive tracers, has a high identification rate, it still relies on an invasive surgical procedure, with associated morbidity. In this study, we have demonstrated a non-invasive single-walled carbon nanotube (SWNT)-enhanced photoacoustic (PA) identification of SLN in a rat model. We have used single-walled carbon nanotubes (SWNTs) as a photoacoustic contrast agent to map non-invasively the sentinel lymph nodes (SLNs) in a rat model in vivo. We were able to identify the SLN non-invasively with high contrast to noise ratio (~90) and high resolution (~500 μm). Due to the broad photoacoustic spectrum of these nanotubes in the near infrared wavelength window we could easily choose a suitable light wavelength to maximize the imaging depth. Our results suggest that this technology could be a useful clinical tool, allowing clinicians to identify SLNs non-invasively in vivo. In the future, these contrast agents could be functionalized to do molecular photoacoustic imaging.

  11. How Long Will I Be Blue? Prolonged Skin Staining Following Sentinel Lymph Node Biopsy Using Intradermal Patent Blue Dye

    PubMed Central

    Gumus, Metehan; Gumus, Hatice; Jones, Sue E; Jones, Peter A; Sever, Ali R; Weeks, Jennifer

    2013-01-01

    Summary Background Blue dye used for sentinel lymph node biopsy (SLNB) in breast cancer patients may cause prolonged skin discoloration at the site of injection. The aim of this study was to assess the duration of such skin discoloration. Patients and Methods 236 consecutive patients who had undergone breast conserving surgery and SLNB for breast cancer were reviewed prospectively from January 2007 to December 2009. Results Of the 236 patients, 2 had undergone bilateral surgery, and 41 had been examined in consecutive yearly reviews. Blue discoloration remained visible at the injection site after 12, 24, and > 36 months in 36.5, 23.6, and 8.6% of the patients, respectively. Conclusion The use of patent blue for identification of the sentinel lymph node in patients undergoing breast cancer surgery may result in prolonged discoloration of the skin at the injection site. PMID:24415970

  12. Augmented reality visualization in head and neck surgery: an overview of recent findings in sentinel node biopsy and future perspectives.

    PubMed

    Profeta, Andrea Corrado; Schilling, Clare; McGurk, Mark

    2016-07-01

    "Augmented reality visualisation", in which the site of an operation is merged with computer-generated graphics, provides a way to view the relevant part of the patient's body in better detail. We describe its role in relation to sentinel lymph node biopsy (SLNB), current advancements, and future directions in the excision of tumours in early-stage cancers of the head and neck. PMID:26809235

  13. An evaluation of molecular markers for improved detection of breast cancer metastases in sentinel nodes

    PubMed Central

    Abdul‐Rasool, S; Kidson, S H; Panieri, E; Dent, D; Pillay, K; Hanekom, G S

    2006-01-01

    Background and objectives In patients with breast cancer (BC), the sentinel node (SN) is the first node in the axillary basin that receives the primary lymphatic flow and can be used to accurately assess the axillary nodal status without removal of the axillary contents. Currently, histology and/or immunohistochemistry are the routine methods of SN analysis. The primary objective of this study was to develop a reproducible reverse transcription (RT) PCR assay, with emphasis on achieving high specificity for accurate detection of BC micrometastases in the SN. To correct for the heterogeneity of BC cells, a multimarker approach was followed, with the further aim of improving the detection rate of the assay. Methods In total, 73 markers were evaluated, of which 7 were breast epithelial markers and 66 were either cancer testis or tumour associated antigens. Twelve BC cell lines and 30 SNs (from 30 patients) were analysed using RT‐PCR to determine the in vitro and in vivo detection rates for each of the markers. In addition, 20 axillary nodes obtained from a patient with brain death were used as controls to optimise the PCR cycle numbers for all the markers. Results Of the 30 SNs, 37% (11/30) were positive on haematoxylin and eosin analysis. Extensive immunohistochemical (IHC) analyses of the haematoxylin and eosin negative nodes confirmed the presence of very small numbers of BC cells in an additional 40% (12/30) of SNs. Molecular analysis with the hMAM‐A alone identified metastases in 70% (21/30) of SNs. Using MAGE‐A3 in combination with hMAM‐A identified metastases in 90% (27/30) of patients. Seven SNs (23%) were negative for micrometastases (with haematoxylin and eosin and IHC) but RT‐PCR positive for either hMAM‐A or MAGE‐A3. Conclusions As IHC analysis resulted in a 77% detection rate compared with 37% for haematoxylin and eosin analysis, we consider that IHC is essential in order not to miss SN micrometastases. Molecular analysis with hMAM‐A and

  14. Which patients with sentinel node-positive breast cancer can avoid axillary dissection?

    PubMed

    Ho, Alice Y; Cody, Hiram S

    2013-01-01

    Sentinel lymph node (SLN) biopsy is standard care for patients with cN0 breast cancer. An extensive literature, including seven randomized trials, has established that patients with negative SLN do not require axillary dissection (ALND), that axillary local recurrence after a negative SLN biopsy is rare, that disease-free and overall survival are unaffected by the addition of ALND to SLN biopsy, and that the morbidity of SLN biopsy is substantially less than that of ALND. It is now clear that many patients with positive SLN do not require ALND. In ACOSOG Z0011, 6-year locoregional control and survival were equivalent with versus without the performance of ALND in cT1-2N0 patients with ≤2 positive SLN treated by breast conservation with whole breast radiation therapy. A small but growing body of data now suggests that ALND may not be required for selected patients outside the Z0011 eligibility criteria, specifically those treated by mastectomy (without post-mastectomy radiation therapy), by partial breast irradiation, and by neoadjuvant chemotherapy. Looking ahead, the principal goals of axillary staging, prognostication, and local control will be accomplished by SLN biopsy for a substantial majority of patients, and the role of ALND will continue to diminish. PMID:23714457

  15. Breast Lymphatic Mapping and Sentinel Lymph Node Biopsy: State of the Art: 2015.

    PubMed

    Reintgen, Michael; Kerivan, Lauren; Reintgen, Eric; Swaninathan, Santosh; Reintgen, Douglas

    2016-06-01

    Lymphatic mapping with sentinel lymph node biopsy (SLNB) was introduced in the 1990s as a method to stage the nodal axilla in women with breast cancer. Very quickly the technique became the standard of care because pathologic staging was more accurate and sensitive and the surgical procedure resulted in low morbidity. SLNB has continued to evolve, and the applications in breast cancer have been expanded. A review of the published data was performed to update the lymphatic mapping technique and identify key issues and trends in the application of SLNB in women with breast cancer in 2015. The importance of axillary staging continues to effect the surgical treatment of patients with breast cancer. Originally described for patients with invasive cancer, the technique now plays an important role in staging women with ductal carcinoma in situ or recurrent breast cancer and patients with advanced breast cancer who are receiving neoadjuvant chemotherapy. Histologic examinations have incorporated multiple sectioning and immunostains. The morbidity has been low, and techniques for limiting lymphedema are being introduced. Lymphatic mapping will continue to play an important role in the treatment of women with breast cancer. The SLNB will evolve by eliminating the need for radioactivity in the operating room, and the technique will become more accurate and used in expanded indications by incorporating preoperative imaging and intraoperative guidance procedures. PMID:26952594

  16. Near-infrared fluorescence sentinel lymph node mapping in breast cancer: a multicenter experience

    PubMed Central

    Verbeek, Floris P.R.; Troyan, Susan L.; Mieog, J. Sven D.; Liefers, Gerrit-Jan; Moffitt, Lorissa A.; Rosenberg, Mireille; Hirshfield-Bartek, Judith; Gioux, Sylvain; van de Velde, Cornelis J.H.; Vahrmeijer, Alexander L.; Frangioni, John V.

    2014-01-01

    NIR fluorescence imaging using indocyanine green (ICG) has the potential to improve the SLN procedure by facilitating percutaneous and intraoperative identification of lymphatic channels and SLNs. Previous studies suggested that a dose of 0.62 mg (1.6 ml of 0.5 mM) ICG is optimal for SLN mapping in breast cancer. The aim of this study was to evaluate the diagnostic accuracy of near-infrared (NIR) fluorescence for sentinel lymph node (SLN) mapping in breast cancer patients when used in conjunction with conventional techniques. Study subjects were 95 breast cancer patients planning to undergo SLN procedure at either the Dana-Farber/Harvard Cancer Center (Boston, MA, USA) or the Leiden University Medical Center (Leiden, the Netherlands) between July 2010 and January 2013. Subjects underwent the standard-of-care SLN procedure at each institution using 99Technetium-colloid in all subjects and patent blue in 27 (28%) of the subjects. NIR fluorescence-guided SLN detection was performed using the Mini-FLARE imaging system. SLN identification was successful in 94 of 95 subjects (99%) using NIR fluorescence imaging or a combination of both NIR fluorescence imaging and radioactive guidance. In 2 of 95 subjects, radioactive guidance was necessary for initial in vivo identification of SLNs. In 1 of 95 subjects, NIR fluorescence was necessary for initial in vivo identification of SLNs. A total of 177 SLNs (mean = 1.9, range = 1–5) were resected: 100% NIR fluorescent, 88% radioactive, and 78% (of 40 nodes) blue. In 2 of 95 subjects (2.1%), SLNs containing macrometastases were found only by NIR fluorescence, and in 1 patient this led to upstaging to N1. This study demonstrates the safe and accurate application of NIR fluorescence imaging for the identification of SLNs in breast cancer patients, but calls into question what technique should be used as the gold standard in future studies. PMID:24337507

  17. Sentinel lymph node biopsy can be omitted in DCIS patients treated with breast conserving therapy.

    PubMed

    van Roozendaal, L M; Goorts, B; Klinkert, M; Keymeulen, K B M I; De Vries, B; Strobbe, L J A; Wauters, C A P; van Riet, Y E; Degreef, E; Rutgers, E J T; Wesseling, J; Smidt, M L

    2016-04-01

    Breast cancer guidelines advise sentinel lymph node biopsy (SLNB) in patients with ductal carcinoma in situ (DCIS) on core biopsy at high risk of invasive cancer or in case of mastectomy. This study investigates the incidence of SLNB and SLN metastases and the relevance of indications in guidelines and literature to perform SLNB in order to validate whether SLNB is justified in patients with DCIS on core biopsy in current era. Clinically node negative patients diagnosed from 2004 to 2013 with only DCIS on core needle biopsy were selected from a national database. Incidence of SLN biopsy and metastases was calculated. With Fisher exact tests correlation between SLNB indications and actual presence of SLN metastases was studied. Further, underestimation rate for invasive cancer and correlation with SLN metastases was analysed. 910 patients were included. SLNB was performed in 471 patients (51.8 %): 94.5 % had pN0, 3.0 % pN1mi and 2.5 % pN1. Patients undergoing mastectomy had 7 % SLN metastases versus 3.5 % for breast conserving surgery (BCS) (p = 0.107). The only factors correlating to SLN metastases were smaller core needle size (p = 0.01) and invasive cancer (p < 0.001). Invasive cancer was detected in 16.7 % by histopathology with 15.6 % SLN metastases versus only 2 % in pure DCIS. SLNB showed metastases in 5.5 % of patients; 3.5 % in case of BCS (any histopathology) and 2 % when pure DCIS was found at definitive histopathology (BCS and mastectomy). Consequently, SLNB should no longer be performed in patients diagnosed with DCIS on core biopsy undergoing BCS. If definitive histopathology shows invasive cancer, SLNB can still be considered after initial surgery. PMID:27083179

  18. Near-infrared fluorescence sentinel lymph node detection in gastric cancer: A pilot study

    PubMed Central

    Tummers, Quirijn R J G; Boogerd, Leonora S F; de Steur, Wobbe O; Verbeek, Floris P R; Boonstra, Martin C; Handgraaf, Henricus J M; Frangioni, John V; van de Velde, Cornelis J H; Hartgrink, Henk H; Vahrmeijer, Alexander L

    2016-01-01

    AIM: To investigate feasibility and accuracy of near-infrared fluorescence imaging using indocyanine green: nanocolloid for sentinel lymph node (SLN) detection in gastric cancer. METHODS: A prospective, single-institution, phase I feasibility trial was conducted. Patients suffering from gastric cancer and planned for gastrectomy were included. During surgery, a subserosal injection of 1.6 mL ICG:Nanocoll was administered around the tumor. NIR fluorescence imaging of the abdominal cavity was performed using the Mini-FLARE™ NIR fluorescence imaging system. Lymphatic pathways and SLNs were visualized. Of every detected SLN, the corresponding lymph node station, signal-to-background ratio and histopathological diagnosis was determined. Patients underwent standard-of-care gastrectomy. Detected SLNs outside the standard dissection planes were also resected and evaluated. RESULTS: Twenty-six patients were enrolled. Four patients were excluded because distant metastases were found during surgery or due to technical failure of the injection. In 21 of the remaining 22 patients, at least 1 SLN was detected by NIR Fluorescence imaging (mean 3.1 SLNs; range 1-6). In 8 of the 21 patients, tumor-positive LNs were found. Overall accuracy of the technique was 90% (70%-99%; 95%CI), which decreased by higher pT-stage (100%, 100%, 100%, 90%, 0% for respectively Tx, T1, T2, T3, T4 tumors). All NIR-negative SLNs were completely effaced by tumor. Mean fluorescence signal-to-background ratio of SLNs was 4.4 (range 1.4-19.8). In 8 of the 21 patients, SLNs outside the standard resection plane were identified, that contained malignant cells in 2 patients. CONCLUSION: This study shows successful use of ICG:Nanocoll as lymphatic tracer for SLN detection in gastric cancer. Moreover, tumor-containing LNs outside the standard dissection planes were identified. PMID:27053856

  19. Guidelines for sentinel node biopsy and lymphatic mapping of patients with breast cancer.

    PubMed Central

    Cox, C E; Pendas, S; Cox, J M; Joseph, E; Shons, A R; Yeatman, T; Ku, N N; Lyman, G H; Berman, C; Haddad, F; Reintgen, D S

    1998-01-01

    OBJECTIVE: To define preliminary guidelines for the use of lymphatic mapping techniques in patients with breast cancer. SUMMARY BACKGROUND DATA: Lymphatic mapping techniques have the potential of changing the standard of surgical care of patients with breast cancer. METHODS: Four hundred sixty-six consecutive patients with newly diagnosed breast cancer underwent a prospective trial of intraoperative lymphatic mapping using a combination of vital blue dye and filtered technetium-labeled sulfur colloid. A sentinel lymph node (SLN) was defined as a blue node and/or a hot node with a 10:1 ex vivo gamma probe ratio of SLN to non-SLN. All SLNs were bivalved, step-sectioned, and examined with routine hematoxylin and eosin (H&E) stains and immunohistochemical stains for cytokeratin. A cytokeratin-positive SLN was defined as any SLN with a defined cluster of positive-staining cells that could be confirmed histologically on H&E sections. RESULTS: Fine-needle aspiration (FNA) or stereotactic core biopsy was used to diagnose 195 of the 422 patients (46.2%) with breast cancer; 227 of 422 patients (53.8%) were diagnosed by excisional biopsy. The SLN was successfully identified in 440 of 466 patients (94.4%). Failure to identify an SLN to the axilla intraoperatively occurred in 26 of 466 patients (5.6%). In all patients who failed lymphatic mappings, a complete axillary dissection was performed, and metastatic disease was documented in 4 of 26 (15.4%) of these patients. Of the 26 patients who failed lymphatic mapping, 11 of 227 (4.8%) were diagnosed by excisional biopsy and 15 of 195 (7.7%) were diagnosed by FNA or stereotactic core biopsy. Of interest, there was only one skip metastasis (defined as a negative SLN with higher nodes in the chain being positive) in a patient with prior excisional biopsy. A mean of 1.92 SLNs were harvested per patient. Twenty percent of the SLNs removed were positive for metastatic disease in 105 of 440 (23.8%) of the patients. Descriptive

  20. The added value of a portable gamma camera for intraoperative detection of sentinel lymph node in squamous cell carcinoma of the oral cavity: A case report.

    PubMed

    Mayoral, M; Paredes, P; Sieira, R; Vidal-Sicart, S; Marti, C; Pons, F

    2014-01-01

    The use of sentinel lymph node biopsy in squamous cell carcinoma of the oral cavity is still subject to debate although some studies have reported its feasibility. The main reason for this debate is probably due to the high false-negative rate for floor-of-mouth tumors per se. We report the case of a 54-year-old man with a T1N0 floor-of-mouth squamous cell carcinoma who underwent the sentinel lymph node procedure. Lymphoscintigraphy and SPECT/CT imaging were performed for lymphatic mapping with a conventional gamma camera. Sentinel lymph nodes were identified at right Ib, left IIa and Ia levels. However, these sentinel lymph nodes were difficult to detect intraoperatively with a gamma probe owing to the activity originating from the injection site. The use of a portable gamma camera made it possible to localize and excise all the sentinel lymph nodes. This case demonstrates the usefulness of this tool to improve sentinel lymph node detecting in floor-of-mouth tumors, especially those close to the injection area. PMID:24581865

  1. Locoregional treatment of early breast cancer with isolated tumor cells or micrometastases on sentinel lymph node biopsy

    PubMed Central

    Tallet, Agnès; Lambaudie, Eric; Cohen, Monique; Minsat, Mathieu; Bannier, Marie; Resbeut, Michel; Houvenaeghel, Gilles

    2016-01-01

    The advent of sentinel lymph-node technique has led to a shift in lymph-node staging, due to the emergence of new entities namely micrometastases (pN1mi) and isolated tumor cells [pN0(i+)]. The prognostic significance of this low positivity in axillary lymph nodes is currently debated, as is, therefore its management. This article provides updates evidence-based medicine data to take into account for treatment decision-making in this setting, discussing the locoregional treatment in pN0(i+) and pN1mi patients (completion axillary dissection, axillary irradiation with or without regional nodes irradiation, or observation), according to systemic treatment, with the goal to help physicians in their daily practice. PMID:27081647

  2. Sentinel Lymph Node Navigation Surgery for Early Gastric Cancer: Is It a Safe Procedure in Countries with Non-Endemic Gastric Cancer Levels? A Preliminary Experience

    PubMed Central

    Dos Santos, Elizabeth Gomes; Victer, Felipe Carvalho; Neves, Marcelo Soares; Pinto, Márcia Ferreira; Carvalho, Carlos Eduardo De Souza

    2016-01-01

    Purpose Early diagnosis of gastric cancer is still the exception in Western countries. In the East, as in Japan and Korea, this disease is an endemic disorder. More conservative surgical procedures are frequently performed in early gastric cancer cases in these countries where sentinel lymph node navigation surgery is becoming a safe option for some patients. This study aims to evaluate preliminary outcomes of patients with early gastric cancer who underwent sentinel node navigation surgeries in Brazil, a country with non-endemic gastric cancer levels. Materials and Methods From September 2008 to March 2014, 14 out of 205 gastric cancer patients underwent sentinel lymph node navigation surgeries, which were performed using intraoperative, endoscopic, and peritumoral injection of patent blue dye. Results Antrectomies with Billroth I gastroduodenostomies were performed in seven patients with distal tumors. The other seven patients underwent wedge resections. Sentinel basin resections were performed in four patients, and lymphadenectomies were extended to stations 7, 8, and 9 in the other 10. Two patients received false-negative results from sentinel node biopsies, and one of those patients had micrometastasis. There was one postoperative death from liver failure in a cirrhotic patient. Another cirrhotic patient died after two years without recurrence of gastric cancer, also from liver failure. All other patients were followed-up for 13 to 79 months with no evidence of recurrence. Conclusions Sentinel lymph node navigation surgery appears to be a safe procedure in a country with non-endemic levels of gastric cancer. PMID:27104022

  3. Significance of Matrix Metalloproteinase 9 Expression as Supporting Marker to Cytokeratin 19 mRNA in Sentinel Lymph Nodes in Breast Cancer Patients

    PubMed Central

    Murawski, Marek; Woźniak, Marta; Duś-Szachniewicz, Kamila; Kołodziej, Paweł; Rzeszutko, Marta; Ziółkowski, Piotr

    2016-01-01

    One-step nucleic acid amplification (OSNA) detects and quantifies, with the use of a polymerase chain reaction, the presence of cytokeratin 19 mRNA in sentinel lymph nodes. The main advantage of the OSNA assay is the avoidance of second surgery in case of positive sentinel lymph node diagnosis. The objective of this study was to evaluate the significance of matrix metalloproteinase 9 expression by immunohistochemistry as supporting marker to cytokeratin 19 mRNA in sentinel lymph nodes in breast cancer patients and to relate this expression with clinicopathological data. This study was conducted on fresh sentinel lymph nodes obtained from 40 patients with tumors classified as carcinoma of no special type. The presence of metastatic cells in the slices of lymph nodes was evaluated by immunohistochemistry using antibodies for CK19 and MMP-9. Expression of CK19 and MMP-9 in lymph nodes was also confirmed by means of Western blot analysis. Results indicated that the strongest correlation with CK19 mRNA was displayed by MMP-9, CK19 (by immunohistochemistry, IHC), and nodal metastases (p < 0.001). Higher histological grading also positively correlated with CK19 mRNA, however that correlation was less significant. Since MMP-9 shows very strong correlation with CK19 mRNA in breast carcinoma of no special type metastases, expression of MMP-9 in sentinel lymph nodes should be considered as useful method whenever OSNA analysis is not available. PMID:27110764

  4. Tumor Cell Adhesion As a Risk Factor for Sentinel Lymph Node Metastasis in Primary Cutaneous Melanoma

    PubMed Central

    Meves, Alexander; Nikolova, Ekaterina; Heim, Joel B.; Squirewell, Edwin J.; Cappel, Mark A.; Pittelkow, Mark R.; Otley, Clark C.; Behrendt, Nille; Saunte, Ditte M.; Lock-Andersen, Jorgen; Schenck, Louis A.; Weaver, Amy L.; Suman, Vera J.

    2015-01-01

    Purpose Less than 20% of patients with melanoma who undergo sentinel lymph node (SLN) biopsy based on American Society of Clinical Oncology/Society of Surgical Oncology recommendations are SLN positive. We present a multi-institutional study to discover new molecular risk factors associated with SLN positivity in thin and intermediate-thickness melanoma. Patients and Methods Gene clusters with functional roles in melanoma metastasis were discovered by next-generation sequencing and validated by quantitative polymerase chain reaction using a discovery set of 73 benign nevi, 76 primary cutaneous melanoma, and 11 in-transit melanoma metastases. We then used polymerase chain reaction to quantify gene expression in a model development cohort of 360 consecutive thin and intermediate-thickness melanomas and a validation cohort of 146 melanomas. Outcome of interest was SLN biopsy metastasis within 90 days of melanoma diagnosis. Logic and logistic regression analyses were used to develop a model for the likelihood of SLN metastasis from molecular, clinical, and histologic variables. Results ITGB3, LAMB1, PLAT, and TP53 expression were associated with SLN metastasis. The predictive ability of a model that included these molecular variables in combination with clinicopathologic variables (patient age, Breslow depth, and tumor ulceration) was significantly greater than a model that only considered clinicopathologic variables and also performed well in the validation cohort (area under the curve, 0.93; 95% CI, 0.87 to 0.97; false-positive and false-negative rates of 22% and 0%, respectively, using a 10% cutoff for predicted SLN metastasis risk). Conclusion The addition of cell adhesion–linked gene expression variables to clinicopathologic variables improves the identification of patients with SLN metastases within 90 days of melanoma diagnosis. PMID:26150443

  5. Clark Level Risk Stratifies Patients with Mitogenic Thin Melanomas for Sentinel Lymph Node Biopsy

    PubMed Central

    Bartlett, Edmund K.; Gimotty, Phyllis A.; Sinnamon, Andrew J.; Wachtel, Heather; Roses, Robert E.; Schuchter, Lynn; Xu, Xiaowei; Elder, David E.; Ming, Michael; Elenitsas, Rosalie; Guerry, DuPont; Kelz, Rachel R.; Czerniecki, Brian J.; Fraker, Douglas L.; Karakousis, Giorgos C.

    2014-01-01

    Background The role for sentinel lymph node biopsy (SLNB) in patients with thin melanoma (≤1mm) remains controversial. We examined a large cohort of patients with thin melanoma to better define predictors of SLN positivity. Methods Between 1995-2011, 781 patients with thin primary melanoma and evaluable clinicopathologic data underwent SLNB at our institution. Predictors of SLN positivity were determined using univariate and multivariate regression analyses, and patients were risk-stratified using a classification and regression tree (CART) analysis. Results In the study cohort (n=781), 29 patients (3.7%) had nodal metastases. In the univariate analysis, mitotic rate (OR=8.11, p=0.005), Clark level (OR=4.04, p=0.003), and thickness (OR=3.33, p=0.011) were significantly associated with SLN positivity. In the multivariate analysis, MR (OR=7.01) and level IV-V (OR=3.45) remained significant predictors of SLN positivity. CART analysis initially stratified lesions by mitotic rate; non-mitogenic lesions (n=273) had a 0.7% SLN positivity rate versus 5.6% in mitogenic lesions (n=425). Mitogenic lesions were further stratified by Clark level; patients with level II-III had a 2.9% SLN positivity rate (n=205) versus 8.2% with level IV-V (n=220). With median follow up of 6.3 years, 5 SLN negative patients developed nodal recurrence and 4 SLN positive patients died of disease. Conclusion SLN positivity is low in patients with thin melanoma (3.7%) and exceedingly so in non-mitogenic lesions (0.7%). Appreciable rates of SLN positivity can be identified in patients with mitogenic lesions, particularly with concurrent level IV-V regardless of thickness. These factors may guide appropriate selection of patients with thin melanoma for SLNB. PMID:24121883

  6. Detection of MAGE-A3 in breast cancer patients’ sentinel lymph nodes

    PubMed Central

    Wascher, R A; Bostick, P J; Huynh, K T; Turner, R; Qi, K; Giuliano, A E; Hoon, D S B

    2001-01-01

    The detection of occult metastatic breast cancer cells by RT-PCR is limited by the poor specificity of most tumour mRNA markers. MAGE-A3 is a highly specific tumour mRNA marker that is not expressed in non-cancer cells. This study assesses MAGE-A3 mRNA as a molecular marker for the detection of tumour cells in the sentinel lymph nodes (SLN) of breast cancer patients. Serial frozen sections of SLN (n= 121) were obtained from 77 AJCC (American Joint Committee on Cancer) Stage I–IIIA breast cancer patients. MAGE-A3 mRNA analysis of SLN was performed by RT-PCR and Southern blot analysis. Tumour cells were detected in 48 of 121 (40%) SLN from 77 patients by H&E or IHC staining, and 35 of 77 (45%) patients, overall, had histopathologically (H&E and/or IHC) positive SLN. Among histopathologically negative SLN, 28 of 73 (38%) SLN were MAGE-A3 mRNA positive by RT-PCR. Overall, 41 of 77 (53%) patients and 50 of 121 (41%) SLN were positive for MAGE-A3. MAGE-A3 mRNA expression in the SLN occurred more frequently with infiltrating lobular carcinoma (P< 0.001) than with infiltrating ductal carcinoma, adding further evidence of possible phenotypic differences between these 2 subtypes of breast cancer. Due to its high specificity, MAGE-A3 mRNA is a potentially useful marker for detecting breast cancer cells in the SLN. One half of breast tumours expressed MAGE-A3 mRNA, which has important potential implications for antigen-specific targeted immunotherapy. © 2001 Cancer Research Campaign PMID:11720472

  7. Meta-Analysis of Sentinel Lymph Node Positivity in Thin Melanoma (≤ 1 mm)

    PubMed Central

    Warycha, Melanie A.; Zakrzewski, Jan; Ni, Quanhong; Shapiro, Richard L.; Berman, Russell S.; Pavlick, Anna C.; Polsky, David; Mazumdar, Madhu; Osman, Iman

    2014-01-01

    Background Despite the lack of an established survival benefit of sentinel lymph node (SLN) biopsy, this technique has been increasingly applied in the staging of thin (≤1 mm) melanoma patients, without clear evidence to support this recommendation. We performed a meta-analysis to estimate the risk, potential predictors, and outcome of SLN positivity in this group of patients. Methods MEDLINE, EMBASE, and Cochrane databases were searched for rates of SLN positivity in patients with thin melanoma. The methodological quality of included studies was assessed using the MINORS criteria. Heterogeneity was assessed using Cochran’s Q-statistic, and publication bias was examined through funnel plot and Begg and Mazumdar’s method. Overall SLN positivity in thin melanoma patients was estimated using DerSimonial-Laird random effect method. Results 34 studies comprising 3,651 patients met inclusion criteria. The pooled SLN positivity rate was 5.6%. Significant heterogeneity among studies was detected (p=0.005). There was no statistical evidence of publication bias (p=0.21). 18 studies reported select clinical and histopathologic data limited to SLN positive patients (n=113). Among the tumors from these patients, 6.1% were ulcerated, 31.5% showed regression, and 47.5% were Clark’s level IV/V. Only 4 melanoma-related deaths were reported. Conclusion Relatively few patients with thin melanoma have a positive SLN. There are no clinical or histopathologic criteria which can reliably identify thin melanoma patients who might benefit from this intervention. Given the increasing diagnosis of thin melanoma, in addition to the cost and potential morbidity of this procedure, alternative strategies to identify patients at risk for nodal disease are needed. PMID:19117354

  8. Clinical trial of combined radio- and fluorescence-guided sentinel lymph node biopsy in breast cancer

    PubMed Central

    Schaafsma, Boudewijn E.; Verbeek, Floris P.R.; Rietbergen, Daphne D.D.; van der Hiel, Bernies; van der Vorst, Joost R.; Liefers, Gerrit-Jan; Frangioni, John V.; van de Velde, Cornelis J.H.; van Leeuwen, Fijs W.B.; Vahrmeijer, Alexander L.

    2013-01-01

    Background Combining radioactive colloids and a near-infrared (NIR) fluorophore permit preoperative planning and intraoperative localization of deeply located sentinel lymph nodes (SLNs) with direct optical guidance by a single lymphatic tracer. The aim of this clinical trial was to evaluate and optimize a hybrid NIR fluorescence and radioactive tracer for SLN detection in breast cancer patients. Method Patients with breast cancer undergoing SLN biopsy were enrolled. The day before surgery, indocyanine green (ICG)-99mTc-Nanocolloid was injected periareolarly and a lymphoscintigram was acquired. Directly before surgery, blue dye was injected. Intraoperative SLN localization was performed by a gamma probe and the Mini-FLARETM NIR fluorescence imaging system. Patients were divided into two dose groups, with one group receiving twice the particle density of ICG and nanocolloid, but the same dose of radioactive 99mTechnetium. Results Thirty-two patients were enrolled in the trial. At least one SLN was identified pre- and intraoperatively. All 48 axillary SLNs could be detected by gamma tracing and NIR fluorescence imaging, but only 42 of them stained blue. NIR fluorescence permitted detection of lymphatic vessels draining to the SLN up to 29 hours after injection. Increasing the particle density by two-fold did not yield a difference in fluorescence intensity, median 255 (range 98 – 542) vs. median 284 (90 – 921; P = 0.590), or signal- to- background ratio, median 5.4 (range 3.0 – 15.4) vs. median 4.9 (3.5 – 16.3; P = 1.000), of the SLN. Conclusion The hybrid NIR fluorescence and radioactive tracer ICG-99mTc-Nanocolloid permitted accurate pre- and intraoperative detection of the SLNs in patients with breast cancer. PMID:23696463

  9. Laparoscopic sentinel lymph node mapping after cervical injection of indocyanine green for endometrial cancer – preliminary report

    PubMed Central

    Reinholz-Jaskolska, Malgorzata; Bidzinski, Mariusz

    2015-01-01

    Introduction Endometrial cancer (EC) has an increasing incidence worldwide, with lymph node metastases as the main prognostic factor. Systemic lymphadenectomy is connected with elevated morbidity. Sentinel lymph node (SLN) biopsy is intended to avoid extensive lymphadenectomy and provide significant oncologic information. Aim To evaluate the accuracy of laparoscopic SLN biopsy guided by indocyanine green (ICG) injection into the cervix in EC patients and to develop ideas to improve this method. The optimal time from dye injection to lymph node visualization was assessed. Material and methods This retrospective study was conducted between July 2014 and March 2015 in a group of 9 women with EC, at low and intermediate risk of recurrence, scheduled for total laparoscopic hysterectomy and pelvic lymphadenectomy. All patients underwent cervical ICG injection and SLN biopsy, followed by surgery. Pelvic lymph nodes were located using an ICG endoscopic camera. Results The following data were collected: There were 9 patients with endometrial cancer at low and intermediate risk of recurrence. Median patient age was 59 years, median body mass index (BMI) 28 kg/m2, endometrioid adenocarcinoma in 9 cases, grading: G1 – 1 patient, G2 – 8 patients. No intraoperative or postoperative complications were noted. Median time from ICG injection and SLN detection during surgery was 25 min. There were no lymph nodes metastasis, all identified by the SLN protocol using ICG injection. Conclusions Sentinel lymph node mapping can play a significant role in lymph node assessment and staging in early-stage EC patients with low risk of recurrence according to the ESMO classification. The use of SLN mapping in EC is much needed and the therapeutic benefit is high. PMID:26649087

  10. Discordance of Intraoperative Frozen Section Analysis with Definitive Histology of Sentinel Lymph Nodes in Breast Cancer Surgery: Complementary Axillary Lymph Node Dissection is Irrelevant for Subsequent Systemic Therapy

    PubMed Central

    Geertsema, D.; Gobardhan, P. D.; Madsen, E. V. E.; Albregts, M.; van Gorp, J.; de Hooge, P.

    2010-01-01

    Background In breast cancer surgery, intraoperative frozen section (FS) analysis of sentinel lymph nodes (SLNs) enables axillary lymph node dissection (ALND) during the same operative procedure. In case of discordance between a “negative” FS analysis and definitive histology, an ALND as a second operation is advocated since additional lymph node metastases may be present. The clinical implications of the subsequent ALND in these patients were evaluated. Materials and Methods Between November 2000 and May 2008, 879 consecutive breast cancer patients underwent surgery including sentinel lymph node biopsy (SLNB) with intraoperative FS analysis of 2 central cuts from axillary SLNs. Following fixation and serial sectioning, SLNs were further examined postoperatively with hematoxylin and eosin (H&E) and immunohistochemical techniques. For patients with a discordant FS examination, the effect of the pathology findings of the subsequent ALND specimen on subsequent nonsurgical therapy were evaluated. Results FS analysis detected axillary metastases in the SLN(s) in 200 patients (23%), while the definitive pathology examination detected metastases in SLNs in another 151 patients (17%). A complementary ALND was performed in 108 of the 151 patients with discordant FS. Additional tumor positive axillary lymph nodes were found in 17 patients (16%), leading to “upstaging” in 7 (6%). Subsequent nonsurgical treatment was adjusted in 4 patients (4%): all 4 had more extensive locoregional radiotherapy; no patient received additional hormonal and/or chemotherapy. Conclusion Discordance between intraoperative FS analysis and definitive histology of SLNs is common. In this selection of patients, a substantial proportion had additional lymph node metastases, but postsurgical treatment was rarely adjusted based on the findings of the complementary ALND. PMID:20422461

  11. Clinical usefulness of intradermal fluorescein and patent blue violet dyes for sentinel lymph node identification in dogs.

    PubMed

    Wells, S; Bennett, A; Walsh, P; Owens, S; Peauroi, J

    2006-06-01

    The first lymph node receiving drainage from a specific anatomic region is referred to as the sentinel lymph node (SLN). This study sought to evaluate the intradermal use of two dyes, patent blue violet (PBV) and fluorescein (FL), for SLN mapping in the dog. Multiple intradermal injections were performed in five healthy dogs using two dyes, PBV in 0.9% NaCl and FL in solutions of 0.9% NaCl and 6% hetastarch. Skin flaps were raised and followed to the first area of discrete stain uptake. Areas of uptake were identified as lymph nodes grossly and by cytology. Identification of a SLN for each area of intradermal injection was accomplished for 98% of the injection sites. Intradermal injections of both PBV and FL dyes produce readily visible staining of lymphatic vessels and SLNs in healthy dogs and are sufficient to allow ready identification of these structures during postmortem dissection. PMID:19754821

  12. Biokinetics of 99mTc-labeled gold nanoparticles conjugated to mannose for specific sentinel node detection

    NASA Astrophysics Data System (ADS)

    Ocampo-García, B. E.; Ferro-Flores, G.; de M. Ramírez, F.; De León-Rodríguez, L. M.; Santos-Cuevas, C. L.; Morales-Avila, E.; de Murphy, C. Arteaga; Pedraza-López, M.; Medina, L. A.; López-Rodríguez, V.

    2010-12-01

    The aim of this research was to evaluate the biological behavior in Wistar rats of a multifunctional system of gold nanoparticles (AuNP) conjugated to 99mTc-HYNIC-GGC and mannose for sentinel lymph node (SLN) specific detection. The radiolabeled nanoconjugate, characterized by TEM and UV-vis, vibrational, XPS and Fluorescence spectroscopic analyses, was administered in rats (footpad) and the radioactivity levels in the popliteal and inguinal lymph nodes determined at different times from 30 min to 24 h. Results showed that 21% of the injected radio-AuNP-mannose was retained in the first lymph node (popliteal) during 24 h. 99mTc-HYNIC-GGC-AuNP-Mannose is a potential target-specific tracer for SLN detection in breast cancer patients.

  13. Sentinel lymph-node biopsy for melanoma of the trunk and extremities: the McGill experience

    PubMed Central

    Tremblay, Francine; Loutfi, Antoine; Shibata, Henry; Meterissian, Sarkis

    2001-01-01

    Objective To determine the effectiveness of sentinel lymph-node (SLN) biopsy for melanoma of the trunk and extremities. Design Case series review. Setting Royal Victoria Hospital, a Canadian university hospital. Patients Thirty-six patients (18 women and 18 men) seen between October 1996 and December 1998 with melanoma 1 mm or more in thickness with clinically negative lymph-node basins. Follow-up was 396 days. Interventions SLN biopsy. Technetium-99m filtered sulfur colloid (0.5 mCi) was injected intradermally around the melanoma or the excision scar 10 to 15 minutes before the surgical skin preparation. The identification of the SLN(s) was done with a hand-held gamma probe. Local anesthesia was used mostly for inguinal SLN biopsy whereas general anesthesia was usually required for axillary SLN biopsy. Preoperative lymphoscintigraphy was used only for trunk melanomas. Outcome measures Morbidity, successful identification of the sentinel node and locoregional recurrence. Results The mean age of patients at diagnosis was 53.4 years (range from 22–76 yr). The melanomas were distributed between the lower extremities (20 patients), upper extremities (8 patients) and trunk (8 patients). The mean Breslow thickness was 2.35 mm (range from 1–8 mm). Lymphoscintigraphy accurately localized the lymph-node drainage basin for trunk melanomas. In 1 patient the SLN could not be identified because the radiocolloid failed to migrate (failure rate 2.8%). The average number of SLNs removed was 1.97. Eight patients (22%) had sentinel nodes positive for malignant disease. The postoperative complication rate was 8.5%. Seven of 8 patients with positive SLNs underwent a complete node dissection (1 patient refused). Of the completion dissections only 2 patients had positive non-SLNs. All patients with positive nodes received interferon alpha-2b as adjuvant treatment. At follow-up, 34 patients are alive with no evidence of disease, 1 patient with a positive SLN is alive with distant

  14. International multicenter tool to predict the risk of four or more tumor-positive axillary lymph nodes in breast cancer patients with sentinel node macrometastases.

    PubMed

    Meretoja, Tuomo J; Audisio, R A; Heikkilä, P S; Bori, R; Sejben, I; Regitnig, P; Luschin-Ebengreuth, G; Zgajnar, J; Perhavec, A; Gazic, B; Lázár, G; Takács, T; Kővári, B; Saidan, Z A; Nadeem, R M; Castellano, I; Sapino, A; Bianchi, S; Vezzosi, V; Barranger, E; Lousquy, R; Arisio, R; Foschini, M P; Imoto, S; Kamma, H; Tvedskov, T F; Jensen, M-B; Cserni, G; Leidenius, M H K

    2013-04-01

    Recently, many centers have omitted routine axillary lymph node dissection (ALND) after metastatic sentinel node biopsy in breast cancer due to a growing body of literature. However, existing guidelines of adjuvant treatment planning are strongly based on axillary nodal stage. In this study, we aim to develop a novel international multicenter predictive tool to estimate a patient-specific risk of having four or more tumor-positive axillary lymph nodes (ALN) in patients with macrometastatic sentinel node(s) (SN). A series of 675 patients with macrometastatic SN and completion ALND from five European centers were analyzed by logistic regression analysis. A multivariate predictive model was created and validated internally by 367 additional patients and then externally by 760 additional patients from eight different centers. All statistical tests were two-sided. Prevalence of four or more tumor-positive ALN in each center's series (P = 0.010), number of metastatic SNs (P < 0.0001), number of negative SNs (P = 0.003), histological size of the primary tumor (P = 0.020), and extra-capsular extension of SN metastasis (P < 0.0001) were included in the predictive model. The model's area under the receiver operating characteristics curve was 0.766 in the internal validation and 0.774 in external validation. Our novel international multicenter-based predictive tool reliably estimates the risk of four or more axillary metastases after identifying macrometastatic SN(s) in breast cancer. Our tool performs well in internal and external validation, but needs to be further validated in each center before application to clinical use. PMID:23558360

  15. Size Control of (99m)Tc-tin Colloid Using PVP and Buffer Solution for Sentinel Lymph Node Detection.

    PubMed

    Kim, Eun-Mi; Lim, Seok Tae; Sohn, Myung-Hee; Jeong, Hwan-Jeong

    2015-06-01

    Colloidal particle size is an important characteristic that allows mapping sentinel nodes in lymphoscintigraphy. This investigation aimed to introduce different ways of making a (99m)Tc-tin colloid with a size of tens of nanometers. All agents, tin fluoride, sodium fluoride, poloxamer-188, and polyvinylpyrrolidone (PVP), were mixed and labeled with (99m)Tc. Either phosphate or sodium bicarbonate buffers were used to adjust the pH levels. When the buffers were added, the size of the colloids increased. However, as the PVP continued to increase, the size of the colloids was controlled to within tens of nanometers. In all samples, phosphate buffer added PVP (30 mg) stabilized tin colloid ((99m)Tc-PPTC-30) and sodium bicarbonate solution added PVP (50 mg) stabilized tin colloid ((99m)Tc-BPTC-50) were chosen for in vitro and in vivo studies. (99m)Tc-BPTC-50 (<20 nm) was primarily located in bone marrow and was then secreted through the kidneys, and (99m)Tc-PPTC-30 (>100 nm) mainly accumulated in the liver. When a rabbit was given a toe injection, the node uptake of (99m)Tc-PPTC-30 decreased over time, while (99m)Tc-BPTC-50 increased. Therefore, (99m)Tc-BPTC-50 could be a good candidate radiopharmaceutical for sentinel node detection. The significance of this study is that nano-sized tin colloid can be made very easily and quickly by PVP. PMID:26028937

  16. Diagnostic accuracy of sentinel node identification is maintained with the addition of local lidocaine and subareolar radioactive colloid injection

    PubMed Central

    Stearns, Vered; Blackford, Amanda; Kessler, Jill; Sbaity, Eman; Habibi, Mehran; Khouri, Nagi; Lee, Cindy S.; May, Evelyn; Jeter, Stacie; Sahebi, Camila; Shehata, Christina; Tarpinian, Karineh; Jacobs, Lisa

    2015-01-01

    Preoperative sentinel node localization (SNL) using a subareolar injection of radiotracer technetium-99m-sulfur colloid (Tc99mSC) is associated with significant pain. Lidocaine use during SNL is not widely adopted partly due to a concern that it can obscure sentinel node identification and reduce its diagnostic accuracy. We prospectively identified women with a biopsy-proven infiltrating breast cancer who were awaiting a SNL. The women completed the McGill pain questionnaire, Visual Analog Scale, and Wong–Baker FACES Pain Rating Scale prior to and following SNL. We identified a retrospective cohort of women with similar demographic and tumor characteristics who did not receive lidocaine before SNL. We compared sentinel lymph node identification rates in the two cohorts. We used Wilcoxon rank sum tests to compare continuous measures and Fisher's exact test for categorical measures. Between January 2011 to July 2012, 110 women consented, and 105 were eligible for and received lidocaine prior to Tc99mSC injection. The post-lidocaine identification rate of SNL was 95 % with Tc99mSC, and 100 % with the addition of intraoperative methylene blue dye/saline. Pain range prior to and following the SNL was unchanged (P = 0.703). We identified 187 women from 2005 to 2009 who did not receive lidocaine during preoperative SNL. There was no significant difference in the success rate of SNL, with or without lidocaine (P = 0.194). The administration of lidocaine during SNL prevents pain related to isotope injection while maintaining the success rate. We have changed our practice at our center to incorporate the use of lidocaine during all SNL. PMID:25788225

  17. Predicting Likelihood of Having Four or More Positive Nodes in Patient With Sentinel Lymph Node-Positive Breast Cancer: A Nomogram Validation Study

    SciTech Connect

    Unal, Bulent; Gur, Akif Serhat; Beriwal, Sushil; Tang Gong; Johnson, Ronald; Ahrendt, Gretchen; Bonaventura, Marguerite; Soran, Atilla

    2009-11-15

    Purpose: Katz suggested a nomogram for predicting having four or more positive nodes in sentinel lymph node (SLN)-positive breast cancer patients. The findings from this formula might influence adjuvant radiotherapy decisions. Our goal was to validate the accuracy of the Katz nomogram. Methods and Materials: We reviewed the records of 309 patients with breast cancer who had undergone completion axillary lymph node dissection. The factors associated with the likelihood of having four or more positive axillary nodes were evaluated in patients with one to three positive SLNs. The nomogram developed by Katz was applied to our data set. The area under the curve of the corresponding receiver operating characteristics curve was calculated for the nomogram. Results: Of the 309 patients, 80 (25.9%) had four or more positive axillary lymph nodes. On multivariate analysis, the number of positive SLNs (p < .0001), overall metastasis size (p = .019), primary tumor size (p = .0001), and extracapsular extension (p = .01) were significant factors predicting for four or more positive nodes. For patients with <5% probability, 90.3% had fewer than four positive nodes and 9.7% had four or more positive nodes. The negative predictive value was 91.7%, and sensitivity was 80%. The nomogram was accurate and discriminating (area under the curve, .801). Conclusion: The probability of four or more involved nodes is significantly greater in patients who have an increased number of positive SLNs, increased overall metastasis size, increased tumor size, and extracapsular extension. The Katz nomogram was validated in our patients. This nomogram will be helpful to clinicians making adjuvant treatment recommendations to their patients.

  18. [Current status and new applications of sentinel lymph node mapping in non-small cell lung cancer].

    PubMed

    Minamiya, Yoshihiro; Ogawa, Jun-Ichi

    2009-03-01

    Sentinel lymph node (SLN) mapping has become a common procedure in the treatment of breast cancer and malignant melanoma. Its primary benefit is that it enables surgeons to avoid nontherapeutic lymph node dissection and the complications that may follow. All present evidence demonstrates the existence of SLNs in non-small cell lung cancer (NSCLC). However, SLN mapping is not widely used in the treatment of NSCLC for several reasons: first, special precautions are required to minimize exposure to radioisotopes; second, it is difficult to detect a dye within anthoracotic thoracic lymph nodes; and third, major complications comparable to the arm edema seen in breast cancer or the lymphedema and nerve injury seen in melanoma are not seen with mediastinal lymph node dissection. However, if the SLN mapping procedure were simplified, it could be used to avoid nontherapeutic mediastinal lymph node dissection in NSCLC. Recently, new applications of SLN mapping have been reported, such as the detection of lymph node micrometastases and segmentectomy for NSCLC. We expect SLN mapping to become a common clinical practice in the treatment of NSCLC in the near future PMID:19348199

  19. Evaluation of a CdTe semiconductor based compact gamma camera for sentinel lymph node imaging

    SciTech Connect

    Russo, Paolo; Curion, Assunta S.; Mettivier, Giovanni; Esposito, Michela; Aurilio, Michela; Caraco, Corradina; Aloj, Luigi; Lastoria, Secondo

    2011-03-15

    Purpose: The authors assembled a prototype compact gamma-ray imaging probe (MediPROBE) for sentinel lymph node (SLN) localization. This probe is based on a semiconductor pixel detector. Its basic performance was assessed in the laboratory and clinically in comparison with a conventional gamma camera. Methods: The room-temperature CdTe pixel detector (1 mm thick) has 256x256 square pixels arranged with a 55 {mu}m pitch (sensitive area 14.08x14.08 mm{sup 2}), coupled pixel-by-pixel via bump-bonding to the Medipix2 photon-counting readout CMOS integrated circuit. The imaging probe is equipped with a set of three interchangeable knife-edge pinhole collimators (0.94, 1.2, or 2.1 mm effective diameter at 140 keV) and its focal distance can be regulated in order to set a given field of view (FOV). A typical FOV of 70 mm at 50 mm skin-to-collimator distance corresponds to a minification factor 1:5. The detector is operated at a single low-energy threshold of about 20 keV. Results: For {sup 99m}Tc, at 50 mm distance, a background-subtracted sensitivity of 6.5x10{sup -3} cps/kBq and a system spatial resolution of 5.5 mm FWHM were obtained for the 0.94 mm pinhole; corresponding values for the 2.1 mm pinhole were 3.3x10{sup -2} cps/kBq and 12.6 mm. The dark count rate was 0.71 cps. Clinical images in three patients with melanoma indicate detection of the SLNs with acquisition times between 60 and 410 s with an injected activity of 26 MBq {sup 99m}Tc and prior localization with standard gamma camera lymphoscintigraphy. Conclusions: The laboratory performance of this imaging probe is limited by the pinhole collimator performance and the necessity of working in minification due to the limited detector size. However, in clinical operative conditions, the CdTe imaging probe was effective in detecting SLNs with adequate resolution and an acceptable sensitivity. Sensitivity is expected to improve with the future availability of a larger CdTe detector permitting operation at shorter

  20. Molecular Imaging Probes for Positron Emission Tomography and Optical Imaging of Sentinel Lymph Node and Tumor

    NASA Astrophysics Data System (ADS)

    Qin, Zhengtao

    Molecular imaging is visualizations and measurements of in vivo biological processes at the molecular or cellular level using specific imaging probes. As an emerging technology, biocompatible macromolecular or nanoparticle based targeted imaging probes have gained increasing popularities. Those complexes consist of a carrier, an imaging reporter, and a targeting ligand. The active targeting ability dramatically increases the specificity. And the multivalency effect may further reduce the dose while providing a decent signal. In this thesis, sentinel lymph node (SLN) mapping and cancer imaging are two research topics. The focus is to develop molecular imaging probes with high specificity and sensitivity, for Positron Emission Tomography (PET) and optical imaging. The objective of this thesis is to explore dextran radiopharmaceuticals and porous silicon nanoparticles based molecular imaging agents. Dextran polymers are excellent carriers to deliver imaging reporters or therapeutic agents due to its well established safety profile and oligosaccharide conjugation chemistry. There is also a wide selection of dextran polymers with different lengths. On the other hand, Silicon nanoparticles represent another class of biodegradable materials for imaging and drug delivery. The success in fluorescence lifetime imaging and enhancements of the immune activation potency was briefly discussed. Chapter 1 begins with an overview on current molecular imaging techniques and imaging probes. Chapter 2 presents a near-IR dye conjugated probe, IRDye 800CW-tilmanocept. Fluorophore density was optimized to generate the maximum brightness. It was labeled with 68Ga and 99mTc and in vivo SLN mapping was successfully performed in different animals, such as mice, rabbits, dogs and pigs. With 99mTc labeled IRDye 800CW-tilmanocept, chapter 3 introduces a two-day imaging protocol with a hand-held imager. Chapter 4 proposed a method to dual radiolabel the IRDye 800CW-tilmanocept with both 68Ga and

  1. TOPICAL REVIEW (Non-targeted) radioactive/fluorescent nanoparticles and their potential in combined pre- and intraoperative imaging during sentinel lymph node resection

    NASA Astrophysics Data System (ADS)

    Buckle, Tessa; Chin, Patrick T. K.; van Leeuwen, Fijs W. B.

    2010-12-01

    One clinical precedent for the use of nanosized imaging agents is the localization of the tumor draining sentinel lymph nodes. In this application, radiocolloids such as 99mTc-NanoColl are currently used to plan the surgical procedure and to provide acoustic guidance during the intervention. Additional injections of dyes are common to provide optical surgical guidance. Bimodal imaging agents, which are both radioactive and fluorescent, have the potential to be used for both surgical planning and intraoperative fluorescence guidance towards the sentinel lymph nodes. This review provides an overview of the radioactive, fluorescent, and size properties of (non-targeted) bimodal nanoparticles, and their (potential) value in sentinel lymph node detection.

  2. Optimal settings and accuracy of indocyanine green fluorescence imaging for sentinel node biopsy in early gastric cancer

    PubMed Central

    KINAMI, SHINICHI; OONISHI, TOSHIO; FUJITA, JUN; TOMITA, YASUTO; FUNAKI, HIROSHI; FUJITA, HIDETO; NAKANO, YASUHARU; UEDA, NOBUHIKO; KOSAKA, TAKEO

    2016-01-01

    Indocyanine green (ICG) fluorescence imaging represents a promising method for sentinel node (SN) biopsy in laparoscopic gastric surgery due to its signal stability. In the present study, the suitability and optimal settings of ICG fluorescence imaging for SN biopsy in early gastric cancer were determined. Patients with single primary superficial-type adenocarcinoma of the stomach, lesions <5 cm in diameter, and no evident nodal metastasis and out of indication for endoscopic submucosal dissection were enrolled. The day prior to surgery, ICG solution was endoscopically injected into four quadrants of the submucosal layer of the tumor. The Photodynamic Eye was used to detect ICG fluorescence. Bright nodes were defined as clearly fluorescent nodes. A total of 72 patients were enrolled; 11 cases presented with metastasis, and of these, 10 could be diagnosed by bright node biopsy. The adequate concentration and injection volume of ICG was determined to be 50 µg/ml (×100) and 0.5 mlx4 points, respectively. There was 1 false-negative case, and this was attributed to the failure of the frozen section diagnosis. These results suggested that ICG fluorescence imaging for SN biopsy in laparoscopic surgery for early gastric cancer is feasible. However, a weakness of ICG fluorescence imaging is the subjectivity of bright node evaluation. PMID:27313740

  3. A dual-reporter fluorescent imaging approach can be used to estimate sentinel lymph node tumor burden

    NASA Astrophysics Data System (ADS)

    Tichauer, Kenneth M.; Samkoe, Kimberley S.; Gunn, Jason R.; Govindan, Ramesh; Viswanathan, Aravind; Hoopes, P. Jack; Hasan, Tayyaba; Kaufman, Peter A.; Pogue, Brian W.

    2013-03-01

    The presence of metastatic tumor cells in tumor-draining lymph nodes is an important indicator for cancer staging and therapy. Current clinical approaches of assessing lymph node tumor burden require invasive surgery that can be associated with nerve damage and other complications. In this study, a dual-reporter fluorescence molecular imaging approach, previously validated for quantifying targeted reporter binding in various human tumor xenographs, was assessed as a means of quantifying tumor burden in metastatic disease in mice. The utility of the dual-reporter imaging approach to measure tumor burden in sentinel lymph nodes was investigated in a bioluminescent human breast cancer xenograph model in 18 female nude mice. Once the presence of tumor in the lymph node was confirmed by bioluminescent imaging, fluorescently labeled anti-EGFR antibody and an untargeted antibody (labeled with a different fluorophore) were injected intradermally, proximal to the lymph node, and the uptake of the two reporters was imaged simultaneously with a with a flat-panel fluorescent scanner. Preliminary results demonstrated a statistically significant correlation between the dual-reporter measured tumor burden and the bioluminescent measure of tumor burden.

  4. γ-Tilmanocept, a New Radiopharmaceutical Tracer for Cancer Sentinel Lymph Nodes, Binds to the Mannose Receptor (CD206)

    PubMed Central

    Azad, Abul K.; Rajaram, Murugesan V. S.; Metz, Wendy L.; Cope, Frederick O.; Blue, Michael S.; Vera, David R.

    2015-01-01

    γ-Tilmanocept (99mTc-labeled-tilmanocept or [99mTc]-tilmanocept) is the first mannose-containing, receptor-directed, radiolabeled tracer for the highly sensitive imaging of sentinel lymph nodes in solid tumor staging. To elucidate the mannose-binding receptor that retains tilmanocept in this microenvironment, human macrophages were used that have high expression of the C-type lectin mannose receptor (MR; CD206). Cy3-labeled tilmanocept exhibited high specificity binding to macrophages that was nearly abolished in competitive inhibition experiments. Furthermore, Cy3-tilmanocept binding was markedly reduced on macrophages deficient in the MR by small interfering RNA treatment and was increased on MR-transfected HEK 293 cells. Finally, confocal microscopy revealed colocalization of Cy3-tilmanocept with the macrophage membrane MR and binding of labeled tilmanocept to MR+ cells (macrophages and/or dendritic cells) in human sentinel lymph node tissues. Together these data provide strong evidence that CD206 is a major binding receptor for γ-tilmanocept. Identification of CD206 as the γ-tilmanocept–binding receptor enables opportunities for designing receptor-targeted advanced imaging agents and therapeutics for cancer and other diseases. PMID:26202986

  5. The impact of previous para-areolar incision in the upper outer quadrant of the breast on the localization of the sentinel lymph node in a canine model

    PubMed Central

    Vasques, Paulo Henrique Diógenes; Pinheiro, Luiz Gonzaga Porto; de Meneses e Silva, João Marcos; de Moura Torres-de-Melo, José Ricardo; Pinheiro, Karine Bessa Porto; Rocha, João Ivo Xavier

    2011-01-01

    OBJECTIVES: This paper discusses the influence of a para-areolar incision in the upper outer quadrant of the breast on the location of the sentinel lymph node in a canine model. METHODS: The sentinel lymph node was marked with technetium-99, which was injected into the subareolar skin of the cranial breast. After the marker had migrated to the axilla, an arcuate para-areolar incision was performed 2 cm from the nipple in the upper outer quadrant. Patent blue dye was then injected above the upper border of the incision. At the marked site, an axillary incision was made, and the sentinel lymph node was identified by gamma probe and/or by direct visualization of the dye. The agreement between the two injection sites and the two sentinel lymph node identification methods was determined. Our sample group consisted of 40 cranial breasts of 23 adult females of the species Canis familiaris. The data were analyzed by using the McNemar test and by determining the kappa agreement coefficient. RESULT: Our findings showed that in 95% of the breasts, the sentinel lymph node was identified by the injection of technetium-99 m into the subareolar region, and in 82% of the cases, the sentinel lymph node was identified by the injection of patent blue dye above the upper border of the incision. The methods agreed 82% of the time. CONCLUSIONS: Previous para-areolar incisions in the upper outer quadrant did not interfere significantly with the biopsy when the dye was injected above the upper border of the incision. PMID:21915493

  6. Sentinel lymph node biopsy revisited: ultrasound-guided photoacoustic detection of micrometastases using molecularly targeted plasmonic nanosensors

    PubMed Central

    Luke, Geoffrey P.; Myers, Jeffrey N.; Emelianov, Stanislav Y.; Sokolov, Konstantin V.

    2014-01-01

    Metastases rather than primary tumors are responsible for killing most cancer patients. Cancer cells often invade regional lymph nodes (LN) before colonizing other parts of the body. However, due to the low sensitivity and specificity of current imaging methods to detect localized nodal spread, an invasive surgical procedure - sentinel lymph node biopsy - is generally employed to identify metastatic cancer cells. Here we introduce a new approach for more sensitive in vivo detection of lymph node micrometastases, based on the use of ultrasound-guided spectroscopic photoacoustic (sPA) imaging of molecularly-activated plasmonic nanosensors (MAPS). Using a metastatic murine model of oral squamous cell carcinoma, we showed that MAPS targeted to the EGFR shifted their optical absorption spectrum to the red-near-infrared region after specific interactions with nodal metastatic cells, enabling their non-invasive detection by sPA. Notably, LN metastases as small as 50 μm were detected at centimeter-depth range with high sensitivity and specificity. Large sPA signals appeared in metastatic LN within 30 minutes of MAPS injection, in support of the clinical utility of this method. Our findings offer a rapid and effective tool to non-invasively identify micrometastases as an alternate to sentinal node biopsy analysis. PMID:25106426

  7. The use of 99mTc-Al2O3 for detection of sentinel lymph nodes in breast cancer

    NASA Astrophysics Data System (ADS)

    Sinilkin, I.; Chernov, V.; Medvedeva, A.; Zeltchan, R.; Slonimskaya, E.; Doroshenko, A.; Varlamova, N.; Skuridin, V.

    2016-08-01

    Purpose: to study the feasibility of using the new radiopharmaceutical based on the technetium-99m-labeled gamma-alumina for identification of sentinel lymph nodes (SLNs) in breast cancer patients. The study included two groups of breast cancer patients who underwent single photon emission computed tomography (SPECT) and intraoperaive gamma probe identification of sentinel lymph nodes (SLNs). To identify SLNs, the day before surgery Group I patients (n = 34) were injected with radioactive 99mTc-Al2O3, and Group II patients (n = 30) received 99mTc-labeled phytate colloid. A total of 37 SLNs were detected in Group I patients. The number of identified SLNs per patient ranged from 1 to 2 (the average number of identified SLNs was 1.08). Axillary lymph nodes were the most common site of SLN localization. 18 hours after 99mTc-Al2O3 injection, the percentage of its accumulation in the SLN was 7-11% (of the counts in the injection site) by SPECT and 17-31% by gamma probe detection. In Group II SLNs were detected in 27 patients. 18 hours after injection of the phytate colloid the percentage of its accumulation in the SLN was 1.5-2% out of the counts in the injection site by SPECT and 4-7% by gamma probe. The new radiopharmaceutical based on the 99mTc-Al2O3 demonstrates high accumulation in SLNs without redistribution through the entire lymphatic basin. The sensitivity and specificity of 99mTc-Al2O3 were 100% for both SPECT and intraoperative gamma probe identification.

  8. Sentinel lymph node detection in breast cancer patients using surgical navigation system based on fluorescence molecular imaging technology

    NASA Astrophysics Data System (ADS)

    Chi, Chongwei; Kou, Deqiang; Ye, Jinzuo; Mao, Yamin; Qiu, Jingdan; Wang, Jiandong; Yang, Xin; Tian, Jie

    2015-03-01

    Introduction: Precision and personalization treatments are expected to be effective methods for early stage cancer studies. Breast cancer is a major threat to women's health and sentinel lymph node biopsy (SLNB) is an effective method to realize precision and personalized treatment for axillary lymph node (ALN) negative patients. In this study, we developed a surgical navigation system (SNS) based on optical molecular imaging technology for the precise detection of the sentinel lymph node (SLN) in breast cancer patients. This approach helps surgeons in precise positioning during surgery. Methods: The SNS was mainly based on the technology of optical molecular imaging. A novel optical path has been designed in our hardware system and a feature-matching algorithm has been devised to achieve rapid fluorescence and color image registration fusion. Ten in vivo studies of SLN detection in rabbits using indocyanine green (ICG) and blue dye were executed for system evaluation and 8 breast cancer patients accepted the combination method for therapy. Results: The detection rate of the combination method was 100% and an average of 2.6 SLNs was found in all patients. Our results showed that the method of using SNS to detect SLN has the potential to promote its application. Conclusion: The advantage of this system is the real-time tracing of lymph flow in a one-step procedure. The results demonstrated the feasibility of the system for providing accurate location and reliable treatment for surgeons. Our approach delivers valuable information and facilitates more detailed exploration for image-guided surgery research.

  9. Sentinel lymph node biopsy in T1/T2 squamous cell carcinomas of the tongue: A prospective study

    PubMed Central

    SAGHEB, KEYVAN; SAGHEB, KAWE; RAHIMI-NEDJAT, ROMAN; TAYLOR, KATHY; AL-NAWAS, BILAL; WALTER, CHRISTIAN

    2016-01-01

    Commonly used staging procedures often cannot predict the absence of cervical metastases (CM) in squamous cell carcinomas (SCCs) of the oral cavity. Due to the high incidence of occult CM in numerous N0 cases in the clinic, an elective neck dissection (ND) is performed. The sentinel lymph node biopsy (SNB) is a common concept in the modern surgical therapy of malignancies. The present study evaluates the applicability of this concept for T1/T2-SCC of the tongue. In a prospective clinical study, 10 consecutive patients with T1/T2-SCC of the tongue and cN0 necks, were enrolled. Following sentinel lymph node (SLN) scintigraphy, all patients underwent SNB with a γ-probe and a subsequent ND. SNB specimens were compared with histopathological assessments of surgical specimens from the ND. A total of 5 female and 5 male patients (mean age, 52 years; women, 62 years; men, 42 years), with a median follow-up time of 33.5 months (range, 10–40 months), were treated. All patients presented with detectable SLNs. In 7 cases, the SLN(s) and the residual ND were negative for CM. In 3 cases, the SLN(s) were positive without further CM in the other neck nodes. Furthermore, 1 patient showed additional CMs after 10 months in the contralateral neck and lung metastasis after 18 months, but none at the time of the initial treatment. The concept of an SNB appears to be applicable to the management of the cN0 neck in small SCC of the tongue. The role of SNB in the management of SCC requires further investigation by prospective trials with larger patient numbers. PMID:26870253

  10. Feasibility and optimal dosage of indocyanine green fluorescence for sentinel lymph node detection using robotic single-site instrumentation: preclinical study.

    PubMed

    Levinson, Kimberly L; Mahdi, Haider; Escobar, Pedro F

    2013-01-01

    The present study was performed to determine the optimal dosage of indocyanine green (ICG) to accurately differentiate the sentinel node from surrounding tissue and then to test this dosage using novel single-port robotic instrumentation. The study was performed in healthy female pigs. After induction of anesthesia, all pigs underwent exploratory laparotomy, dissection of the bladder, and colpotomy to reveal the cervical os. With use of a 21-gauge needle, 0.5 mL normal saline solution was injected at the 3- and 9-o'clock positions as control. Four concentrations of ICG were constituted for doses of 1000, 500, 250, and 175 μg per 0.5 mL. ICG was then injected at the 3- and 9-o'clock positions on the cervix. The SPY camera was used to track ICG into the sentinel nodes and to quantify the intensity of light emitted. SPY technology uses an intensity scale of 1 to 256; this scale was used to determine the difference in intensity between the sentinel node and surrounding tissues. The optimal dosage was tested using single-port robotic instrumentation with the same injection techniques. A sentinel node was identified at all doses except 175 μg, at which ICG stayed in the cervix and vasculature only. For both the 500- and 250-μg doses, the sentinel node was identified before reaching maximum intensity. At maximum intensity, the difference between the surrounding tissue and the node was 207 (251 vs 44) for the 500-μg dose and 159 (251 vs 92) for the 250-μg dose. Sentinel lymph node (SLN) biopsy was successfully performed using single-port robotic technology with both the 250- and 500-μg doses. For SLN detection, the dose of ICG is related to the ability to differentiate the sentinel node from the surrounding tissue. An ICG dose of 250 to 500 μg enables identification of a SLN with more distinction from the surrounding tissues, and this procedure is feasible using single-port robotics instrumentation. PMID:24034538

  11. The Impact on Post-surgical Treatment of Sentinel Lymph Node Biopsy of Internal Mammary Lymph Nodes in Patients with Breast Cancer

    PubMed Central

    Madsen, EVE; Gobardhan, PD; Bongers, V; Albregts, M; Burgmans, JPJ; De Hooge, P; Van Gorp, J

    2007-01-01

    Background Since the introduction of the sentinel lymph node (SLN) biopsy in breast cancer patients there is a renewed interest in lymphatic drainage to the internal mammary (IM) chain nodes. We evaluated the frequency of lymphatic drainage to the IM chain, the rate of SLNs that contain metastases and the clinical implications of IM LN metastases. Methods Between June 1999 and April 2005 506 consecutive patients underwent SLN biopsy as a staging procedure for clinically T1-2N0 breast cancer. In all patients preoperative lymphoscintigraphy was combined with the intraoperative use of a gammaprobe. In patients with IM SLNs visualized on lymphoscintigraphy, LNs were extirpated through an intercostal parasternal incision. Results SLNs were visualized by preoperative lymphoscintigraphy in 99% of all patients (502/506): axillary SLNs in 499 patients (99%), ipsilateral IM LNs in 109 patients (22%). In 85 patients with visualized IM SLNs the IM nodes could be removed (78%). In 20 of the latter 85 patients IM SLNs contained metastases (24%). IM metastases were associated with axillary LN metastases (P < 0.001). In 17 patients IM metastases led to extension of the radiotherapy field, while additional (adjuvant) systemic therapy was given in six patients. Conclusion SLNs in the IM chain are common in breast cancer patients and can be extirpated in the majority of these patients. The proportion of patients in whom radiotherapeutic treatment was adjusted due to IM LN metastases was substantial. We advocate retrieval of IM SLNs when visualized by preoperative lymphoscintigraphy. PMID:17253106

  12. Contemporary controversies and perspectives in the staging and treatment of patients with lymph node metastasis from melanoma, especially with regards positive sentinel lymph node biopsy.

    PubMed

    Pasquali, Sandro; Spillane, Andrew

    2014-09-01

    The management of melanoma lymph node metastasis particularly when detected by sentinel lymph node biopsy (SLNB) is still controversial. Results of the only randomized trial conducted to assess the therapeutic value of SLNB, the Multicenter Selective Lymphadenectomy Trial (MSLT-1), have not conclusively proven the effectiveness of this procedure but are interpreted by the authors and guidelines as indicating SLNB is standard of care. After surgery, interferon alpha had a small survival benefit and radiotherapy has limited effectiveness for patient at high-risk of regional recurrence. New drugs, including immune modulating agents and targeted therapies, already shown to be effective in patients with distant metastasis, are being evaluated in the adjuvant setting. In this regard, ensuring high quality of surgery through the identification of reliable quality assurance indicators and improving the homogeneity of prognostic stratification of patients entered onto clinical trials is paramount. Here, we review the controversial issues regarding the staging and treatment of melanoma patients with lymph node metastasis, present a summary of important and potentially practice changing ongoing research and provide a commentary on what it all means at this point in time. PMID:25023758

  13. Diagnostic Performance of Indocyanine Green-Guided Sentinel Lymph Node Biopsy in Breast Cancer: A Meta-Analysis

    PubMed Central

    Zhou, Yidong; Mao, Feng; Lin, Yan; Guan, Jinghong; Sun, Qiang

    2016-01-01

    Background The diagnostic performance of indocyanine green (ICG) fluorescence-guided sentinel lymph node biopsy (SLNB) for the presence of metastases in breast cancer remains unclear. Objective We performed a meta-analysis to investigate the diagnostic performance of ICG-guided SLNB. Methods Eligible studies were identified from searches of the databases PubMed and EMBASE up to September 2015. Studies that reported the detection rate of ICG fluorescence-guided SLNB with full axillary lymph node dissection and histological or immunohistochemical examinations were included. A meta-analysis was performed to generate pooled detection rate, sensitivity, specificity, false negative rate, diagnostic odds ratio (DOR) and a summary receiver operator characteristic curve (SROC). Results Nineteen published studies were included to generate a pooled detection rate, comprising 2594 patients. The pooled detection rate was 0.98 (95% confidence interval [CI], 0.96–0.99). Six studies finally met the criteria for meta-analysis, which yielded a pooled sensitivity of 0.92 (95% CI, 0.85–0.96), specificity 1 (95% CI, 0.97–1), and DOR 311.47 (95% CI, 84.11–1153.39). The area under the SROC was 0.9758. No publication bias was found. Conclusion ICG fluorescence-guided SLNB is viable for detection of lymph node metastases in breast cancer. Large-scale randomized multi-center trials are necessary to confirm our results. PMID:27280407

  14. A quantitative reverse transcription-PCR assay for rapid, automated analysis of breast cancer sentinel lymph nodes.

    PubMed

    Hughes, Steven J; Xi, Liqiang; Gooding, William E; Cole, David J; Mitas, Michael; Metcalf, John; Bhargava, Rohit; Dabbs, David; Ching, Jesus; Kozma, Lynn; McMillan, William; Godfrey, Tony E

    2009-11-01

    We have previously reported that a quantitative reverse transcription (QRT)-PCR assay accurately analyzes sentinel lymph nodes (SLNs) from breast cancer patients. The aim of this study was to assess a completely automated, cartridge-based version of the assay for accuracy, predictive value, and reproducibility. The triplex (two markers + control) QRT-PCR assay was incorporated into a single-use cartridge for point-of-care use on the GeneXpert system. Three academic centers participated equally. Twenty-nine positive lymph nodes and 30 negative lymph nodes were analyzed to establish classification rules. SLNs from 120 patients were subsequently analyzed by QRT-PCR and histology (including immunohistochemistry), and the predetermined decision rules were used to classify the SLNs; 112 SLN specimens produced an informative result by both QRT-PCR and histology. By histological analysis, 21 SLNs were positive and 91 SLNs were negative for metastasis. QRT-PCR characterization produced a classification with 100% sensitivity, 97.8% specificity, and 98.2% accuracy compared with histology (91.3% positive predictive value and 100% negative predictive value). Interlaboratory reproducibility analyses demonstrated that a 95% prediction interval for a new measurement (DeltaCt) ranged between 0.403 and 0.956. This fully automated QRT-PCR assay accurately characterizes breast cancer SLNs for the presence of metastasis. Furthermore, the assay is not dependent on subjective interpretation, is reproducible across three clinical environments, and is rapid enough to allow intraoperative decision making. PMID:19797614

  15. In vivo non-ionizing photoacoustic mapping of sentinel lymph nodes and bladders with ICG-enhanced carbon nanotubes

    NASA Astrophysics Data System (ADS)

    Koo, Jasung; Jeon, Mansik; Oh, Yunok; Kang, Hyun Wook; Kim, Jeehyun; Kim, Chulhong; Oh, Junghwan

    2012-12-01

    We demonstrate the feasibility of mapping a sentinel lymph node (SLN) and urinary bladder by using modified single-walled carbon nanotubes (SWNTs) as a nonionizing photoacoustic (PA) contrast agent. To improve the PA sensitivity, indocyanine green (ICG) was conjugated with SWNTs and the optical absorption of SWNTs-ICG was enhanced by approximately four times compared to that of plain SWNTs at a concentration of 0.3 µM. In vivo PA imaging results showed that the SLN and bladder were clearly visualized due to accumulation of SWNTs-ICG. This implies that the SWNTs-ICG could be potentially utilized to identify SLNs in breast cancer patients and tracking vesicoureteral reflux in combination with PA imaging.

  16. The Study of 99mTc-Aluminum Oxide Using for Sentinel Lymph Nodes Detection in Experiment

    NASA Astrophysics Data System (ADS)

    Medvedeva, A. A.; Sinilkin, I. G.; Zelchan, R. V.; Chernov, V. I.; Lyapunov, A. Yu.; Bragina, O. D.; Varlamova, N. V.; Skuridin, V. S.; Dergilev, A. P.

    2016-06-01

    The purpose of the study was a comparative research of the possibility of using the radiopharmaceuticals 99mTc-Al2O3 and 99mTc-Nanocis for visualizing sentinel lymph nodes in the experiment. Measurement of the sizes of 99mTc-Al2O3 and 99mTc-Nanocis colloidal particles was performed in seven series of radiopharmaceuticals. Pharmacokinetics of 99mTc-Al2O3 and 99mTc-Nanocis was researched on 50 white male rats. The possibility of the use of 99mTc-Al2O3 and 99mTc-Nanocis for lymphoscintigraphy was studied in the experiments on 12 white male rats. Average dynamic diameter of the sol particle was 52-77 nm for 99mTc-Al2O3 and 16.7-24.5 nm for 99mTc-Nanocis. Radiopharmaceuticals accumulated in the inguinal lymph node - at 1 hour after administration the average uptake of 99mTc-Al2O3 was 8.6% in it and the accumulation of 99mTc-Nanocis was significantly lower - 1,8% (p <0,05). In all study point average uptake of 99mTc-Al2O3 in the lymph node was significantly higher 99mTc-Nanocis accumulation. The results dynamic scintigraphic studies in rats showed that 99mTc-Al2O3 and 99mTc-Nanocis actively accumulated into the lymphatic system. By using 99mTc-Al2O3 inguinal lymph node was determined in 5 minutes after injection and clearly visualize in all the animals in the 15th minute, when the accumulation became more than 1% of the administered dose. Further observation indicated that the 99mTc-Al2O3 accumulation reaches a plateau in a lymph node (average 10.5%) for 2 hour study and then its accumulation remains practically at the same level, slightly increasing to 12% at 24 hours. In the case of 99mTc-Nanocis inguinal lymph node visualized in all animals for 15 minutes when it was accumulated on the average 1.03% of the administered dose. Plateau of 99mTc-Nanocis accumulation in the lymph node (average 2.05%) occurred at 2 hour of the study and remained almost on the same level (in average 2.3%) to 24 hours. Thus, the experimental study of a new domestic radiopharmaceutical showed

  17. Predictive role of preoperative lymphoscintigraphy on the status of the sentinel lymph node in clinically node-negative patients with cutaneous melanoma.

    PubMed

    Solari, Nicola; Gipponi, Marco; Stella, Mattia; Queirolo, Paola; di Somma, Carmine; Villa, Giuseppe; Piccardo, Arnoldo; Gualco, Marina; Cardinale, Francesco; Cafiero, Ferdinando

    2009-08-01

    We reviewed our experience to assess the predictive role of preoperative lymphoscintigraphy with regard to the pathological status of sentinel lymph node (sN) in patients with cutaneous melanoma, to optimize the surgical treatment planning with regard to the use of intraoperative frozen section examination of sN. Eighty-eight patients with clinically node-negative cutaneous melanoma pT1b-T4 stage underwent preoperative lymphoscintigraphy for the lymphatic mapping of sN. A lymphoscintigraphic 'score' (from L1 to L5) was developed based on the ratio of radiotracer concentration within sN nodes as compared with the injection site. Our score allowed us to foresee that sN of patients with thick melanomas (T3 and T4) and a low preoperative score (L1-L2-L3) had a 90% expected likelihood (P<0.001) of harboring metastasis, whereas sN in patients with thin melanomas (T1b-T2) and high preoperative score (from L4 to L5) showed a 100% likelihood of being metastasis free. In conclusion, the sN is a reliable predictor of regional lymph node status in patients with cutaneous malignant melanoma. Moreover, we suggest that a low score (L1-L2-L3) associated with a thick melanoma is a good predictive factor of the positive sN involvement. This information could be useful in scheduling the intraoperative frozen-section examination with an expected benefit of a positive test in almost 90% of patients. Such patients might be selected for a 'one-stage' procedure with a more effective cost/benefit ratio and decreased hospitalization costs. PMID:19584766

  18. One-step nucleic acid amplification assay for intraoperative prediction of advanced axillary lymph node metastases in breast cancer patients with sentinel lymph node metastasis

    PubMed Central

    KUBOTA, MICHIYO; KOMOIKE, YOSHIFUMI; HAMADA, MIKA; SHINZAKI, WATARU; AZUMI, TATSUYA; HASHIMOTO, YUKIHIKO; IMOTO, SHIGERU; TAKEYAMA, YOSHIFUMI; OKUNO, KIYOTAKA

    2016-01-01

    The one-step nucleic acid amplification (OSNA) assay is used to semiquantitatively measure the cytokeratin (CK)19 mRNA copy numbers of each sentinel lymph node (SLN) in breast cancer patients. The aim of the present study was to evaluate whether the diagnosis of ≥4 LN metastases is possible using the OSNA assay intraoperatively. Between May, 2010 and December, 2014, a total of 134 patients who underwent axillary lymph node dissection (ALND) of positive SLNs were analyzed. The total tumor load (TTL) was defined as the total CK19 mRNA copies of all positive SLNs. The correlation between TTL and ≥4 LN metastases was evaluated. Of the 134 patients, 31 (23.1%) had ≥4 LN metastases. TTL ≥5.4×104 copies/µl evaluated by receiver operator characteristic curve analysis was examined along with other clinicopathological variables. In the multivariate analysis, only TTL ≥5.4×104 copies/µl was correlated with ≥4 LN metastases (odds ratio = 2.95, 95% confidence interval: 1.17–7.97, P=0.022). Therefore, TTL assessed by the OSNA assay has the potential to be a predictor of ≥4 LN metastases and it may be useful for the selection of patients with positive SLNs in whom ALND may be safely omitted. PMID:26893855

  19. Sentinel node biopsy using blue dye and technetium99 in advanced gastric cancer: anatomical drainage and clinical application

    PubMed Central

    Santos, F.A.V.; Drummond-Lage, A.P.; Rodrigues, M.A.; Cabral, M.A.; Pedrosa, M.S.; Braga, H.; Wainstein, A.J.A.

    2016-01-01

    Lymph node metastases are an independent prognosis factor in gastric carcinoma (GC) patients. Radical lymphadenectomy can improve survival but it can also increase surgical morbidity. As a principle, sentinel node (SN) navigation surgery can avoid unnecessary lymphadenectomy without compromising prognosis. In this pilot study, 24 patients with untreated GC were initially screened for SN navigation surgery, of which 12 were eligible. Five patients had T2 tumors, 5 had T3 tumors and 2 had T1 tumors. In 33% of cases, tumor diameter was greater than 5.0 cm. Three hundred and eighty-seven lymph nodes were excised with a median of 32.3 per patient. The SN navigation surgery was feasible in all patients, with a median of 4.5 SNs per patient. The detection success rate was 100%. All the SNs were located in N1 and N2 nodal level. In 70.9% of cases, the SNs were located at lymphatic chains 6 and 7. The SN sensitivity for nodal staging was 91.6%, with 8.3% of false negative. In 4 patients who were initially staged as N0, the SNs were submitted to multisection analyses and immunohistochemistry, confirming the N0 stage, without micrometastases. In one case initially staged as negative for nodal metastases based on SN analyses, metastases in lymph nodes other than SN were found, resulting in a 20% skip metastases incidence. This surgery is a reproducible procedure with 100% detection rate of SN. Tumor size, GC location and obesity were factors that imposed some limitations regarding SN identification. Results from nodal multisection histology and immunohistochemistry analysis did not change initial nodal staging. PMID:27409337

  20. Frozen section evaluation of breast carcinoma sentinel lymph nodes: a retrospective review of 1,940 cases.

    PubMed

    Poling, Justin S; Tsangaris, Theodore N; Argani, Pedram; Cimino-Mathews, Ashley

    2014-11-01

    Many sentinel lymph node biopsies (SLNBs) are evaluated intraoperatively by frozen section, which may impact the need for further axillary dissection (AD). However, the need for AD in patients with small metastases has been recently called into question, meaning that frozen SLNB may be unnecessary. Furthermore, frozen section can compromise tissue for further study. At our institution, we grossly evaluate all SLNB and freeze half of the node. Here, we evaluate the frozen SLNB discrepancy rate using this method, focusing on cause of discrepancy and need for further surgery. We reviewed surgical pathology records for all breast cancer resections with frozen section of SLNB examined from 2003 to 2012. For cases with a frozen section discrepancy, we compiled clinicopathologic data. In total, 1,940 cases involved frozen section evaluation of SLNB. In 95 cases (4.9% of total cases, 23.8% of positive node cases), the SLNB was called negative on frozen but positive on final examination (false negatives). The majority of missed metastases are isolated tumor cells or micrometastases. A trend was observed toward fewer patients receiving completion AD after a discrepant frozen SLNB in the later years of the study. The protocol of freezing half of a SLNB is a reasonable method, with results similar to or better than other studies. The main adverse outcome is the need for separate AD; however, additional positive nodes are uncommon. The trend of fewer patients getting additional AD after a discrepant frozen SLNB suggests that clinicians may be using this information differently recently. PMID:25318925

  1. Rapid Molecular Detection of Metastatic Head and Neck Squamous Cell Carcinoma as an Intraoperative Adjunct to Sentinel Lymph Node Biopsy

    PubMed Central

    Ferris, Robert L.; Stefanika, Patrick; Xi, Liqiang; Gooding, William; Seethala, Raja R.; Godfrey, Tony E.

    2012-01-01

    Objectives Clinical staging of early head and neck squamous cell carcinoma (SCCHN) is often inaccurate, leading to elective neck dissection to detect the 30% of patients with micrometastatic disease. Sentinel node biopsy (SNB) accurately stages the regional lymphatics, but intraoperative pathology is only moderately sensitive and final pathology takes several days to complete. To facilitate immediate neck dissection where necessary, we have identified several promising marker genes of SCCHN metastasis and developed a rapid, accurate and automated quantitative real time PCR (qRT-PCR) assay for intraoperative use. Design Prospective tissue collection, retrospective pathologic correlation with qRT-PCR Methods From a 40-gene marker screen, we quantified expression of 11 potential tumor genes using a test set of primary tumors (n=32), metastatic (n=19), and benign (n=10) lymph nodes. Eight patients’ paired primary tumor and metastatic nodes were included. A validation set of 442 grossly tumor-negative nodes was evaluated for expression of the most promising markers, comparing metastasis detection by qRT-PCR with pathologic analysis (H&E and immunohistochemistry). A novel multiplexed, automated, single-tube qRT-PCR assay was used to analyze over 100 lymph nodes using a two marker, 35-minute assay to determine its negative predictive value (NPV). Results Based on expression of 11 tumor-associated genes from the marker screen, the two most promising markers of SCCHN metastasis in the test set, pemphigus vulgaris antigen (PVA) and tumor-associated calcium signal transducer 1 (TACSTD1), also known as epithelial cell adhesion molecule (EpCAM), were selected. Development of a multiplexed qRT-PCR assay for the detection of metastasis compared favorably with pathologic analysis in the additional 442 node set. A rapid, multiplexed assay using PVA and TACSTD1 demonstrated excellent reproducibility, linearity, and accuracy (~96% NPV) for identifying positive (n=40) and negative

  2. Sentinel lymph node biopsy in a patient with ruptured poly implant prothese (PIP) implants: A case report

    PubMed Central

    Tafazal, H.; Basu, N.N.; Jewkes, A.

    2014-01-01

    Introduction Around 400,000 silicone gel breast implants produced by the French company poly implant prothese (PIP) were used worldwide. Following revelations that the company were using non- medical grade silicone for the production of their implants there has been growing concern over the increased rupture rate of these implants and the implications this may have on patients. Presentation of Case We report the case of a 57-year old lady with ruptured bilateral cosmetic PIP breast implants in whom a right breast lesion was detected on screening mammograms. Biopsies demonstrated a grade 1 tubular carcinoma. Histology from the sentinel lymph node biopsy showed axillary silicone granulomas but no evidence of metastatic disease. Discussion To our knowledge, this is the first reported case to describe SLNB in the presence of ruptured PIP implants, although SLNB in ruptured non-PIP implants has been previously described. Conclusion We conclude that SLNB can be utilised even in the context of concurrent PIP implant rupture and the presence of silicone granulomas in the axillary lymph nodes. PMID:25460455

  3. Multispectral real-time fluorescence imaging for intraoperative detection of the sentinel lymph node in gynecologic oncology.

    PubMed

    Crane, Lucia M A; Themelis, George; Buddingh, K Tim; Buddingh, Tim; Harlaar, Niels J; Pleijhuis, Rick G; Sarantopoulos, Athanasios; van der Zee, Ate G J; Ntziachristos, Vasilis; van Dam, Gooitzen M

    2010-01-01

    The prognosis in virtually all solid tumors depends on the presence or absence of lymph node metastases. Surgical treatment most often combines radical excision of the tumor with a full lymphadenectomy in the drainage area of the tumor. However, removal of lymph nodes is associated with increased morbidity due to infection, wound breakdown and lymphedema. As an alternative, the sentinel lymph node procedure (SLN) was developed several decades ago to detect the first draining lymph node from the tumor. In case of lymphogenic dissemination, the SLN is the first lymph node that is affected (Figure 1). Hence, if the SLN does not contain metastases, downstream lymph nodes will also be free from tumor metastases and need not to be removed. The SLN procedure is part of the treatment for many tumor types, like breast cancer and melanoma, but also for cancer of the vulva and cervix. The current standard methodology for SLN-detection is by peritumoral injection of radiocolloid one day prior to surgery, and a colored dye intraoperatively. Disadvantages of the procedure in cervical and vulvar cancer are multiple injections in the genital area, leading to increased psychological distress for the patient, and the use of radioactive colloid. Multispectral fluorescence imaging is an emerging imaging modality that can be applied intraoperatively without the need for injection of radiocolloid. For intraoperative fluorescence imaging, two components are needed: a fluorescent agent and a quantitative optical system for intraoperative imaging. As a fluorophore we have used indocyanine green (ICG). ICG has been used for many decades to assess cardiac function, cerebral perfusion and liver perfusion. It is an inert drug with a safe pharmaco-biological profile. When excited at around 750 nm, it emits light in the near-infrared spectrum around 800 nm. A custom-made multispectral fluorescence imaging camera system was used. The aim of this video article is to demonstrate the detection of

  4. Multispectral Real-time Fluorescence Imaging for Intraoperative Detection of the Sentinel Lymph Node in Gynecologic Oncology

    PubMed Central

    Crane, Lucia M.A.; Themelis, George; Buddingh, K. Tim; Harlaar, Niels J.; Pleijhuis, Rick G.; Sarantopoulos, Athanasios; van der Zee, Ate G.J.; Ntziachristos, Vasilis; van Dam, Gooitzen M.

    2010-01-01

    The prognosis in virtually all solid tumors depends on the presence or absence of lymph node metastases.1-3 Surgical treatment most often combines radical excision of the tumor with a full lymphadenectomy in the drainage area of the tumor. However, removal of lymph nodes is associated with increased morbidity due to infection, wound breakdown and lymphedema.4,5 As an alternative, the sentinel lymph node procedure (SLN) was developed several decades ago to detect the first draining lymph node from the tumor.6 In case of lymphogenic dissemination, the SLN is the first lymph node that is affected (Figure 1). Hence, if the SLN does not contain metastases, downstream lymph nodes will also be free from tumor metastases and need not to be removed. The SLN procedure is part of the treatment for many tumor types, like breast cancer and melanoma, but also for cancer of the vulva and cervix.7 The current standard methodology for SLN-detection is by peritumoral injection of radiocolloid one day prior to surgery, and a colored dye intraoperatively. Disadvantages of the procedure in cervical and vulvar cancer are multiple injections in the genital area, leading to increased psychological distress for the patient, and the use of radioactive colloid. Multispectral fluorescence imaging is an emerging imaging modality that can be applied intraoperatively without the need for injection of radiocolloid. For intraoperative fluorescence imaging, two components are needed: a fluorescent agent and a quantitative optical system for intraoperative imaging. As a fluorophore we have used indocyanine green (ICG). ICG has been used for many decades to assess cardiac function, cerebral perfusion and liver perfusion.8 It is an inert drug with a safe pharmaco-biological profile. When excited at around 750 nm, it emits light in the near-infrared spectrum around 800 nm. A custom-made multispectral fluorescence imaging camera system was used.9. The aim of this video article is to demonstrate the

  5. Sentinel lymph node biopsy reduces the incidence of secondary neck metastasis in patients with oral squamous cell carcinoma

    PubMed Central

    HIRAKI, AKIMITSU; FUKUMA, DAIKI; NAGATA, MASASHI; SHIRAISHI, SHINYA; KAWAHARA, KENTA; MATSUOKA, YUICHIRO; NAKAGAWA, YOSHIHIRO; YOSHIDA, RYOJI; TANAKA, TAKUYA; YOSHITAKE, YOSHIHIRO; SHINOHARA, MASANORI; YAMASHITA, YASUYUKI; NAKAYAMA, HIDEKI

    2016-01-01

    It has recently been established that sentinel node biopsy (SNB) is an applicable and feasible procedure for the prediction of neck lymph node status in patients with early oral squamous cell carcinoma (OSCC) who are clinically negative for neck metastasis (cN0). The aim of this study was to retrospectively compare excision followed by watchful waiting with excision and SNB, in order to determine the effectiveness of SNB. A total of 125 patients with cN0 early OSCC were divided into two groups, namely the excision alone (n=78) and excision with SNB (n=47) groups. The clinical data of these two groups between 2006 and 2013 were analyzed. In the excision with SNB group, the negative predictive value and false-negative rate of SNB were 94% (30/32) and 18% (2/11), respectively. Secondary neck metastasis, also known as delayed neck metastasis, occurred in 24.2% of the patients in the excision alone group and 4.9% of the patients in the excision with SNB group. The 5-year overall survival (OS) rates were 84.0 and 97.5% in the excision alone and excision with SNB groups, respectively. Significant differences were found in the rate of secondary neck metastasis and OS between the two groups. SNB may be effective in the detection of occult neck lymph node metastasis, with a reduction in the incidence of secondary neck metastasis and improvements in the 5-year OS in patients with early-stage (stage I/II) oral cancer. PMID:27330766

  6. A near-infrared fluorescence-based surgical navigation system imaging software for sentinel lymph node detection

    NASA Astrophysics Data System (ADS)

    Ye, Jinzuo; Chi, Chongwei; Zhang, Shuang; Ma, Xibo; Tian, Jie

    2014-02-01

    Sentinel lymph node (SLN) in vivo detection is vital in breast cancer surgery. A new near-infrared fluorescence-based surgical navigation system (SNS) imaging software, which has been developed by our research group, is presented for SLN detection surgery in this paper. The software is based on the fluorescence-based surgical navigation hardware system (SNHS) which has been developed in our lab, and is designed specifically for intraoperative imaging and postoperative data analysis. The surgical navigation imaging software consists of the following software modules, which mainly include the control module, the image grabbing module, the real-time display module, the data saving module and the image processing module. And some algorithms have been designed to achieve the performance of the software, for example, the image registration algorithm based on correlation matching. Some of the key features of the software include: setting the control parameters of the SNS; acquiring, display and storing the intraoperative imaging data in real-time automatically; analysis and processing of the saved image data. The developed software has been used to successfully detect the SLNs in 21 cases of breast cancer patients. In the near future, we plan to improve the software performance and it will be extensively used for clinical purpose.

  7. A self-assembled multimodal complex for combined pre- and intraoperative imaging of the sentinel lymph node

    NASA Astrophysics Data System (ADS)

    Buckle, Tessa; van Leeuwen, Anne C.; Chin, Patrick T. K.; Janssen, Hans; Muller, Sara H.; Jonkers, Jos; van Leeuwen, Fijs W. B.

    2010-09-01

    Specific removal of the sentinel lymph node (SLN) during breast cancer surgery presents physicians with the opportunity to detect early metastatic disease. To increase the accuracy of intraoperative SLN detection, new methods with higher sensitivity and specificity are required. We have quantitatively compared conventional preoperative lymphoscintigraphy with albumin radiocolloids (99mTc-NanoColl) with optical intraoperative guidance using the near infrared dye indocyanine green (ICG) in an orthotopic mouse model for metastatic breast cancer. Furthermore, we have applied a self-assembled multimodal complex, in which ICG is non-covalently bound to the albumin radiocolloid, to attain identical dynamics of the radioactive and optical components. The SLN specificity of the multimodal complex is similar to conventional lymphoscintigraphy, while the fluorescent signal-to-noise ratio is improved by 86% compared to ICG alone. In addition, the multimodal complex permits scintigraphic validation of the fluorescent findings. The multimodal ICG-99mTc-NanoColl complex can be used both for lymphoscintigraphy by preoperative single photon emission computed tomography/computed tomography and for surgical navigation by intraoperative fluorescence imaging.

  8. Navigation surgery for intraoperative sentinel lymph node detection using Indocyanine green (ICG) fluorescence real-time imaging in breast cancer.

    PubMed

    Toh, U; Iwakuma, N; Mishima, M; Okabe, M; Nakagawa, S; Akagi, Y

    2015-09-01

    A new sensitive fluorescence imaging system was developed for the real-time identification of sentinel lymph nodes (SLNs) in patients with early breast cancer. The purpose of this study was to evaluate the utility of a color charge-coupled device camera system for the intraoperative detection of SLNs and to determine its clinical efficacy and sensitivity in patients with operable breast cancer. We assessed a total of 168 patients diagnosed with or suspected of having early-stage breast cancer without metastasis in SLNs. The intraoperative detection of SLNs was performed using the conventional Indigo Carmine dye (indigotindisulfonate sodium) technique combined with a new Indocyanine green (ICG) imaging system (HyperEye Medical System: HEMS, MIZUHO IKAKOGYO, Japan) to map SLNs, in which the lymphatic vessels and SLNs were visualized transcutaneously with illuminating ICG fluorescence. Between January 2012 and May 2013, SLNs were successfully identified in all 168 patients (detection rate: 100%). By histopathology, the sensitivity was 93.8% for the detection of the metastatic involvement of SLNs (15 of 16 nodal-positive patients). After a median follow-up of 30.5 months, none of the patients presented with axillary recurrence. These results suggest that the HEMS imaging system is a feasible and effective method for the detection of SLNs in breast cancer. Furthermore, the HEMS device permitted the transcutaneous visualization of lymphatic vessels under light conditions, thus facilitating the identification and detection of SLNs without affecting the surgical procedure, together with a high sensitivity and specificity. PMID:26267663

  9. In vivo fiber-based multicolor photoacoustic detection and photothermal purging of metastasis in sentinel lymph nodes targeted by nanoparticles.

    PubMed

    Galanzha, Ekaterina I; Kokoska, Mimi S; Shashkov, Evgeny V; Kim, Jin-Woo; Tuchin, Valery V; Zharov, Vladimir P

    2009-09-01

    This report introduces a novel diagnostic and therapeutic platform for in vivo non-invasive detection and treatment of metastases in sentinel lymph nodes (SLNs) at single cell level using an integrated system of multicolor photoacoustic (PA) lymph flow cytometry, PA lymphography, absorption image cytometry, and photothermal (PT) therapy. A melanoma-bearing mouse model was used to demonstrate the capability of this platform for real-time lymphatic mapping, counting of disseminated tumor cells (DTCs) in prenodal lymphatics, and detecting metastasis in SLNs and its purging. The detection and ablation of non-pigmented breast cancer cells in SLNs was achieved by labeling them with nanoparticles. The association between DTC count and SLN metastasis progression supports lymphatic DTCs as a novel prognostic marker of metastasis. The fiber-based portable PA device may replace the conventional SLN(s) excision and histology-based staging. The earliest detection of DTCs in the lymphatic vessels before the establishment of nodal metastasis may prevent metastasis by well-timed ablation of DTCs. PMID:19743443

  10. A Rapid, Fully Automated, Molecular-Based Assay Accurately Analyzes Sentinel Lymph Nodes for the Presence of Metastatic Breast Cancer

    PubMed Central

    Hughes, Steven J.; Xi, Liqiang; Raja, Siva; Gooding, William; Cole, David J.; Gillanders, William E.; Mikhitarian, Keidi; McCarty, Kenneth; Silver, Susan; Ching, Jesus; McMillan, William; Luketich, James D.; Godfrey, Tony E.

    2006-01-01

    Objective: To develop a fully automated, rapid, molecular-based assay that accurately and objectively evaluates sentinel lymph nodes (SLN) from breast cancer patients. Summary Background Data: Intraoperative analysis for the presence of metastatic cancer in SLNs from breast cancer patients lacks sensitivity. Even with immunohistochemical staining (IHC) and time-consuming review, alarming discordance in the interpretation of SLN has been observed. Methods: A total of 43 potential markers were evaluated for the ability to accurately characterize lymph node specimens from breast cancer patients as compared with complete histologic analysis including IHC. Selected markers then underwent external validation on 90 independent SLN specimens using rapid, multiplex quantitative reverse transcription-polymerase chain reaction (QRT-PCR) assays. Finally, 18 SLNs were analyzed using a completely automated RNA isolation, reverse transcription, and quantitative PCR instrument (GeneXpert). Results: Following analysis of potential markers, promising markers were evaluated to establish relative level of expression cutoff values that maximized classification accuracy. A validation set of 90 SLNs from breast cancer patients was prospectively characterized using 4 markers individually or in combinations, and the results compared with histologic analysis. A 2-marker assay was found to be 97.8% accurate (94% sensitive, 100% specific) compared with histologic analysis. The fully automated GeneXpert instrument produced comparable and reproducible results in less than 35 minutes. Conclusions: A rapid, fully automated QRT-PCR assay definitively characterizes breast cancer SLN with accuracy equal to conventional pathology. This approach is superior to intraoperative SLN analysis and can provide standardized, objective results to assist in pathologic diagnosis. PMID:16495705

  11. Binocular Goggle Augmented Imaging and Navigation System provides real-time fluorescence image guidance for tumor resection and sentinel lymph node mapping

    PubMed Central

    B. Mondal, Suman; Gao, Shengkui; Zhu, Nan; Sudlow, Gail P.; Liang, Kexian; Som, Avik; Akers, Walter J.; Fields, Ryan C.; Margenthaler, Julie; Liang, Rongguang; Gruev, Viktor; Achilefu, Samuel

    2015-01-01

    The inability to identify microscopic tumors and assess surgical margins in real-time during oncologic surgery leads to incomplete tumor removal, increases the chances of tumor recurrence, and necessitates costly repeat surgery. To overcome these challenges, we have developed a wearable goggle augmented imaging and navigation system (GAINS) that can provide accurate intraoperative visualization of tumors and sentinel lymph nodes in real-time without disrupting normal surgical workflow. GAINS projects both near-infrared fluorescence from tumors and the natural color images of tissue onto a head-mounted display without latency. Aided by tumor-targeted contrast agents, the system detected tumors in subcutaneous and metastatic mouse models with high accuracy (sensitivity = 100%, specificity = 98% ± 5% standard deviation). Human pilot studies in breast cancer and melanoma patients using a near-infrared dye show that the GAINS detected sentinel lymph nodes with 100% sensitivity. Clinical use of the GAINS to guide tumor resection and sentinel lymph node mapping promises to improve surgical outcomes, reduce rates of repeat surgery, and improve the accuracy of cancer staging. PMID:26179014

  12. Imaging methods for the local lymphatic system of the axilla in early breast cancer in patients qualified for sentinel lymph node biopsy.

    PubMed

    Nowikiewicz, Tomasz; Kurylcio, Andrzej; Polkowski, Wojciech; Zegarski, Wojciech

    2016-03-01

    Breast cancer is the most common malignancy in women in well-developed countries. Despite a constant increase in its incidence, the percentage of patients diagnosed with the disease in the non-invasive stage is also rising. This allows more frequently for the use of breast-preserving surgical techniques, involving the breast and the regional lymphatic system. According to current guidelines of expert panels and research societies, the recommended method of identifying the sentinel lymph node is the use of an isotope marker with a dye (a combined isotope and dye method). Cooperation with a nuclear medicine unit is essential (performing a preoperative lymphoscintigraphic scan to identify the lymphatic drainage basin and sentinel lymph node). In the case of smaller centers treating breast cancer, it can be associated with a number of difficulties, including organizational ones, and also increasing general treatment costs. A possible solution to these problems is to use alternative techniques of visualizing the sentinel lymph node, which do not require a radiotracer. In this paper we discuss the currently available methods of mapping the lymphatic system of the axillary region in patients with early breast cancer. The review is limited to reporting on methods of proven (based on clinical research) high diagnostic value. PMID:27095960

  13. Binocular Goggle Augmented Imaging and Navigation System provides real-time fluorescence image guidance for tumor resection and sentinel lymph node mapping.

    PubMed

    Mondal, Suman B; Gao, Shengkui; Zhu, Nan; Sudlow, Gail P; Liang, Kexian; Som, Avik; Akers, Walter J; Fields, Ryan C; Margenthaler, Julie; Liang, Rongguang; Gruev, Viktor; Achilefu, Samuel

    2015-01-01

    The inability to identify microscopic tumors and assess surgical margins in real-time during oncologic surgery leads to incomplete tumor removal, increases the chances of tumor recurrence, and necessitates costly repeat surgery. To overcome these challenges, we have developed a wearable goggle augmented imaging and navigation system (GAINS) that can provide accurate intraoperative visualization of tumors and sentinel lymph nodes in real-time without disrupting normal surgical workflow. GAINS projects both near-infrared fluorescence from tumors and the natural color images of tissue onto a head-mounted display without latency. Aided by tumor-targeted contrast agents, the system detected tumors in subcutaneous and metastatic mouse models with high accuracy (sensitivity = 100%, specificity = 98% ± 5% standard deviation). Human pilot studies in breast cancer and melanoma patients using a near-infrared dye show that the GAINS detected sentinel lymph nodes with 100% sensitivity. Clinical use of the GAINS to guide tumor resection and sentinel lymph node mapping promises to improve surgical outcomes, reduce rates of repeat surgery, and improve the accuracy of cancer staging. PMID:26179014

  14. Imaging methods for the local lymphatic system of the axilla in early breast cancer in patients qualified for sentinel lymph node biopsy

    PubMed Central

    Kurylcio, Andrzej; Polkowski, Wojciech; Zegarski, Wojciech

    2016-01-01

    Breast cancer is the most common malignancy in women in well-developed countries. Despite a constant increase in its incidence, the percentage of patients diagnosed with the disease in the non-invasive stage is also rising. This allows more frequently for the use of breast-preserving surgical techniques, involving the breast and the regional lymphatic system. According to current guidelines of expert panels and research societies, the recommended method of identifying the sentinel lymph node is the use of an isotope marker with a dye (a combined isotope and dye method). Cooperation with a nuclear medicine unit is essential (performing a preoperative lymphoscintigraphic scan to identify the lymphatic drainage basin and sentinel lymph node). In the case of smaller centers treating breast cancer, it can be associated with a number of difficulties, including organizational ones, and also increasing general treatment costs. A possible solution to these problems is to use alternative techniques of visualizing the sentinel lymph node, which do not require a radiotracer. In this paper we discuss the currently available methods of mapping the lymphatic system of the axillary region in patients with early breast cancer. The review is limited to reporting on methods of proven (based on clinical research) high diagnostic value. PMID:27095960

  15. Absence of Tumor-Infiltrating Lymphocyte Is a Reproducible Predictive Factor for Sentinel Lymph Node Metastasis: A Multicenter Database Study by the Brazilian Melanoma Group

    PubMed Central

    Duprat, João Pedreira; Brechtbülh, Eduard René; Costa de Sá, Bianca; Enokihara, Mauro; Fregnani, Jose Humberto; Landman, Gilles; Maia, Marcus; Riccardi, Felice; Belfort, Francisco Alberto; Wainstein, Alberto; Moredo, Luciana F.; Steck, Higino; Brandão, Miguel; Moreno, Marcelo; Miranda, Eduardo; Santos, Ivan Dunshee de Oliveira

    2016-01-01

    Aims The aim of this study is to confirm the function of tumor-infiltrating lymphocytes (TILs) in sentinel lymph node (SLN) metastasis. Materials and Methods This retrospective study included 633 patients with invasive melanoma who underwent sentinel lymph node biopsy in 7 referral centers certified by the Brazilian Melanoma Group. Independent risk factors of sentinel node metastasis (SNL) were identified by multiple logistic regression. Results SLN metastasis was detected in 101 of 633 cases (16.1%) and in 93 of 428 patients (21.7%) when melanomas ≤ 1mm were excluded. By multiple logistic regression, the absence of TILs was as an independent risk factor of SLN metastasis (OR = 1.8; 95%CI: 1.1–3.0), in addition to Breslow index (greater than 2.00 mm), lymph vascular invasion, and presence of mitosis. Conclusion SLNB can identify patients who might benefit from immunotherapy, and the determination of predictors of SLNB positivity can help select the proper population for this type of therapy. The absence of TILs is a reproducible parameter that can predict SLNB positivity in melanoma patients, since this study was made with several centers with different dermatopathologists. PMID:26859408

  16. Binocular Goggle Augmented Imaging and Navigation System provides real-time fluorescence image guidance for tumor resection and sentinel lymph node mapping

    NASA Astrophysics Data System (ADS)

    B. Mondal, Suman; Gao, Shengkui; Zhu, Nan; Sudlow, Gail P.; Liang, Kexian; Som, Avik; Akers, Walter J.; Fields, Ryan C.; Margenthaler, Julie; Liang, Rongguang; Gruev, Viktor; Achilefu, Samuel

    2015-07-01

    The inability to identify microscopic tumors and assess surgical margins in real-time during oncologic surgery leads to incomplete tumor removal, increases the chances of tumor recurrence, and necessitates costly repeat surgery. To overcome these challenges, we have developed a wearable goggle augmented imaging and navigation system (GAINS) that can provide accurate intraoperative visualization of tumors and sentinel lymph nodes in real-time without disrupting normal surgical workflow. GAINS projects both near-infrared fluorescence from tumors and the natural color images of tissue onto a head-mounted display without latency. Aided by tumor-targeted contrast agents, the system detected tumors in subcutaneous and metastatic mouse models with high accuracy (sensitivity = 100%, specificity = 98% ± 5% standard deviation). Human pilot studies in breast cancer and melanoma patients using a near-infrared dye show that the GAINS detected sentinel lymph nodes with 100% sensitivity. Clinical use of the GAINS to guide tumor resection and sentinel lymph node mapping promises to improve surgical outcomes, reduce rates of repeat surgery, and improve the accuracy of cancer staging.

  17. Cervical conization and sentinel lymph node mapping in the treatment of stage I cervical cancer: is less enough?

    PubMed Central

    Andikyan, Vaagn; Khoury-Collado, Fady; Denesopolis, John; Park, Kay J.; Hussein, Yaser R.; Brown, Carol L.; Sonoda, Yukio; Chi, Dennis S.; Barakat, Richard R.; Abu-Rustum, Nadeem R.

    2016-01-01

    Objective To determine the feasibility of cervical conization and sentinel lymph node (SLN) mapping as a fertility-sparing strategy to treat stage I cervical cancer and estimate the tumor margin status needed to achieve no residual carcinoma in the cervix. Methods We identified all patients who desired fertility-preservation and underwent SLN mapping with cervical conization for stage I cervical cancer from 9/2005–8/2012. Relevant demographic, clinical, and pathological information was collected. Results Ten patients were identified. Median age was 28 years (range,18–36). None of the patients had a grossly visible tumor. The initial diagnosis of invasive carcinoma was made either on a loop electrosurgical excision procedure (LEEP) or cone biopsy. All patients underwent preoperative radiologic evaluation (MRI and PET-CT). None of the patients had evidence of gross tumor or suspicion of lymph node metastasis on imaging. Stage distribution included: IA1 with lymphovascular invasion, 7(70%); and microscopic IB1, 3(30%). Histology included: squamous cell carcinoma, 8(80%); adenocarcinoma, 1(10%); and clear cell carcinoma, 1(10%). Nine patients underwent repeat cervical conization with SLN mapping, and 1 patient underwent post-conization cervical biopsies and SLN mapping. None of the patients had residual tumor identified on the final specimen. The median distance from the invasive carcinoma to the endocervical margin was 2.25mm, and the distance from the invasive carcinoma to the ectocervical margin was 1.9mm. All collected lymph nodes were negative for metastasis. After a median follow-up of 17 months (range,1–83), none of the patients were diagnosed with recurrent disease and 3 patients (30%) achieved pregnancy. Conclusion Cervical conization and SLN mapping appears to be an acceptable treatment strategy for selected patients with small-volume stage I cervical cancer. Tumor clearance of ≥2mm appears to correlate well with no residual on repeat conization. A

  18. Implementation of the american college of surgeons oncology group z1071 trial data in clinical practice: is there a way forward for sentinel lymph node dissection in clinically node-positive breast cancer patients treated with neoadjuvant chemotherapy?

    PubMed

    Mittendorf, Elizabeth A; Caudle, Abigail S; Yang, Wei; Krishnamurthy, Savitri; Shaitelman, Simona; Chavez-MacGregor, Mariana; Woodward, Wendy A; Bedrosian, Isabelle; Kuerer, Henry M; Hunt, Kelly K

    2014-08-01

    For clinically node-positive breast cancer patients receiving neoadjuvant chemotherapy, approximately 40 % will be found to be pathologically node negative. The American College of Surgeons Oncology Group Z1071 trial was therefore conducted to evaluate sentinel lymph node dissection (SLND) in these patients. The trial's primary end point was to determine the false-negative rate (FNR) among patients with clinical N1 disease in whom at least 2 sentinel lymph nodes (SLNs) were identified. The FNR was 12.6 %, which exceeded the prespecified end point of 10.0 %. After data publication, our multidisciplinary team discussed the trial results and how we may incorporate the findings into clinical practice. Patient selection and surgical technique are critical. As an example, when dual tracer technique was used, the FNR was 10.8 %. Data from the trial presented at the San Antonio Breast Cancer Symposium suggested that the FNR could be improved if a clip was placed in the biopsy-proven positive lymph node and removal of that node during SLND was confirmed. Taking this into consideration, we have proposed an approach to surgical management of the axilla in clinically node-positive patients receiving neoadjuvant chemotherapy termed targeted axillary dissection (TAD). TAD involves placing a clip at the time a lymph node is determined to be positive. After completion of neoadjuvant chemotherapy, the clipped node is localized by using a wire or radioactive seed, and during the SLND procedure, all SLNs and the clipped node are removed. We are currently evaluating the efficacy of TAD in axillary staging after neoadjuvant chemotherapy. PMID:24841348

  19. Non-invasive Photoacoustic and Fluorescence Sentinel Lymph Node Identification using Dye-loaded Perfluorocarbon Nanoparticles

    PubMed Central

    Akers, Walter J.; Kim, Chulhong; Berezin, Mikhail; Guo, Kevin; Fuhrhop, Ralph; Lanza, Gregory M.; Fischer, Georg M.; Daltrozzo, Ewald; Zumbusch, Andreas; Cai, Xin; Wang, Lihong V.; Achilefu, Samuel

    2010-01-01

    The contrast mechanisms used for photoacoustic tomography (PAT) and fluorescence imaging differ in subtle but significant ways. Design of contrast agents for each or both modalities requires an understanding of the spectral characteristics as well as intra- and intermolecular interactions that occur during formulation. We found that fluorescence quenching that occurs in the formulation of near infrared (NIR) fluorescent dyes in nanoparticles results in enhanced contrast for PAT. The ability of the new PAT method to utilize strongly absorbing chromophores for signal generation allowed us to convert a highly fluorescent dye into an exceptionally high PA contrast material. Spectroscopic characterization of the developed NIR dye-loaded perfluorocarbon-based nanoparticles for combined fluorescence and PA imaging revealed distinct dye-dependent photophysical behavior. We demonstrate that the enhanced contrast allows detection of regional lymph nodes of rats in vivo with time-domain optical and photoacoustic imaging methods. The results further show that the use of fluorescence lifetime (FLT) imaging, which is less dependent on fluorescence intensity, provides a strategic approach to bridge the disparate contrast reporting mechanisms of fluorescence and PA imaging methods. PMID:21171567

  20. Resection of Sentinel Lymph Nodes by an Extraperitoneal Minilaparoscopic Approach Using Indocyanine Green for Uterine Malignancies: A Preclinical Comparative Study.

    PubMed

    Ferreira, Hélder; Nogueira-Silva, Cristina; Miranda, Alice; Correia-Pinto, Jorge

    2016-08-01

    Background The sentinel lymph node (SLN) concept might minimize surgical aggressiveness in cervical and endometrial malignancies. The aim of the study was to test the feasibility and reliability of minilaparoscopic extraperitoneal SLN excision after indocyanine green (ICG) cervical injection using a high-definition near infrared (NIR) imaging system in an in vivo porcine model. The same procedure was performed using conventional laparoscopic instruments and both outcomes were compared. Methods Twenty-four animals were equally and randomly divided into a minilaparoscopic group (group A) and a 5-mm conventional laparoscopic group (group B). A high-definition NIR imaging system and a 30° ICG endoscope were used. First, ICG (0.5 mL) was injected in the paracervical region. The SLN coloring time was recorded. An extraperitoneal approach to the SLN was executed with the same CO2 retropneumoperitoneum pressures (10 mm Hg). In both groups, the times for SLN localization and excision, as well as complications, were registered. Finally, a laparotomy was then done to evaluate whether any stained SLN still remained. The same surgical team performed all experiments. Results SLNs were identified and extraperitoneally excised in all animals without major complications. The SLN localization varied between animals from external iliac to preaortic regions. The surgical times were shorter with minilaparoscopy (39.3 ± 13 minutes) than with conventional 5-mm instruments (51.3 ± 14.17 minutes; P = .042). In group B, one stained SLN remained and was only detected by laparotomy. Conclusions We confirmed the feasibility and reliability of extraperitoneal minilaparoscopic approach for identification, dissection, and excision of SLN using an NIR imaging system and ICG. PMID:26637497

  1. Self-illuminating quantum dots for highly sensitive in vivo real-time luminescent mapping of sentinel lymph nodes.

    PubMed

    Wu, Qiang; Chu, Maoquan

    2012-01-01

    Quantum dots (QDs) show promise as novel nanomaterials for sentinel lymph node (SLN) mapping through their use in noninvasive in vivo fluorescence imaging, and they have provided remarkable results. However, in vivo fluorescence imaging has limitations mainly reflected in the strong autofluorescence and low deepness of tissue penetration associated with this technique. Here, we report on the use of self-illuminating 3-mercaptopropionic acid-capped CdTe/CdS QDs for mouse axillary SLN mapping by bioluminescence resonance energy transfer, which was found to overcome these limitations [corrected]. We used CdTe/CdS QDs synthesized in aqueous solution to conjugate a mutant of the bioluminescent protein, Renilla reniformis luciferase. The nanobioconjugates obtained had an average hydrodynamic diameter of 19 nm, and their luminescence catalyzed by the substrate (coelenterazine) could penetrate into at least 20 mm of hairless pigskin, which could be observed using an in vivo imaging system equipped with a 700 nm emission filter. Conversely, the fluorescence of the nanobioconjugates penetrated no more than 10 mm of pigskin and was observed with a strong background. When 80 μL of the nanobioconjugates (containing about 0.5 μmol/L of QDs) and 5 μL of coelenterazine (1 μg/μL) were intradermally injected into a mouse paw, the axillary SLN could be imaged in real time without external excitation, and little background interference was detected. Furthermore, the decayed luminescence of QD-Luc8 in SLNs could be recovered after being intradermally reinjected with the coelenterazine. Our data showed that using self-illuminating QDs, as opposed to fluorescence QDs, has greatly enhanced sensitivity in SLN mapping, and that the SLN could be identified synchronously by the luminescence and fluorescence of the self-illuminating QDs. PMID:22848169

  2. Synthesis and evaluation of Cy5.5-Rit tracer for specific near-infrared fluorescence imaging of sentinel lymph node.

    PubMed

    Li, Nan; Zhu, Hua; Li, Yan; Wang, Jing; Yang, Zhi

    2016-09-01

    Sentinel lymph nodes biopsy (SLNB) is a critically important technique to determine the metastatic status of primary breast cancer. Here we reported the new use of a conjugate, Cy5.5-Rituximab (Cy5.5-Rit), which is specific toward the CD20 receptor, as an imaging agent for non-invasive near-infrared fluorescence (NIRF) imaging of sentinel lymph nodes (SLN). The conjugate, Cy5.5-Rit, was synthesized with the ratio of dye to Rituximab close to 1.0. Both gel electrophoresis and mass spectrometry analysis confirmed the molecular integrity of Cy5.5-Rit. For in vivo NIRF imaging, the conjugate stayed in SLN as long as 9days post injection. The in vivo imaging results of SLN targeting were also confirmed by in vitro HE stain. In addition, the direct fluorescence signal of dissected lymph node demonstrated that Cy5.5-Rit binds to the surface of lymph node cells. All of these results showed that the conjugate Cy5.5-Rit has potential for non-invasive optical imaging of SLN. PMID:27497982

  3. Role of Axillary Clearance After a Tumor-Positive Sentinel Node in the Administration of Adjuvant Therapy in Early Breast Cancer

    PubMed Central

    Straver, Marieke E.; Meijnen, Philip; van Tienhoven, Geertjan; van de Velde, Cornelis J.H.; Mansel, Robert E.; Bogaerts, Jan; Demonty, Gaston; Duez, Nicole; Cataliotti, Luigi; Klinkenbijl, Jean; Westenberg, Helen A.; van der Mijle, Huub; Hurkmans, Coen; Rutgers, Emiel J.T.

    2010-01-01

    Purpose The After Mapping of the Axilla: Radiotherapy or Surgery? (AMAROS) phase III study compares axillary lymph node dissection (ALND) and axillary radiation therapy (ART) in early breast cancer patients with tumor-positive sentinel nodes. In the ART arm, the extent of nodal involvement remains unknown, which could have implications on the administration of adjuvant therapy. In this preliminary analysis, we studied the influence of random assignment to ALND or ART on the choice for adjuvant treatment. Patients and Methods In the first 2,000 patients enrolled in the AMAROS trial, we analyzed the administration of adjuvant systemic therapy. Multivariate analysis was used to assess variables affecting the administration of adjuvant chemotherapy. Adjuvant therapy was applied according to institutional guidelines. Results Of 2,000 patients, 566 patients had a positive sentinel node and were treated per random assignment. There was no significant difference in the administration of adjuvant systemic therapy. In the ALND and ART arms, 58% (175 of 300) and 61% (162 of 266) of the patients, respectively, received chemotherapy. Endocrine therapy was administered in 78% (235 of 300) of the patients in the ALND arm and in 76% (203 of 266) of the patients in the ART arm. Treatment arm was not a significant factor in the decision, and no interactions between treatment arm and other factors were observed. Multivariate analysis showed that age, tumor grade, multifocality, and size of the sentinel node metastasis significantly affected the administration of chemotherapy. Within the ALND arm, the extent of nodal involvement remained not significant in a sensitivity multivariate analysis. Conclusion Absence of knowledge regarding the extent of nodal involvement in the ART arm appears to have no major impact on the administration of adjuvant therapy. PMID:20038733

  4. Multimodal Surgical Guidance during Sentinel Node Biopsy for Melanoma: Combined Gamma Tracing and Fluorescence Imaging of the Sentinel Node through Use of the Hybrid Tracer Indocyanine Green-(99m)Tc-Nanocolloid.

    PubMed

    van den Berg, Nynke S; Brouwer, Oscar R; Schaafsma, Boudewijn E; Mathéron, Hanna M; Klop, W Martin C; Balm, Alfons J M; van Tinteren, Harm; Nieweg, Omgo E; van Leeuwen, Fijs W B; Valdés Olmos, Renato A

    2015-05-01

    Purpose To evaluate the hybrid approach in a large population of patients with melanoma in the head and neck, on the trunk, or on an extremity who were scheduled for sentinel node (SN) biopsy. Materials and Methods This prospective study was approved by the institutional review board. Between March 2010 and March 2013, 104 patients with a melanoma, including 48 women (average age, 54.3 years; range, 18.5-87.4 years) and 56 men (average age, 55.2 years; range, 22.4-77.4 years) (P = .76) were enrolled after obtaining written informed consent. Following intradermal hybrid tracer administration, lymphoscintigraphy and single photon emission computed tomography/computed tomography were performed. Blue dye was intradermally injected prior to the start of the surgical operation (excluding patients with a facial melanoma). Intraoperatively, SNs were initially pursued by using gamma tracing followed by fluorescence imaging (FI) and, when applicable, blue-dye detection. A portable gamma camera was used to confirm SN removal. Collected data included number and location of the preoperatively and intraoperatively identified SNs and the intraoperative number of SNs that were radioactive, fluorescent, and blue. A two-sample test for equality of proportions was performed to evaluate differences in intraoperative SN visualization through FI and blue-dye detection. Results Preoperative imaging revealed 2.4 SNs (range, 1-6) per patient. Intraoperatively, 93.8% (286 of 305) of the SNs were radioactive, 96.7% (295 of 305) of the SNs were fluorescent, while only 61.7% (116 of 188) of the SNs stained blue (P < .0001). FI was of value for identification of near-injection-site SNs (two patients), SNs located in complex anatomic areas (head and neck [28 patients]), and SNs that failed to accumulate blue dye (19 patients). Conclusion The hybrid tracer enables both preoperative SN mapping and intraoperative SN identification in melanoma patients. In the setup of this study, optical

  5. Image-Guided Sentinel Lymph Node Mapping and Nanotechnology-Based Nodal Treatment in Lung Cancer using Invisible Near-Infrared Fluorescent Light

    PubMed Central

    Khullar, Onkar; Frangioni, John V.; Colson, Yolonda L.

    2011-01-01

    Current methods for sentinel lymph node (SLN) mapping and nodal treatment in lung cancer remain inadequate for routine clinical use. Here we discuss the potential for using the combination of invisible near-infrared (NIR) fluorescent light and nanotechnology for these applications. NIR fluorescence imaging has recently received significant attention for in vivo imaging applications because of its low tissue autofluorescence, high photon penetration into living tissue, and high signal-to-background ratio. Our large animal in vivo studies have been able to successfully identify sentinel lymph nodes in lung tissue and several clinical studies have examined the use of NIR fluorescence imaging systems for SLN mapping in breast and gastric cancer. Promising new nanoparticle technologies, when combined with NIR fluorescence imaging, offer the potential for image-guided treatment of lymph nodes at high risk for tumor recurrence. This review provides a theoretical and empirical framework for developing the next-generation of diagnostic and therapeutic agents for lung cancer. PMID:20226343

  6. The interplay between hospital and surgeon factors and the use of sentinel lymph node biopsy for breast cancer

    PubMed Central

    Yen, Tina W.F.; Li, Jianing; Sparapani, Rodney A.; Laud, Purushuttom W.; Nattinger, Ann B.

    2016-01-01

    Abstract Background: Several surgeon characteristics are associated with the use of sentinel lymph node biopsy (SLNB) for breast cancer. No studies have systematically examined the relative contribution of both surgeon and hospital factors on receipt of SLNB. Objective: To evaluate the relationship between surgeon and hospital characteristics, including a novel claims-based classification of hospital commitment to cancer care (HC), and receipt of SLNB for breast cancer, a marker of quality care. Data Sources/Study Design: Observational prospective survey study was performed in a population-based cohort of Medicare beneficiaries who underwent incident invasive breast cancer surgery, linked to Medicare claims, state tumor registries, American Hospital Association Annual Survey Database, and American Medical Association Physician Masterfile. Multiple logistic regression models determined surgeon and hospital characteristics that were predictors of SLNB. Results: Of the 1703 women treated at 471 different hospitals by 947 different surgeons, 65% underwent an initial SLNB. Eleven percent of hospitals were high-volume and 58% had a high commitment to cancer care. In separate adjusted models, both high HC (odds ratio [OR] 1.53, 95% confidence interval [CI] 1.12–2.10) and high hospital volume (HV, OR 1.90, 95% CI 1.28–2.79) were associated with SLNB. Adding surgeon factors to a model including both HV and HC minimally modified the effect of high HC (OR 1.34, 95% CI 0.95–1.88) but significantly weakened the effect of high HV (OR 1.25, 95% CI 0.82–1.90). Surgeon characteristics (higher volume and percentage of breast cancer cases) remained strong independent predictors of SLNB, even when controlling for various hospital characteristics. Conclusions: Hospital factors are associated with receipt of SLNB but surgeon factors have a stronger association. Since regionalization of breast cancer care in the U.S. is unlikely to occur, efforts to improve the surgical care and

  7. Successful migration of three tracers without identification of sentinel nodes during intraoperative lymphatic mapping for non-small cell lung cancer.

    PubMed

    Meyer, Antoine; Cheng, Cai; Antonescu, Christian; Pezzetta, Edgardo; Bischof-Delaloye, Angelika; Ris, Hans-Beat

    2007-04-01

    Prospective comparative evaluation of patent V blue, fluorescein and (99m)TC-nanocolloids for intraoperative sentinel lymph node (SLN) mapping during surgery for non-small cell lung cancer (NSCLC). Ten patients with peripherally localised clinical stage I NSCLC underwent thoracotomy and peritumoral subpleural injection of 2 ml of patent V blue dye, 1 ml of 10% fluorescein and 1ml of (99m)Tc-nanocolloids (0.4 mCi). The migration and spatial distribution pattern of the tracers was assessed by direct visualisation (patent V blue), visualisation of fluorescence signalling by a lamp of Wood (fluorescein) and radioactivity counting with a hand held gamma-probe ((99m)Tc-nanocolloids). Lymph nodes at interlobar (ATS 11), hilar (ATS 10) and mediastinal (right ATS 2,4,7; left ATS 5,6,7) levels were systematically assessed every 10 min up to 60 min after injection, followed by lobectomy and formal lymph node dissection. Successful migration from the peritumoral area to the mediastinum was observed for all three tracers up to 60 min after injection. The interlobar lympho-fatty tissue (station ATS 11) revealed an early and preferential accumulation of all three tracers for all tumours assessed and irrespective of the tumour localisation. However, no preferential accumulation in one or two distinct lymph nodes was observed up to 60 min after injection for all three tracers assessed. Intraoperative SLN mapping revealed successful migration of the tracers from the site of peritumoral injection to the mediastinum, but in a diffuse pattern without preferential accumulation in sentinel lymph nodes. PMID:17669814

  8. Sentinel Lymph Node Biopsy

    MedlinePlus

    ... therapy , or both), and 82 percent had external-beam radiation therapy to the affected breast. The researchers ... treated with surgery, adjuvant systemic therapy, and external-beam radiation therapy. Subsequently, the American College of Surgeons ...

  9. Extra-nodal extension of sentinel lymph node metastasis is a marker of poor prognosis in breast cancer patients: A systematic review and an exploratory meta-analysis.

    PubMed

    Nottegar, A; Veronese, N; Senthil, M; Roumen, R M; Stubbs, B; Choi, A H; Verheuvel, N C; Solmi, M; Pea, A; Capelli, P; Fassan, M; Sergi, G; Manzato, E; Maruzzo, M; Bagante, F; Koç, M; Eryilmaz, M A; Bria, E; Carbognin, L; Bonetti, F; Barbareschi, M; Luchini, C

    2016-07-01

    Invasive breast cancer is the most common malignancy in women. Its most common site of metastasis is represented by the lymph nodes of axilla, and the sentinel lymph node (SLN) is the first station of nodal metastasis. Axillary SLN biopsy accurately predicts axillary lymph node status and has been accepted as standard of care for nodal staging in breast cancer. To date, the morphologic aspects of SLN metastasis have not been considered by the oncologic staging system. Extranodal extension (ENE) of nodal metastasis, defined as extension of neoplastic cells through the nodal capsule into the peri-nodal adipose tissue, has recently emerged as an important prognostic factor in several types of malignancies. It has also been considered as a possible predictor of non-sentinel node tumor burden in SLN-positive breast cancer patients. We sought out to clarify the prognostic role of ENE in SLN-positive breast cancer patients in terms of overall and disease-free survival by conducting a systematic review and meta-analysis. Among 172 screened articles, 5 were eligible for the meta-analysis; they globally include 624 patients (163 ENE+ and 461 ENE-) with a median follow-up of 58 months. ENE was associated with a higher risk of both mortality (RR = 2.51; 95% CI: 1.66-3.79, p < 0.0001, I(2) = 0%) and recurrence of disease (RR = 2.07, 95% CI: 1.38-3.10, p < 0.0001, I(2) = 0%). These findings recommend the consideration of ENE from the gross sampling to the histopathological evaluation, in perspectives to be validated and included in the oncologic staging. PMID:27005805

  10. A grid matrix-based Raman spectroscopic method to characterize different cell milieu in biopsied axillary sentinel lymph nodes of breast cancer patients.

    PubMed

    Som, Dipasree; Tak, Megha; Setia, Mohit; Patil, Asawari; Sengupta, Amit; Chilakapati, C Murali Krishna; Srivastava, Anurag; Parmar, Vani; Nair, Nita; Sarin, Rajiv; Badwe, R

    2016-01-01

    Raman spectroscopy which is based upon inelastic scattering of photons has a potential to emerge as a noninvasive bedside in vivo or ex vivo molecular diagnostic tool. There is a need to improve the sensitivity and predictability of Raman spectroscopy. We developed a grid matrix-based tissue mapping protocol to acquire cellular-specific spectra that also involved digital microscopy for localizing malignant and lymphocytic cells in sentinel lymph node biopsy sample. Biosignals acquired from specific cellular milieu were subjected to an advanced supervised analytical method, i.e., cross-correlation and peak-to-peak ratio in addition to PCA and PC-LDA. We observed decreased spectral intensity as well as shift in the spectral peaks of amides and lipid bands in the completely metastatic (cancer cells) lymph nodes with high cellular density. Spectral library of normal lymphocytes and metastatic cancer cells created using the cellular specific mapping technique can be utilized to create an automated smart diagnostic tool for bench side screening of sampled lymph nodes. Spectral library of normal lymphocytes and metastatic cancer cells created using the cellular specific mapping technique can be utilized to develop an automated smart diagnostic tool for bench side screening of sampled lymph nodes supported by ongoing global research in developing better technology and signal and big data processing algorithms. PMID:26552923

  11. Value of staging squamous cell carcinoma of the anal margin and canal using the sentinel lymph node procedure: an update of the series and a review of the literature

    PubMed Central

    Mistrangelo, D M; Bellò, M; Cassoni, P; Milanesi, E; Racca, P; Munoz, F; Fora, G; Rondi, N; Gilbo, N; Senetta, R; Ricardi, U; Morino, M

    2013-01-01

    Background: Inguinal metastases in patients affected by anal cancer are an independent prognostic factor for local failure and overall mortality. Since 2001, sentinel lymph node biopsy was applied in these patients. This original study reports an update of personal and previous published series, which were compared with Literature to value the incidence of inguinal metastases T-stage related and the overall incidence of false negative inguinal metastases at sentinel node. Methods: In all, 63 patients diagnosed with anal cancer submitted to inguinal sentinel node. Furthermore a research in the Pub Med database was performed to find papers regarding this technique. Results: In our series, detection rate was 98.4%. Inguinal metastases were evidentiated in 13 patients (20.6%). Our median follow-up was 35 months. In our series, no false negative nodes were observed. Conclusion: Sentinel node technique in the detection of inguinal metastases in patients affected by anal cancer should be considered as a standard of care. It is indicated for all T stages in order to select patients to be submitted to inguinal radiotherapy, avoiding related morbidity in negative ones. An overall 3.7% rate of false negative must be considered acceptable. PMID:23329231

  12. The first experience of using of 99mTc-Al2O3 for detection of sentinel lymph nodes in breast cancer

    NASA Astrophysics Data System (ADS)

    Doroshenko, A.; Chernov, V.; Medvedeva, A.; Zeltchan, R.; Slonimskaya, E.; Varlamova, N.; Skuridin, V.; Dergilev, A.; Sinilkin, I.

    2016-06-01

    Purpose: to study the feasibility of using the new radiopharmaceutical based on the technetium-99m-labeled gamma-alumina for identification of sentinel lymph nodes (SLNs) in breast cancer patients. Materials and methods. The study included two groups of breast cancer patients who underwent single photon emission computed tomography (SPECT) and intraoperaive gamma probe identification of sentinel lymph nodes (SLNs). To identify SLNs, the day before surgery Group I patients (n=34) were injected with radioactive 99mTc-Al203, and Group II patients (n=30) received 99mTc-labeled phytate colloid. Results. A total of 37 SLNs were detected in Group I patients. The number of identified SLNs per patient ranged from 1 to 2 (the average number of identified SLNs was 1.08). Axillary lymph nodes were the most common site of SLN localization. At 18 hours after 99mTc-Al203 injection, the percentage of its accumulation in the SLN was 7-11% (of the counts in the injection site) by SPECT and 17-31% by gamma probe detection. In Group II patients, SLNs were detected in 27 patients. At 18 hours after injection of the phytate colloid, the percentage of its accumulation in the SLN was 1.5-2% out of the counts in the injection site by SPECT and 4-7% by gamma probe. Conclusion. The new radiopharmaceutical based on the 99mTc - Al203 demonstrates high accumulation in SLNs without redistribution through the entire lymphatic basin. Sensitivity and specificity of 99mTc - Al203 were 100% for both SPECT and intraoperative gamma probe identification.

  13. Comparing patients' and clinicians' assessment of outcomes in a randomised trial of sentinel node biopsy for breast cancer (the RACS SNAC trial).

    PubMed

    Smith, Michaella J; Gill, P Grantley; Wetzig, Neil; Sourjina, Tatiana; Gebski, Val; Ung, Owen; Campbell, Ian; Kollias, James; Coskinas, Xanthi; Macphee, Avis; Young, Leonie; Simes, R John; Stockler, Martin R

    2009-09-01

    The RACS sentinel node biopsy versus axillary clearance (SNAC) trial compared sentinel-node-based management (SNBM) and axillary lymph-node dissection (ALND) for breast cancer. In this sub study, we sought to determine whether patient ratings of arm swelling, symptoms, function and disability or clinicians' measurements were most efficient at detecting differences between randomized groups, and therefore, which of these outcome measures would minimise the required sample sizes in future clinical trials. 324 women randomised to SNBM and 319 randomised to ALND were included. The primary endpoint of the trial was percentage increase in arm volume calculated from clinicians' measurements of arm circumference at 10 cm intervals. Secondary endpoints included reductions in range of motion and sensation (both measured by clinicians); and, patients' ratings of arm swelling, symptoms and quality of life, using the European Organisation for Research and Treatment of Cancer Breast Cancer Module (EORTC QLM-BR23), the body image after breast cancer questionnaire (BIBC) and the SNAC study specific scales (SSSS). The relative efficiency (RE, the squared ratio of the test statistics, with 95% confidence intervals calculated by bootstrapping) was used to compare these measures in detecting differences between the treatment groups. Patients' self-ratings of arm swelling were generally more efficient than clinicians' measurements of arm volume in detecting differences between treatment groups. The SSSS arm symptoms scale was the most efficient (RE = 7.1) The entire SSSS was slightly less so (RE = 4.6). Patients' ratings on single items were 3-5 times more efficient than clinicians' measurements. Primary endpoints based on patient-rated outcome measures could reduce the required sample size in future surgical trials. PMID:18925434

  14. Hybrid Modality Fusion of Planar Scintigrams and CT Topograms to Localize Sentinel Lymph Nodes in Breast Lymphoscintigraphy: Technical Description and Phantom Studies

    PubMed Central

    Dickinson, Renée L.; Erwin, William D.; Stevens, Donna M.; Bidaut, Luc M.; Mar, Martha V.; Macapinlac, Homer A.; Wendt, Richard E.

    2011-01-01

    Lymphoscintigraphy is a nuclear medicine procedure that is used to detect sentinel lymph nodes (SLNs). This project sought to investigate fusion of planar scintigrams with CT topograms as a means of improving the anatomic reference for the SLN localization. Heretofore, the most common lymphoscintigraphy localization method has been backlighting with a 57Co sheet source. Currently, the most precise method of localization through hybrid SPECT/CT increases the patient absorbed dose by a factor of 34 to 585 (depending on the specific CT technique factors) over the conventional 57Co backlighting. The new approach described herein also uses a SPECT/CT scanner, which provides mechanically aligned planar scintigram and CT topogram data sets, but only increases the dose by a factor of two over that from 57Co backlighting. Planar nuclear medicine image fusion with CT topograms has been proven feasible and offers a clinically suitable compromise between improved anatomic details and minimally increased radiation dose. PMID:21490727

  15. Ultrasonography of the axilla in the follow-up of breast cancer patients who have a negative sentinel node biopsy and who avoid axillary clearance.

    PubMed

    Leikola, Junnu; Saarto, Tiina; Joensuu, Heikki; Sarvas, Krista; Vironen, Jaana; Von Smitten, Karl; Virkkunen, Pekka; Vanharanta, Brita; Mäkelä, Pekka; Leidenius, Marjut

    2006-01-01

    The clinical value of ultrasonography of the axilla in detection of breast cancer recurrence is not known among patients who have a negative sentinel node biopsy and avoid axillary clearance. We studied a cohort of 205 such patients using ultrasonography one and three years after breast surgery. A recurrent tumour was found in the axilla in only two (0.5%) of the total of 383 ultrasound examinations performed during the study, and only one (0.3%) of the 369 examinations performed at the scheduled study visits revealed cancer. None of the ultrasound examinations was false positive, and no study participant was subjected to unnecessary surgery due to ultrasound monitoring. We conclude that the rate of breast cancer recurrence in the ipsilateral axilla is low following sparing of the axillary contents, and that monitoring of such patients with repeated ultrasound examinations is unlikely to be cost-effective. PMID:16864171

  16. Nomogram including the total tumoral load in the sentinel nodes assessed by one-step nucleic acid amplification as a new factor for predicting nonsentinel lymph node metastasis in breast cancer patients.

    PubMed

    Rubio, Isabel T; Espinosa-Bravo, Martin; Rodrigo, Maxi; Amparo Viguri Diaz, Maria; Hardisson, David; Sagasta, Amaia; Dueñas, Basilio; Peg, Vicente

    2014-09-01

    Several models have been developed to predict non-sentinel nodes (NSLN) metastasis in patients with a positive sentinel node (SLN) that incorporates a standard pathology examination of the SLN. It has been reported that total tumoral load (TTL) in the SLNs assessed by one-step nucleic acid amplification (OSNA) is a predictive factor for additional NSLN metastasis in the axillary lymph node dissection (ALND). The objective was to develop a nomogram that predicts patient´s risk of additional NSLN metastasis incorporating TTL in the SLNs assessed by OSNA. Six hundred and ninety-seven consecutive patients with positive SLN evaluation by OSNA and a completion ALND were recruited. Pathologic features of the primary tumor and SLN metastases, including TTL were collected. Multivariate logistic regression identified factors predictive of non-SLN metastasis. A nomogram was developed with these variables and validated in an external cohort. On multivariate logistic regression analysis, tumor size, number of affected SLN, Her2 overexpression, lymphovascular invasion, and TTL were each associated with the likelihood of additional NSLN metastasis (p < 0.05). The overall predictive accuracy of the nomogram, as measured by the AUC was 0.7552 (95 %CI 0.7159-0.7945). When applied to the external cohort the nomogram was accurate with an AUC = 0.678 (95 %CI 0.621-0.736). This novel nomogram that incorporates TTL assessed by OSNA performs well and may help clinicians to make decisions about ALND for individual patients. Moreover, the standardization of pathologic assessment by OSNA may help to achieve interinstitutional reproducibility among nomograms. PMID:25164972

  17. Fast 18F Labeling of a Near-Infrared Fluorophore Enables Positron Emission Tomography and Optical Imaging of Sentinel Lymph Nodes

    PubMed Central

    2010-01-01

    We combine a novel boronate trap for F− with a near-infrared fluorophore into a single molecule. Attachment to targeting ligands enables localization by positron emission tomography (PET) and near-infrared fluorescence (NIRF). Our first application of this generic tag is to label Lymphoseek (tilmanocept), an agent designed for receptor-specific sentinel lymph node (SLN) mapping. The new conjugate incorporates 18F− in a single, aqueous step, targets mouse SLN rapidly (1 h) with reduced distal lymph node accumulation, permits PET or scintigraphic imaging of SLN, and enables NIRF-guided excision and histological verification even after 18F decay. This embodiment is superior to current SLN mapping agents such as nontargeted [99mTc]sulfur colloids and Isosulfan Blue, as well as the phase III targeted ligand [99mTc]SPECT Lymphoseek counterpart, species that are visible by SPECT or visible absorbance separately. Facile incorporation of 18F into a NIRF probe should promote many synergistic PET and NIRF combinations. PMID:20873712

  18. Near-infrared gold nanocages as a new class of tracers for photoacoustic sentinel lymph node mapping on a rat model.

    PubMed

    Song, Kwang Hyun; Kim, Chulhong; Cobley, Claire M; Xia, Younan; Wang, Lihong V

    2009-01-01

    This work demonstrated the use of Au nanocages as a new class of lymph node tracers for noninvasive photoacoustic (PA) imaging of a sentinel lymph node (SLN). Current SLN mapping methods based on blue dye and/or nanometer-sized radioactive colloid injection are intraoperative due to the need for visual detection of the blue dye and low spatial resolution of Geiger counters in detecting radioactive colloids. Compared to the current methods, PA mapping based on Au nanocages shows a number of attractive features: noninvasiveness, strong optical absorption in the near-infrared region (for deep penetration), and the accumulation of Au nanocages with a higher concentration than the initial solution for the injection. In an animal model, these features allowed us to identify SLNs containing Au nanocages as deep as 33 mm below the skin surface with good contrast. Most importantly, compared to methylene blue Au nanocages can be easily bioconjugated with antibodies for targeting specific receptors, potentially eliminating the need for invasive axillary staging procedures in addition to providing noninvasive SLN mapping. PMID:19072058

  19. Comparative Study of the One-step Nucleic Acid Amplification Assay and Conventional Histological Examination for the Detection of Breast Cancer Sentinel Lymph Node Metastases.

    PubMed

    Terada, Mizuho; Niikura, Naoki; Tsuda, Banri; Masuda, Shinobu; Kumaki, Nobue; Tang, Xiaoyan; Okamura, Takuho; Saito, Yuki; Suzuki, Yasuhiro; Tokuda, Yutaka

    2014-09-01

    Intraoperative sentinel lymph node (SLN) biopsy is widely used in patients with early-stage breast cancer and is conventionally performed using hematoxylin and eosin-based histological examination. The one-step nucleic acid amplification (OSNA) assay is a molecular diagnostic tool and a semi-automated lymph node examination method. The purpose of this study was to compare the performance of the OSNA assay and conventional histological examination with frozen sections (FSs) by using 111 SLN biopsy samples from 89 patients at the Tokai University Hospital. The SLN samples were split into 3 slices: the middle slice was used for FS histological examination and the other slices were used for the OSNA assay. The McNemar test was used to compare the differences in the sensitivity and specificity between the OSNA assay and FS histological examination. The sensitivity of the OSNA assay (97.1%) was less than that of FS histological examination (100%), but this difference was not statistically significant (P = 0.125). The specificity of both the methods was identical (96.9%). Despite previously published results suggesting that the OSNA assay is as reliable as histological examinations, our results indicate that this assay often fails to detect micrometastases or isolated tumor cells in SLNs. PMID:25248427

  20. Nodes

    NASA Technical Reports Server (NTRS)

    Hanson, John; Martinez, Andres; Petro, Andrew

    2015-01-01

    Nodes is a technology demonstration mission that is scheduled for launch to the International SpaceStation no earlier than Nov.19, 2015. The two Nodes satellites will be deployed from the Station in early 2016 todemonstrate new network capabilities critical to the operation of swarms of spacecraft. They will demonstrate the ability ofmulti spacecraft swarms to receive and distribute ground commands, exchange information periodically, andautonomously configure the network by determining which spacecraft should communicate with the ground each day ofthe mission.

  1. The first experience of using 99mTc-Al2O3-based radiopharmaceutical for the detection of sentinel lymph nodes in cervical cancer patients

    NASA Astrophysics Data System (ADS)

    Sinilkin, I. G.; Chernov, V. I.; Lyapunov, A. Yu.; Medvedeva, A. A.; Zelchan, R. V.; Chernyshova, A. L.; Kolomiets, L. A.

    2016-08-01

    The purpose of the study was to evaluate the feasibility of using 99mTc-Al2O3-based radiopharmaceutical, a novel molecular imaging agent for sentinel lymph node detection in patients with invasive cervical cancer. The study included 23 cervical cancer patients (T1aNxMx-T2bNxMx) treated at the Tomsk Cancer Research Institute. In the 18 hours before surgery, 80 MBq of the 99mTc-Al2O3 in peritumoral injected, followed by single-photon emission computed tomography (SPECT) of the pelvis and intraoperative SLN identification. Twenty-seven SLNs were detected by SPECT, and 34 SLNs were identified by intraoperative gamma probe. The total number of identified SLNs per patient ranged from 1 to 3 (the mean number of SLNs was 1.4 per patient). The most common site for SLN detection was the external iliac region (57.2%), followed by the internal iliac (14%), obturator (14%), presacral and retrosacral regions (14%), and the parametrial region (1%). Sensitivity in detecting SLNs was 100% for intraoperative SLN identification and 79% for SPECT image.

  2. The use of 99mTc-Al2O3 for detection of sentinel lymph nodes in cervical cancer patients

    NASA Astrophysics Data System (ADS)

    Sinilkin, I. G.; Chernov, V. I.; Lyapunov, A. Yu; Medvedeva, A. A.; Zelchan, R. V.; Chernyshova, A. L.; Kolomiets, L. A.

    2016-06-01

    The purpose of the study was to evaluate the feasibility of using 99mTc-Al2O3- based radiopharmaceutical, a novel molecular imaging agent for sentinel lymph node detection in patients with invasive cervical cancer. The study included 23 cervical cancer patients (TlaNxMx- T2bNxMx) treated at the Tomsk Cancer Research Institute. At 18 hours before surgery, 80 MBq of the 99mTc-Al2O3 were injected peritumorally, followed by single-photon emission computed tomography (SPECT) of the pelvis and intraoperative SLN identification. Twenty-seven SLNs were detected by SPECT, and 34 SLNs were identified by intraoperative gamma probe. The total number of identified SLNs per patient ranged from 1 to 3(the mean number of SLNs was 1.4 per patient). The most common site for SLN detection was the external iliac region (57.2%), followed by the internal iliac, obturator, presacral and retrosacral regions (they amounted to 14%, respectively),and the parametrial region (1%). Sensitivity in detecting SLNs was 100% for intraoperative SLN identification and 79% for SPECT image.

  3. Near-Infrared Sentinel Lymph Node Mapping With Indocyanine Green Using the VITOM II ICG Exoscope for Open Surgery for Gynecologic Malignancies.

    PubMed

    Buda, Alessandro; Dell'Anna, Tiziana; Vecchione, Francesca; Verri, Debora; Di Martino, Giampaolo; Milani, Rodolfo

    2016-01-01

    Sentinel lymph node (SLN) mapping is emerging as an effective method for surgical staging of different gynecologic malignancies. Near-infrared (NIR) technology using a fluorescent dye such as indocyanine green (ICG) represents an interesting and feasible method for SLN mapping even in traditional open surgeries by applying video telescope operating microscope (VITOM) system technology. We report our preliminary experience in 12 women who underwent surgical nodal staging for early-stage vulvar and uterine or cervical cancer. Surgical and pathological outcomes are described, and the VITOM II ICG system's intraoperative image quality, handling and docking, and teaching value are assessed. The general impression of the surgical staff was that the VITOM II system is easy to use, and that the image quality of the anatomic structures is impressive. Traditional open SLN mapping with ICG appears to be easy to perform and reproducible, providing a new tool in the management of patients with gynecologic malignancies. Moreover, we believe that this technology has great potential as an operative teaching and learning modality for trainers for open surgical cases. Additional studies involving the VITOM system with a large sample size of patients are needed to confirm these promising results. PMID:26921484

  4. Metastasis Detection in Sentinel Lymph Nodes: Comparison of a Limited Widely Spaced (NSABP protocol B-32) and a Comprehensive Narrowly Spaced Paraffin Block Sectioning Strategy

    PubMed Central

    Weaver, Donald L.; Le, U. Phuong; Dupuis, Stacey L.; Weaver, Katherine A. E.; Harlow, Seth P.; Ashikaga, Takamaru; Krag, David N.

    2009-01-01

    The NSABP B-32 trial is examining whether patients with initially negative sentinel lymph nodes (SLNs) who have occult metastases detected on deeper levels and cytokeratin immunohistochemistry (CK-IHC) stains are at risk for regional or distant metastases. The experimental B-32 protocol was designed to detect metastases larger than 1.0 mm by examining sections approximately 0.5 and 1.0 mm deeper into the paraffin blocks (2 levels; wide spacing). This pilot quality assurance study compares detection rates to a comprehensive protocol designed to detect metastases larger than 0.2 mm (multilevel; narrow spacing). All SLNs were sectioned grossly at close to 2.0 mm and all sections embedded in paraffin blocks. For clinical treatment, a single H&E section was examined from each block. For 54 cases with 1–5 SLNs and all SLNs negative, additional CK-IHC sections were evaluated every 0.18 mm through the block until no tissue remained. 20 of 176 (11.4%) blocks harbored occult metastases; the B-32 protocol detected metastases in 11 blocks (6.3%) and 9 additional blocks (5.1%) with metastases were detected on sections that would not have been evaluated (p=0.002; correlated proportions). Median number of levels examined per block on the comprehensive protocol was 11 (range 3–26); the B-32 protocol was fixed at 2 levels (median 2; range 1–2). Median thickness of node sections in the block was 2.1 mm (range 0.7–4.8 mm) and the modal thickness was 2.3 mm. Although more comprehensive sectioning of SLNs detects additional micrometastases, the data suggest diminishing returns and reduced cost effectiveness for the comprehensive strategy. PMID:19730364

  5. Minimally Invasive Electro-Magnetic Navigational Bronchoscopy-Integrated Near-Infrared-Guided Sentinel Lymph Node Mapping in the Porcine Lung

    PubMed Central

    Wada, Hironobu; Hirohashi, Kentaro; Anayama, Takashi; Nakajima, Takahiro; Kato, Tatsuya; Chan, Harley H. L.; Qiu, Jimmy; Daly, Michael; Weersink, Robert; Jaffray, David A.; Irish, Jonathan C.; Waddell, Thomas K.; Keshavjee, Shaf; Yoshino, Ichiro; Yasufuku, Kazuhiro

    2015-01-01

    Background The use of near-infrared (NIR) fluorescence imaging with indocyanine green (ICG) for sentinel lymph node (SN) mapping has been investigated in lung cancer; however, this has not been fully adapted for minimally invasive surgery (MIS). The aim of our study was to develop a minimally invasive SN mapping integrating pre-operative electro-magnetic navigational bronchoscopy (ENB)-guided transbronchial ICG injection and intraoperative NIR thoracoscopic imaging. Methods A NIR thoracoscope was used to visualize ICG fluorescence. ICG solutions in a 96-well plate and ex vivo porcine lungs were examined to optimize ICG concentrations and injection volumes. Transbronchial ICG injection (n=4) was assessed in comparison to a traditional transpleural approach (n=3), where after thoracotomy an ICG solution (100μL at 100μg/mL) was injected into the porcine right upper lobe for SN identification. For further translation into clinical use, transbronchial ICG injection prior to thoracotomy followed by NIR thoracoscopic imaging was validated (n=3). ENB was used for accurate targeting in two pigs with a pseudo-tumor. Results The ICG fluorescence at 10 μg/mL was the brightest among various concentrations, unchanged by the distance between the thoracoscope and ICG solutions. Injected ICG of no more than 500μL showed a localized fluorescence area. All 7 pigs showed a bright paratracheal lymph node within 15 minutes post-injection, with persistent fluorescence for 60 minutes. The antecedent transbronchial ICG injection succeeded in SN identification in all 3 cases at the first thoracoscopic inspection within 20 minutes post-injection. The ENB system allowed accurate ICG injection surrounding the pseudo-tumors. Conclusions ENB-guided ICG injection followed by NIR thoracoscopy was technically feasible for SN mapping in the porcine lung. This promising platform may be translated into human clinical trials and is suited for MIS. PMID:25993006

  6. Analysis of EpCAM positive cells isolated from sentinel lymph nodes of breast cancer patients identifies subpopulations of cells with distinct transcription profiles

    PubMed Central

    2011-01-01

    Introduction The presence of tumor cells in the axillary lymph nodes is the most important prognostic factor in early stage breast cancer. However, the optimal method for sentinel lymph node (SLN) examination is still sought and currently many different protocols are employed. To examine two approaches for tumor cell detection we performed, in sequence, immunomagnetic enrichment and RT-PCR analysis on SLN samples from early stage breast cancer patients. This allowed us to compare findings based on the expression of cell surface proteins with those based on detection of intracellular transcripts. Methods Enrichment of EpCAM and Mucin 1 expressing cells from fresh SLN samples was achieved using magnetic beads coated with the appropriate antibodies. All resulting cell fractions were analyzed by RT-PCR using four chosen breast epithelial markers (hMAM, AGR2, SBEM, TFF1). Gene expression was further analyzed using RT-PCR arrays and markers for epithelial to mesenchymal transition (EMT). Results Both EpCAM and Mucin 1 enriched for the epithelial-marker expressing cells. However, EpCAM-IMS identified epithelial cells in 71 SLNs, whereas only 35 samples were positive with RT-PCR targeting breast epithelial transcripts. Further analysis of EpCAM positive but RT-PCR negative cell fractions showed that they had increased expression of MMPs, repressors of E-cadherin, SPARC and vimentin, all transcripts associated with the process of epithelial to mesenchymal transition. Conclusions The EpCAM IMS-assay detected tumor cells with epithelial and mesenchymal-like characteristics, thus proving to be a more robust marker than pure epithelial derived biomarkers. This finding has clinical implications, as most methods for SLN analysis today rely on the detection of epithelial transcripts or proteins. PMID:21816090

  7. Multicenter Selective Lymphadenectomy Trial-I confirms the central role of sentinel node biopsy in contemporary melanoma management: response to 'No survival benefit for patients with melanoma undergoing sentinel lymph node biopsy: critical appraisal of the Multicenter Selective Lymphadenectomy Trial-I final report'.

    PubMed

    Faries, M B; Cochran, A J; Elashoff, R M; Thompson, J F

    2015-03-01

    Sentinel lymph node (SLN) biopsy has become a standard procedure for many patients with melanoma and is recommended in numerous national and professional melanoma guidelines. The Multicenter Selective Lymphadenectomy Trial (MSLT-1) confirms earlier large database studies and prospective clinical trials in demonstrating the independent and unequalled prognostic value of the SLN. It also demonstrates the ability of biopsy-directed management to provide effective regional disease control with the least possible morbidity. These benefits are not in question and provide ample justification for the procedure, even without evidence of a survival benefit. However, MSLT-1 also provides strong evidence of a substantial reduction in the risk of melanoma death for patients with intermediate thickness melanomas who harbour occult nodal metastases at the time of presentation. Denying appropriately selected patients with melanoma the opportunity to undergo SLN biopsy is no longer reasonable or acceptable. PMID:25776247

  8. Validation of Contrast Enhanced Ultrasound Technique to Wire Localization of Sentinel Lymph Node in Patients with Early Breast Cancer.

    PubMed

    Esfehani, Maryam H; Yazdankhah-Kenari, Adel; Omranipour, Ramesh; Mahmoudzadeh, Habib Allah; Shahriaran, Shahriar; Zafarghandi, Mohammad Reza; Amoli, Hadi Ahmadi

    2015-12-01

    Axillary staging is one of the primary steps in management of Breast cancer patients. Current standard methods including blue dye and radicolloid have limitations and disadvantages. In this study, the feasibility of visualization of lymph node pathways and localization of SLN with the help of CEUS was assessed. 50 patients with early breast cancer diagnosis underwent CEUS and wire localization, methylenblue dye, and isotope scan methods for SLN detection. The pathology findings of the wired SLN were compared with those obtained from, methylenblue dye, and isotope scan methods. Lymph node wiring was successfully performed in 48 patients.Radio-isotope technique detected SLN in all 50 patients while blue-dye succeeded in 48. Sensitivity of CEUS to detect SLN compared with radio-isotope and blue dye methods was 96 % and 100 %, respectively. Considering costs and facilities required to perform radio-isotope technique and complications of blue dye we may accept CEUS with the help of micro-bubble contrasts as a viable alternative. However, more studies with larger sample volumes, using various drugs, and including non-selective population are warranted to better clarify feasibility and accuracy of this technique in comparison with current methods. PMID:27065663

  9. The next evolution in radioguided surgery: breast cancer related sentinel node localization using a freehandSPECT-mobile gamma camera combination.

    PubMed

    Engelen, Thijs; Winkel, Beatrice Mf; Rietbergen, Daphne Dd; KleinJan, Gijs H; Vidal-Sicart, Sergi; Olmos, Renato A Valdés; van den Berg, Nynke S; van Leeuwen, Fijs Wb

    2015-01-01

    Accurate pre- and intraoperative identification of the sentinel node (SN) forms the basis of the SN biopsy procedure. Gamma tracing technologies such as a gamma probe (GP), a 2D mobile gamma camera (MGC) or 3D freehandSPECT (FHS) can be used to provide the surgeon with radioguidance to the SN(s). We reasoned that integrated use of these technologies results in the generation of a "hybrid" modality that combines the best that the individual radioguidance technologies have to offer. The sensitivity and resolvability of both 2D-MGC and 3D-FHS-MGC were studied in a phantom setup (at various source-detector depths and using varying injection site-to-SN distances), and in ten breast cancer patients scheduled for SN biopsy. Acquired 3D-FHS-MGC images were overlaid with the position of the phantom/patient. This augmented-reality overview image was then used for navigation to the hotspot/SN in virtual-reality using the GP. Obtained results were compared to conventional gamma camera lymphoscintigrams. Resolution of 3D-FHS-MGC allowed identification of the SNs at a minimum injection site (100 MBq)-to-node (1 MBq; 1%) distance of 20 mm, up to a source-detector depth of 36 mm in 2D-MGC and up to 24 mm in 3D-FHS-MGC. A clinically relevant dose of approximately 1 MBq was clearly detectable up to a depth of 60 mm in 2D-MGC and 48 mm in 3D-FHS-MGC. In all ten patients at least one SN was visualized on the lymphoscintigrams with a total of 12 SNs visualized. 3D-FHS-MGC identified 11 of 12 SNs and allowed navigation to all these visualized SNs; in one patient with two axillary SNs located closely to each other (11 mm), 3D-FHS-MGC was not able to distinguish the two SNs. In conclusion, high sensitivity detection of SNs at an injection site-to-node distance of 20 mm-and-up was possible using 3D-FHS-MGC. In patients, 3D-FHS-MGC showed highly reproducible images as compared to the conventional lymphoscintigrams. PMID:26069857

  10. The FLARE™ Intraoperative Near-Infrared Fluorescence Imaging System: A First-in-Human Clinical Trial in Breast Cancer Sentinel Lymph Node Mapping

    PubMed Central

    Troyan, Susan L.; Kianzad, Vida; Gibbs-Strauss, Summer L.; Gioux, Sylvain; Matsui, Aya; Oketokoun, Rafiou; Ngo, Long; Khamene, Ali; Azar, Fred; Frangioni, John V.

    2009-01-01

    Background Invisible NIR fluorescent light can provide high sensitivity, high-resolution, and real-time image-guidance during oncologic surgery, but imaging systems that are presently available do not display this invisible light in the context of surgical anatomy. The FLARE™ imaging system overcomes this major obstacle. Methods Color video was acquired simultaneously, and in real-time, along with two independent channels of NIR fluorescence. Grayscale NIR fluorescence images were converted to visible “pseudo-colors” and overlaid onto the color video image. Yorkshire pigs weighing 35 kg (n = 5) were used for final pre-clinical validation of the imaging system. A 6-patient pilot study was conducted in women undergoing sentinel lymph node (SLN) mapping for breast cancer. Subjects received 99mTc-sulfur colloid lymphoscintigraphy. In addition, 12.5 µg of indocyanine green (ICG) diluted in human serum albumin (HSA) was used as an NIR fluorescent lymphatic tracer. Results The FLARE™ system permitted facile positioning in the operating room. NIR light did not change the look of the surgical field. Simultaneous pan-lymphatic and SLN mapping was demonstrated in swine using clinically available NIR fluorophores and the dual NIR capabilities of the system. In the pilot clinical trial, a total of 9 SLNs were identified by 99mTc-lymphoscintigraphy and 9 SLNs were identified by NIR fluorescence, although results differed in two patients. No adverse events were encountered. Conclusions We describe the successful clinical translation of a new NIR fluorescence imaging system for image-guided oncologic surgery. PMID:19582506

  11. Melanin nanoparticles derived from a homology of medicine and food for sentinel lymph node mapping and photothermal in vivo cancer therapy.

    PubMed

    Chu, Maoquan; Hai, Wangxi; Zhang, Zheyu; Wo, Fangjie; Wu, Qiang; Zhang, Zefei; Shao, Yuxiang; Zhang, Ding; Jin, Lu; Shi, Donglu

    2016-06-01

    The use of non-toxic or low toxicity materials exhibiting dual functionality for use in sentinel lymph node (SLN) mapping and cancer therapy has attracted considerable attention during the past two decades. Herein, we report that the natural black sesame melanin (BSM) extracted from black sesame seeds (Sesamum indicum L.) shows exciting potential for SLN mapping and cancer photothermal therapy. Aqueous solutions of BSM under neutral and alkaline conditions can assemble into sheet-like nanoparticles ranging from 20 to 200 nm in size. The BSM nanoparticles were encapsulated by liposomes to improve their water solubility and the encapsulated and bare BSM nanoparticles were both non-toxic to cells. Furthermore, the liposome-encapsulated BSM nanoparticles (liposome-BSM) did not exhibit any long-term toxicity in mice. The liposome-BSM nanoparticles were subsequently used to passively target healthy and tumor-bearing mice SLNs, which were identified by the black color of the nanoparticles. BSM also strongly absorbed light in the near-infrared (NIR) range, which was rapidly converted to heat energy. Human esophagus carcinoma cells (Eca-109) were killed efficiently by liposome-BSM nanocomposites upon NIR laser irradiation. Furthermore, mouse tumor tissues grown from Eca-109 cells were seriously damaged by the photothermal effects of the liposome-BSM nanocomposites, with significant tumor growth suppression compared with controls. Given that BSM is a safe and nutritious biomaterial that can be easily obtained from black sesame seed, the results presented herein represent an important development in the use of natural biomaterials for clinical SLN mapping and cancer therapy. PMID:27031812

  12. Comprehensive cost analysis of sentinel node biopsy in solid head and neck tumors using a time-driven activity-based costing approach.

    PubMed

    Crott, Ralph; Lawson, Georges; Nollevaux, Marie-Cécile; Castiaux, Annick; Krug, Bruno

    2016-09-01

    Head and neck cancer (HNC) is predominantly a locoregional disease. Sentinel lymph node (SLN) biopsy offers a minimally invasive means of accurately staging the neck. Value in healthcare is determined by both outcomes and the costs associated with achieving them. Time-driven activity-based costing (TDABC) may offer more precise estimates of the true cost. Process maps were developed for nuclear medicine, operating room and pathology care phases. TDABC estimates the costs by combining information about the process with the unit cost of each resource used. Resource utilization is based on observation of care and staff interviews. Unit costs are calculated as a capacity cost rate, measured as a Euros/min (2014), for each resource consumed. Multiplying together the unit costs and resource quantities and summing across all resources used will produce the average cost for each phase of care. Three time equations with six different scenarios were modeled based on the type of camera, the number of SLN and the type of staining used. Total times for different SLN scenarios vary between 284 and 307 min, respectively, with a total cost between 2794 and 3541€. The unit costs vary between 788€/h for the intraoperative evaluation with a gamma-probe and 889€/h for a preoperative imaging with a SPECT/CT. The unit costs for the lymphadenectomy and the pathological examination are, respectively, 560 and 713€/h. A 10 % increase of time per individual activity generates only 1 % change in the total cost. TDABC evaluates the cost of SLN in HNC. The total costs across all phases which varied between 2761 and 3744€ per standard case. PMID:27170361

  13. Feasibility of preoperative 125I seed-guided tumoural tracer injection using freehand SPECT for sentinel lymph node mapping in non-palpable breast cancer

    PubMed Central

    2014-01-01

    Background This study was designed to explore the feasibility of replacing the conventional peri-/intratumoural ultrasound (US)-guided technetium-99m albumin nanocolloid (99mTc-nanocolloid) administration by an injection of the same tracer guided by a freehand single-photon emission computed tomography (SPECT) device in patients with non-palpable breast cancer with an iodine-125 (125I) seed as tumour marker, who are scheduled for a sentinel lymph node biopsy (SLNB). This approach aimed to decrease the workload of the radiology department, avoiding a second US-guided procedure. Methods In ten patients, the implanted 125I seed was primarily localised using freehand SPECT and subsequently verified by conventional US in order to inject the 99mTc-nanocolloid. The following 34 patients were injected using only freehand SPECT localisation. In these patients, additional SPECT/CT was acquired to measure the distance between the 99mTc-nanocolloid injection depot and the 125I seed. In retrospect, a group of 21 patients with US-guided 99mTc-nanocolloid administrations was included as a control group. Results The depth difference measured by US and freehand SPECT in ten patients was 1.6 ± 1.6 mm. In the following 36 125I seeds (34 patients), the average difference between the 125I seed and the centre of the 99mTc-nanocolloid injection depot was 10.9 ± 6.8 mm. In the retrospective study, the average distance between the 125I seed and the centre of the 99mTc-nanocolloid injection depot as measured in SPECT/CT was 9.7 ± 6.5 mm and was not significantly different compared to the freehand SPECT-guided group (two-sample Student's t test, p = 0.52). Conclusion We conclude that using freehand SPECT for 99mTc-nanocolloid administration in patients with non-palpable breast cancer with previously implanted 125I seed is feasible. This technique may improve daily clinical logistics, reducing the workload of the radiology department. PMID:24949282

  14. Sentinel Network

    Cancer.gov

    The Sentinel Network is an integrated, electronic, national medical product safety initiative that compiles information about the safe and effective use of medical products accessible to patients and healthcare practitioners.

  15. Data preparation solution for e-beam multiple pass exposure: reaching sub-22nm nodes with a tool dedicated to 45 nm

    NASA Astrophysics Data System (ADS)

    Martin, Luc; Manakli, Serdar; Bayle, Sébastien; Choi, Kang-Hoon; Gutsch, Manuela; Pradelles, Jonathan; Bustos, Jessy

    2011-04-01

    Electron Beam Direct Write (EBDW) lithography is used in the IC manufacturing industry to sustain optical lithography for prototyping applications and low volume manufacturing. It is also used in R&D to develop advanced technologies, ahead of mass production. As microelectronics is now moving towards the 32nm node and beyond, the specifications in terms of dimension control and roughness becomes tighter. In addition, the shrink of the size and pitch of features significantly reduces the process window of lithographic tools. In EBDW, the standard proximity effects corrections only based on dose modulation show difficulties to provide the required Energy Latitude for patterning structures designed below 45nm. A new approach is thus needed to improve the process window of EBDW lithography and push its resolution capabilities. In previous papers, a new writing strategy based on multiple pass exposure has been introduced and optimized to pattern critical dense lines. This new technique consists in adding small electron Resolution Improvement Features (eRIFs) on top of the nominal structures. Then this new design is exposed in two successive passes with optimized doses. Previous studies were led to evaluate this new writing technique and establish rules to optimize the design of the eRIF. Significant improvements have already been demonstrated on SRAM and Logic structures down to the 16nm node. These results were obtained with a tool dedicated to the 45nm node. The next step of this work is thus to automatically implement the eRIF to correct large-scale layouts. In this paper, a new data preparation flow is set up for EBDW lithography. It uses the eRIF solution as a full advanced correction method for critical structures. The specific correction rules established in our previous studies are implemented to improve the CD control and the patterning of corners and line ends. Moreover, the dose and shape of the eRIFs are automatically tuned to best fit the nominal design

  16. Axillary Lymph Nodes and Breast Cancer

    MedlinePlus

    ... more likely to affect arm function and cause lymphedema. For this reason, sentinel node biopsy is the ... OR supraclavicular (above the clavicle) nodes have cancer Lymphedema Lymphedema [lim-fa-DEE-ma] is a build- ...

  17. The value of breast MRI in high-risk patients with newly diagnosed breast cancer to exclude invasive disease in the contralateral prophylactic mastectomy: Is there a role to choose wisely patients for sentinel node biopsy?

    PubMed

    Freitas, Vivianne; Crystal, Pavel; Kulkarni, Supriya R; Ghai, Sandeep; Bukhanov, Karina; Escallon, Jaime; Scaranelo, Anabel M

    2016-06-01

    The aim of this study was to evaluate the presence of clinically and mammographically occult disease using breast MRI in a cohort of cancer patients undergoing contralateral prophylactic mastectomy (CPM) and the utmost indication of axillary assessment (sentinel node biopsy (SLNB)) for this side. A retrospective review of patients with unilateral invasive breast cancer or ductal carcinoma in situ (DCIS) from institutional MRI registry data (2004-2010) was conducted. Characteristics of patients undergoing CPM with breast MRI obtained less than 6 month before surgery were evaluated. A total of 2322 consecutive patients diagnosed with DCIS or stage I to III infiltrating breast cancer underwent preoperative breast MRI. Of these, 1376 patients (59.2%) had contralateral clinical breast exam and mammography without abnormalities; and 116 patients (4.9%) underwent CPM (28 excluded patients had breast MRI more than 6 months before CPM). The mean age of the 88 patients was 49 years (range 28-76 years). Two (2.3%) DCIS identified on surgical pathology specimen were not depicted by MRI and the 5 mm T1N0 invasive cancer (1.1%) was identified on MRI. Preoperative MRI showed 95% accuracy to demonstrate absence of occult disease with negative predicted value (NPV) of 98% (95% CI: 91.64-99.64%). Occult disease was present in 3.4% of CPM. MRI accurately identified the case of invasive cancer in this cohort. The high negative predictive value suggests that MRI can be used to select patients without consideration of SLNB for the contralateral side. PMID:26992816

  18. Sensor sentinel computing device

    DOEpatents

    Damico, Joseph P.

    2016-08-02

    Technologies pertaining to authenticating data output by sensors in an industrial environment are described herein. A sensor sentinel computing device receives time-series data from a sensor by way of a wireline connection. The sensor sentinel computing device generates a validation signal that is a function of the time-series signal. The sensor sentinel computing device then transmits the validation signal to a programmable logic controller in the industrial environment.

  19. Sentinel-1 Instrument Overview

    NASA Astrophysics Data System (ADS)

    Snoeij, Paul; Torres, Ramon; Geudtner, Dirk; Brown, Michael; Deghaye, Patrick; Navas-Traver, Ignacio; Ostergaard, Allan; Rommen, Bjorn; Floury, Nicolas; Davidson, Malcolm

    2013-03-01

    The forthcoming European Space Agency (ESA) Sentinel-1 (S-1) C-band SAR constellation will provide continuous all-weather day/night global coverage, with six days exact repetition time (near daily coverage over Europe and Canada) and with radar data delivery within 3 to 24 hours. These features open new possibilities for operational maritime services. The Sentinel-1 space segment has been designed and is being built by an industrial consortium with Thales Alenia Space Italia as prime contractor and EADS Astrium GmbH as C-SAR instrument responsible. It is expected that Sentinel-1A be launched in 2013. This paper will provide an overview of the Sentinel-1 system, the status and characteristics of the technical implementation. The key elements of the system supporting the maritime user community will be highlighted.

  20. Multiple node remote messaging

    DOEpatents

    Blumrich, Matthias A.; Chen, Dong; Gara, Alan G.; Giampapa, Mark E.; Heidelberger, Philip; Ohmacht, Martin; Salapura, Valentina; Steinmacher-Burow, Burkhard; Vranas, Pavlos

    2010-08-31

    A method for passing remote messages in a parallel computer system formed as a network of interconnected compute nodes includes that a first compute node (A) sends a single remote message to a remote second compute node (B) in order to control the remote second compute node (B) to send at least one remote message. The method includes various steps including controlling a DMA engine at first compute node (A) to prepare the single remote message to include a first message descriptor and at least one remote message descriptor for controlling the remote second compute node (B) to send at least one remote message, including putting the first message descriptor into an injection FIFO at the first compute node (A) and sending the single remote message and the at least one remote message descriptor to the second compute node (B).

  1. Sentinel Asia step 2 utilization for disaster management in Malaysia

    NASA Astrophysics Data System (ADS)

    Moslin, S. I.; Wahap, N. A.; Han, O. W.

    2014-02-01

    With the installation of Wideband InterNetworking engineering test and Demonstration Satellite (WINDS) communication system in the National Space Centre, Banting; officially Malaysia is one of the twelve Sentinel Asia Step2 System Regional Servers in the Asia Pacific region. The system will be dedicated to receive and deliver images of disaster struck areas observed by Asia Pacific earth observation satellites by request of the Sentinel Asia members via WINDS satellite or 'Kizuna'. Sentinel Asia is an initiative of collaboration between space agencies and disaster management agencies, applying remote sensing and web-GIS technologies to assist disaster management in Asia Pacific. When a disaster occurred, participating members will make an Emergency Observation Request (EOR) to the Asian Disaster Reduction Centre (ADRC). Subsequently, the Data Provider Node (DPN) will execute the emergency observation using the participating earth observation satellites. The requested images then will be processed and analysed and later it will be uploaded on the Sentinel Asia website to be utilised for disaster management and mitigation by the requestor and any other international agencies related to the disaster. Although the occurrences of large scale natural disasters are statistically seldom in Malaysia, but we can never be sure with the unpredictable earth climate nowadays. This paper will demonstrate the advantage of using Sentinel Asia Step2 for local disaster management. Case study will be from the recent local disaster occurrences. In addition, this paper also will recommend a local disaster management support system by using the Sentinel Asia Step2 facilities in ANGKASA.

  2. The Nordic SentiMag trial: a comparison of super paramagnetic iron oxide (SPIO) nanoparticles versus Tc(99) and patent blue in the detection of sentinel node (SN) in patients with breast cancer and a meta-analysis of earlier studies.

    PubMed

    Karakatsanis, Andreas; Christiansen, Peer Michael; Fischer, Lone; Hedin, Christina; Pistioli, Lida; Sund, Malin; Rasmussen, Nils Ryegaard; Jørnsgård, Hjørdis; Tegnelius, Daniel; Eriksson, Staffan; Daskalakis, Kosmas; Wärnberg, Fredrik; Markopoulos, Christos J; Bergkvist, Leif

    2016-06-01

    The aim of the study is to compare the efficacy of SPIO as a tracer in sentinel node biopsy (SNB) in breast cancer with Tc and patent blue in a multicentre prospective study and perform a meta-analysis of all published studies. It also aims to follow skin discoloration after SPIO injection and describe when and how it resolves. Totally 206 patients with early breast cancer were recruited. Tc and patent blue were administered in standard fashion. Patients were injected with SPIO (Sienna+) preoperatively. SNB was performed and detection rates were recorded for both methods. Skin discoloration was followed and documented postoperatively. Data extraction and subsequent meta-analysis of all previous studies were also performed. SN detection rates were similar between standard technique succeeded and SPIO both per patient (97.1 vs. 97.6 %, p = 0.76) as well as per node (91.3 vs. 93.3 %, p = 0.34), something which was not affected by the presence of malignancy. Concordance rates were also consistently high (98.0 % per patient and 95.9 % per node). Discoloring was present in 35.5 % of patients postoperatively, almost exclusively in breast conservation. It fades slowly and is still detectable in 8.6 % of patients after 15 months. Meta-analysis depicted similar detection rates (p = 0.71) and concordance rates (p = 0.82) per patient. However, it seems that SPIO is characterized by higher nodal retrieval (p < 0.001). SPIO is an effective method for the detection of SN in patients with breast cancer. It is comparable to the standard technique and seems to simplify logistics. Potential skin discoloration is something of consideration in patients planned for breast conservation. PMID:27117158

  3. Sentinel-2 Mission status

    NASA Astrophysics Data System (ADS)

    Hoersch, Bianca; Colin, Olivier; Gascon, Ferran; Arino, Olivier; Spoto, Francois; Marchese, Franco; Krassenburg, Mike; Koetz, Benjamin

    2016-04-01

    Copernicus is a joint initiative of the European Commission (EC) and the European Space Agency (ESA), designed to establish a European capacity for the provision and use of operational monitoring information for environment and security applications. Within the Copernicus programme, ESA is responsible for the development of the Space Component, a fully operational space-based capability to supply earth-observation data to sustain environmental information Services in Europe. The Sentinel missions are Copernicus dedicated Earth Observation missions composing the essential elements of the Space Component. In the global Copernicus framework, they are complemented by other satellites made available by third-parties or by ESA and coordinated in the synergistic system through the Copernicus Data-Access system versus the Copernicus Services. The Copernicus Sentinel-2 mission provides continuity to services relying on multi-spectral high-resolution optical observations over global terrestrial surfaces. Sentinel-2 capitalizes on the technology and the vast experience acquired in Europe and the US to sustain the operational supply of data for services such as forest monitoring, land cover changes detection or natural disasters management. The Sentinel-2 mission offers an unprecedented combination of the following capabilities: ○ Systematic global coverage of land surfaces: from 56°South to 84°North, coastal waters and Mediterranean sea; ○ High revisit: every 5 days at equator under the same viewing conditions with 2 satellites; ○ High spatial resolution: 10m, 20m and 60m; ○ Multi-spectral information with 13 bands in the visible, near infra-red and short wave infra-red part of the spectrum; ○ Wide field of view: 290 km. The data from the Sentinel-2 mission are available openly and freely for all users with online easy access since December 2015. The presentation will give a status report on the Sentinel-2 mission, and outlook for the remaining ramp-up Phase, the

  4. Incidence of metastasis in circumflex iliac nodes distal to the external iliac nodes in cervical cancer

    PubMed Central

    Okamoto, Kazuhira; Kato, Hidenori

    2016-01-01

    Objective A causal relationship between removal of circumflex iliac nodes distal to the external iliac nodes (CINDEIN) and lower leg edema has been recently suggested. The aim of this study was to elucidate the incidence of CINDEIN metastasis in cervical cancer. Methods A retrospective chart review was carried out for 531 patients with cervical cancer who underwent lymph node dissection between 1993 and 2014. CINDEIN metastasis was pathologically identified by microscopic investigation. After 2007, sentinel lymph node biopsy was performed selectively in patients with non-bulky cervical cancer. The sentinel node was identified using 99mTc-phytate and by scanning the pelvic cavity with a γ probe. Results Two hundred and ninety-seven patients (55.9%) underwent CINDEIN dissection and 234 (44.1%) did not. The percentage of International Federation of Gynecology and Obstetrics stage IIb to IV (42.4% vs. 23.5%, p<0.001) was significantly higher in patients who underwent CINDEIN dissection than those who did not. CINDEIN metastasis was identified in 1.9% overall and in 3.4% of patients who underwent CINDEIN dissection. For patients with stage Ia to IIa disease, CINDEIN metastasis was identified in 0.6% overall and in 1.2% of patients who underwent CINDEIN dissection. Of 115 patients with sentinel node mapping, only one (0.9%) had CINDEIN detected as a sentinel node. In this case, the other three lymph nodes were concurrently detected as sentinel lymph nodes. Conclusion CINDEIN dissection can be eliminated in patients with stage Ia to IIa disease. CINDEIN might not be regional lymph nodes in cervical cancer. PMID:27102250

  5. SNAP (Sentinel Application Platform) and the ESA Sentinel 3 Toolbox

    NASA Astrophysics Data System (ADS)

    Zuhlke, Marco; Fomferra, Norman; Brockmann, Carsten; Peters, Marco; Veci, Luis; Malik, Julien; Regner, Peter

    2015-12-01

    ESA is developing three new free open source Toolboxes for the scientific exploitation of the Sentinel-1, Sentinel-2 and Sentinel-3 missions. The Toolboxes are based on a common software platform, namely the Sentinel Application Platform (SNAP). SNAP is an evolution of the proven ESA BEAM/NEST architecture inheriting all current BEAM and NEST functionality including multi-mission support for SAR and optical missions to support ESA and third party missions for years to come. The Sentinel-3 Toolbox includes generic function for visualisation and analysis of Sentinel-3 OLCI and SLSTR Level 1 and Level 2 data, as well as specific processing tools such as cloud screening, water constituent retrieval and SST retrieval. The Toolbox will put emphasis on access to remote in-situ databases such as Felyx or MERMAID, and exploitation of the data-uncertainty information which is included in the Sentinel-3 data products. New image classification, segmentation and filtering methods, as well as interoperability with the ORFEO Toolbox and the GDAL libraries will be additional new tools. New challenges stemming from Sentinel-3 sensors, such as raster data in different resolutions within a single dataset, will be supported gracefully. The development of SNAP and the Sentinel Toolboxes is funded through the “Scientific Exploitation of Operational Missions (SEOM)” programme, a new programme element of ESA’s fourth period of the Earth Observation Envelope Programme (2013-2017).

  6. Overview of Sentinel-2

    NASA Astrophysics Data System (ADS)

    Fernandez, Valerie; Martimort, Philippe; Spoto, Francois; Sy, Omar; Laberinti, Paolo

    2013-10-01

    GMES is a joint initiative of the European Commission (EC) and the European Space Agency (ESA), designed to establish a European capacity for the provision and use of operational monitoring information for environment and security applications. ESA's role in GMES is to provide the definition and the development of the space- and ground-related system elements. GMES Sentinel-2 mission provides continuity to services relying on multi-spectral highresolution optical observations over global terrestrial surfaces. The key mission objectives for Sentinel-2 are: (1) to provide systematic global acquisitions of high-resolution multi-spectral imagery with a high revisit frequency, (2) to provide enhanced continuity of multi-spectral imagery provided by the SPOT series of satellites, and (3) to provide observations for the next generation of operational products such as landcover maps, land change detection maps, and geophysical variables. Consequently, Sentinel-2 will directly contribute to the Land Monitoring, Emergency Response, and Security services. The corresponding user requirements have driven the design towards a dependable multi-spectral Earthobservation system featuring the MSI with 13 spectral bands spanning from the visible and the near infrared to the short wave infrared. The spatial resolution varies from 10 m to 60 m depending on the spectral band with a 290 km field of view. This unique combination of high spatial resolution, wide field of view and large spectral coverage will represent a major step forward compared to current multi-spectral missions. The mission foresees a series of satellites, each having a 7.25-year lifetime (extendable to 12 years) over a 20-year period starting with the launch of Sentinel-2A foreseen by mid-2014. During full operations two identical satellites will be maintained in the same sun synchronous orbit with a phase delay of 180° providing a revisit time of five days at the equator.

  7. Sentinel-3 for Science

    NASA Astrophysics Data System (ADS)

    Benveniste, J.; Regner, P.; Desnos, Y. L.

    2015-12-01

    The Scientific Exploitation of Operational Mission (SEOM) programme element (http://seom.esa.int/) is part of the ESA's Fourth Earth Observation Envelope Programme (2013-2017). The prime objective is to federate, support and expand the international research community that the ERS, ENVISAT and the Envelope programmes have built up over the last 25 years. It aims to further strengthen the leadership of the European Earth Observation research community by enabling them to extensively exploit future European operational EO missions. SEOM is enabling the science community to address new scientific research that are opened by free and open access to data from operational EO missions. The Programme is based on community-wide recommendations for actions on key research issues, gathered through a series of international thematic workshops and scientific user consultation meetings such as the Sentinel-3 for Science Workshop held last June in Venice, Italy (see http://seom.esa.int/S3forScience2015). The 2015 SEOM work plan includes the launch of new R&D studies for scientific exploitation of the Sentinels, the development of open-source multi-mission scientific toolboxes, the organization of advanced international training courses, summer schools and educational materials, as well as activities for promoting the scientific use of EO data, also via the organization of Workshops. This paper will report the recommendations from the International Scientific Community concerning the Sentinel-3 Scientific Exploitation, as expressed in Venice, keeping in mind that Sentinel-3 is an operational mission to provide operational services (see http://www.copernicus.eu).

  8. Sentinel-3 For Land Applications

    NASA Astrophysics Data System (ADS)

    Goryl, Philippe; Gobron, Nadine; Mecklenburg, Susanne; Donlon, Craig; Bouvet, Marc; Buongiorno, Alessandra; Wilson, Hilary

    2016-07-01

    The Copernicus Programme, being Europe's Earth Observation and Monitoring Programme led by the European Union, aims to provide, on a sustainable basis, reliable and timely services related to environmental and security issues. The Sentinel-3 mission forms part of the Copernicus Space Component. Its main objectives, building on the heritage and experience of the European Space Agency's (ESA) ERS and ENVISAT missions, are to measure sea-surface topography, sea- and land-surface temperature and ocean- and land-surface colour in support of ocean forecasting systems, and for environmental and climate monitoring. The series of Sentinel-3 satellites will ensure global, frequent and near-real time ocean, ice and land monitoring, with the provision of observation data in a routine, long-term (up to 20 years of operations) and continuous fashion, with a consistent quality and a high level of reliability and availability. The launch of Sentinel-3 was successful last February 2016. The Sentinel-3 missions are jointly operated by ESA and EUMETSAT. ESA will be responsible for the operations, maintenance and evolution of the Sentinel-3 ground segment on land related products and EUMETSAT on the marine products and the satellite monitoring and control. All facilities supporting the Sentinel-3 operations are in place. The Sentinel-3 ground segment systematically acquires, processes and distributes a set of pre-defined core data products to the users. For a detailed description of the core data products please see https://earth.esa.int/web/sentinel/missions/sentinel-3/data-products. On request from the European Commission, ESA and EUMETSAT are presently assessing the possibility to include further core data products, in particular on aerosol optical depth, fire monitoring and synergistic products over land. This paper will provide an update on the status of the mission operations after the initial months in orbit and provide in particular an overview on the status of the Sentinel-3

  9. Initial results of imaging melanoma metastasis in resected human lymph nodes using photoacoustic computed tomography

    NASA Astrophysics Data System (ADS)

    Jose, Jithin; Grootendorst, Diederik J.; Vijn, Thomas W.; Wouters, Michel W.; van Boven, Hester; van Leeuwen, Ton G.; Steenbergen, Wiendelt; Ruers, Theo J. M.; Manohar, Srirang

    2011-09-01

    The pathological status of the sentinel lymph node is important for accurate melanoma staging, ascertaining prognosis and planning treatment. The standard procedure involves biopsy of the node and histopathological assessment of its status. Drawbacks of this examination include a finite sampling of the node with the likelihood of missing metastases, and a significant time-lag before histopathological results are available to the surgeon. We studied the applicability of photoacoustic computed tomographic imaging as an intraoperative modality for examining the status of resected human sentinel lymph nodes. We first applied the technique to image ex vivo pig lymph nodes carrying metastases-simulating melanoma cells using multiple wavelengths. The experience gained was applied to image a suspect human lymph node. We validated the photoacoustic imaging results by comparing a reconstructed slice with a histopathological section through the node. Our results suggest that photoacoustics has the potential to develop into an intraoperative imaging method to detect melanoma metastases in sentinel lymph nodes.

  10. Regional lymph node staging in breast cancer: the increasing role of imaging and ultrasound-guided axillary lymph node fine needle aspiration.

    PubMed

    Mainiero, Martha B

    2010-09-01

    The status of axillary lymph nodes is a key prognostic indicator in patients with breast cancer and helps guide patient management. Sentinel lymph node biopsy is increasingly being used as a less morbid alternative to axillary lymph node dissection. However, when sentinel lymph node biopsy is positive, axillary dissection is typically performed for complete staging and local control. Axillary ultrasound and ultrasound-guided fine needle aspiration (USFNA) are useful for detecting axillary nodal metastasis preoperatively and can spare patients sentinel node biopsy, because those with positive cytology on USFNA can proceed directly to axillary dissection or neoadjuvant chemotherapy. Internal mammary nodes are not routinely evaluated, but when the appearance of these nodes is abnormal on imaging, further treatment or metastatic evaluation may be necessary. PMID:20868896

  11. Sentinel-1A and Sentinel-1B CSAR status

    NASA Astrophysics Data System (ADS)

    Snoeij, Paul; Brown, Mike; Davidson, Malcolm; Rommen, Bjorn; Floury, Nicolas; Geudtner, Dirk; Torres, Ramon

    2011-11-01

    The ESA Sentinels constitute the first series of operational satellites responding to the Earth Observation needs of the EU-ESA Global Monitoring for Environment and Security programme. The GMES space component relies on existing and planned space assets as well as on new complementary developments by ESA. In particular, as part of the GMES space component, ESA is currently undertaking the development of 3 Sentinels mission families. Each Sentinel is based on a constellation of 2 satellites in the same orbital plane. This configuration allows to fulfil the revisit and coverage requirements and to provide a robust and affordable operational service. The launch of the 2nd satellite is scheduled 18 months after the launch of the 1st spacecraft of the constellation. The lifetime of the individual satellite is specified as 7 years, with consumables allowing mission extension up to 12 years. The lifecycle of the space segment is planned to be in the order of 15-20 years. The strategy for Sentinel procurement and replacement over this period is being elaborated, but will likely result in a need for 4-5 satellites of each type if the desired robustness for the service that GMES will provide is to be achieved. This paper will describe the operational and observational capabilities of the Sentinel-1 mission based on the user requirements, including potential emergency requests. An example of a pre-defined mission timeline for each and every cycle will be given.

  12. Lymph nodes

    MedlinePlus Videos and Cool Tools

    The lymphatic system is a complex network of thin vessels, valves, ducts, nodes, and organs. It helps to protect and maintain the fluid ... The most common cause of swollen lymph nodes is infection, which might occur even if the infection ...

  13. Lymph nodes

    MedlinePlus Videos and Cool Tools

    ... and conveying lymph and by producing various blood cells. Lymph nodes play an important part in the ... the microorganisms being trapped inside collections of lymph cells or nodes. Eventually, these organisms are destroyed and ...

  14. Passing excellence

    NASA Astrophysics Data System (ADS)

    Tsoupikova, Daria

    2007-02-01

    This paper describes the research and development of a virtual reality visualization project "Passing excellence" about the world famous architectural ensemble "Kizhi". The Kizhi Pogost is located on an island in Lake Onega in northern Karelia in Russia. It is an authentic museum of an ancient wood building tradition which presents a unique artistic achievement. This ensemble preserves a concentration of masterpieces of the Russian heritage and is included in the List of Most Endangered Sites of the World Monuments Watch protected by World Heritage List of UNESCO. The project strives to create a unique virtual observation of the dynamics of the architectural changes of the museum area beginning from the 15th Century up to the 21st Century. The visualization is being created to restore the original architecture of Kizhi island based on the detailed photographs, architectural and geometric measurements, textural data, video surveys and resources from the Kizhi State Open-Air Museum archives. The project is being developed using Electro, an application development environment for the tiled display high-resolution graphics visualization system and can be shown on the virtual reality systems such as the GeoWall TM and the C-Wall.

  15. Sentinel 2 global reference image

    NASA Astrophysics Data System (ADS)

    Dechoz, C.; Poulain, V.; Massera, S.; Languille, F.; Greslou, D.; de Lussy, F.; Gaudel, A.; L'Helguen, C.; Picard, C.; Trémas, T.

    2015-10-01

    Sentinel-2 is a multispectral, high-resolution, optical imaging mission, developed by the European Space Agency (ESA) in the frame of the Copernicus program of the European Commission. In cooperation with ESA, the Centre National d'Etudes Spatiales (CNES) is responsible for the image quality of the project, and will ensure the CAL/VAL commissioning phase. Sentinel-2 mission is devoted the operational monitoring of land and coastal areas, and will provide a continuity of SPOT- and Landsat-type data. Sentinel-2 will also deliver information for emergency services. Launched in 2015 and 2016, there will be a constellation of 2 satellites on a polar sun-synchronous orbit, imaging systematically terrestrial surfaces with a revisit time of 5 days, in 13 spectral bands in visible and shortwave infra-red. Therefore, multi-temporal series of images, taken under the same viewing conditions, will be available. So as to ensure for the multi-temporal registration of the products, specified to be better than 0.3 pixels at 2σ, a Global Reference Image (GRI) will be produced during the CAL/VAL period. This GRI is composed of a set of Sentinel-2 acquisitions, which geometry has been corrected by bundle block adjustment. During L1B processing, Ground Control Points will be taken between this reference image and the sentinel-2 acquisition processed and the geometric model of the image corrected, so as to ensure the good multi-temporal registration. This paper first details the production of the reference during the CALVAL period, and then details the qualification and geolocation performance assessment of the GRI. It finally presents its use in the Level-1 processing chain and gives a first assessment of the multi-temporal registration.

  16. Sentinel-3 SAR Altimetry Toolbox

    NASA Astrophysics Data System (ADS)

    Benveniste, Jerome; Lucas, Bruno; DInardo, Salvatore

    2015-04-01

    The prime objective of the SEOM (Scientific Exploitation of Operational Missions) element is to federate, support and expand the large international research community that the ERS, ENVISAT and the Envelope programmes have build up over the last 20 years for the future European operational Earth Observation missions, the Sentinels. Sentinel-3 builds directly on a proven heritage of ERS-2 and Envisat, and CryoSat-2, with a dual-frequency (Ku and C band) advanced Synthetic Aperture Radar Altimeter (SRAL) that provides measurements at a resolution of ~300m in SAR mode along track. Sentinel-3 will provide exact measurements of sea-surface height along with accurate topography measurements over sea ice, ice sheets, rivers and lakes. The first of the two Sentinels is expected to be launched in early 2015. The current universal altimetry toolbox is BRAT (Basic Radar Altimetry Toolbox) which can read all previous and current altimetry mission's data, but it does not have the capabilities to read the upcoming Sentinel-3 L1 and L2 products. ESA will endeavour to develop and supply this capability to support the users of the future Sentinel-3 SAR Altimetry Mission. BRAT is a collection of tools and tutorial documents designed to facilitate the processing of radar altimetry data. This project started in 2005 from the joint efforts of ESA (European Space Agency) and CNES (Centre National d'Etudes Spatiales), and it is freely available at http://earth.esa.int/brat. The tools enable users to interact with the most common altimetry data formats, the BratGUI is the front-end for the powerful command line tools that are part of the BRAT suite. BRAT can also be used in conjunction with Matlab/IDL (via reading routines) or in C/C++/Fortran via a programming API, allowing the user to obtain desired data, bypassing the data-formatting hassle. BRAT can be used simply to visualise data quickly, or to translate the data into other formats such as netCDF, ASCII text files, KML (Google Earth

  17. SAR Altimetry Processing on Demand Service for Cryosat-2 and Sentinel-3 at ESA G-Pod

    NASA Astrophysics Data System (ADS)

    Dinardo, Salvatore; Benveniste, Jérôme; Ambrózio, Américo; Restano, Marco

    2016-07-01

    The G-POD SARvatore service to users for the exploitation of CryoSat-2 data was designed and developed by the Altimetry Team at ESA-ESRIN EOP-SER (Earth Observation - Exploitation, Research and Development). The G-POD service coined SARvatore (SAR Versatile Altimetric Toolkit for Ocean Research & Exploitation) is a web platform that allows any scientist to process on-line, on-demand and with user-selectable configuration CryoSat-2 SAR/SARIN data, from L1a (FBR) data products up to SAR/SARin Level-2 geophysical data products. The Processor takes advantage of the G-POD (Grid Processing On Demand) distributed computing platform (350 CPUs in ~70 Working Nodes) to timely deliver output data products and to interface with ESA-ESRIN FBR data archive (155'000 SAR passes and 41'000 SARin passes). The output data products are generated in standard NetCDF format (using CF Convention), therefore being compatible with the Multi-Mission Radar Altimetry Toolbox (BRAT) and other NetCDF tools. By using the G-POD graphical interface, it is straightforward to select a geographical area of interest within the time-frame related to the Cryosat-2 SAR/SARin FBR data products availability in the service catalogue. The processor prototype is versatile, allowing users to customize and to adapt the processing according to their specific requirements by setting a list of configurable options. After the task submission, users can follow, in real time, the status of the processing, which can be lengthy due to the required intense number-crunching inherent to SAR processing. From the web interface, users can choose to generate experimental SAR data products as stack data and RIP (Range Integrated Power) waveforms. The processing service, initially developed to support the awarded development contracts by confronting the deliverables to ESA's prototype, is now made available to the worldwide SAR Altimetry Community for research & development experiments, for on-site demonstrations/training in

  18. SAR Processing on Demand Service for CryoSat-2 and Sentinel-3 at ESA G-POD

    NASA Astrophysics Data System (ADS)

    Benveniste, Jérôme; Ambrózio, Américo; Restano, Marco; Dinardo, Salvatore

    2016-04-01

    The scope of this presentation is to feature the G-POD SARvatore service to users for the exploitation of the CryoSat-2 and Sentniel-3 data, which was designed and developed by the Altimetry Team at ESA-ESRIN EOP-SER (Earth Observation - Exploitation, Research and Development). The G-POD service coined SARvatore (SAR Versatile Altimetric Toolkit for Ocean Research & Exploitation) is a web platform that allows any scientist to process on-line, on-demand and with user-selectable configuration CryoSat-2 SAR/SARIN data, from L1a (FBR) data products up to SAR/SARin Level-2 geophysical data products. The Processor takes advantage of the G-POD (Grid Processing On Demand) distributed computing platform (350 CPUs in ~70 Working Nodes) to timely deliver output data products and to interface with ESA-ESRIN FBR data archive (210'000 SAR passes and 120'000 SARin passes). The output data products are generated in standard NetCDF format (using CF Convention), therefore being compatible with the multi-mission Broadview Radar Altimetry Toolbox (BRAT) and other NetCDF tools. By using the G-POD graphical interface, it is straightforward to select a geographical area of interest within the time-frame related to the Cryosat-2 SAR/SARin FBR data products availability in the service catalogue. The processor prototype is versatile, allowing users to customize and to adapt the processing, according to their specific requirements, by setting a list of configurable options. After the task submission, users can follow, in real time, the status of the processing. From the web interface, users can choose to generate experimental SAR data products as stack data and RIP (Range Integrated Power) waveforms. The processing service, initially developed to support the development contracts awarded by confronting the deliverables to ESA's computations, has been made available to the worldwide SAR Altimetry Community for research & development experiments, for hands-on demonstrations/training in

  19. Selfish sentinels in cooperative mammals.

    PubMed

    Clutton-Brock, T H; O'Riain, M J; Brotherton, P N; Gaynor, D; Kansky, R; Griffin, A S; Manser, M

    1999-06-01

    Like humans engaged in risky activities, group members of some animal societies take turns acting as sentinels. Explanations of the evolution of sentinel behavior have frequently relied on kin selection or reciprocal altruism, but recent models suggest that guarding may be an individual's optimal activity once its stomach is full if no other animal is on guard. This paper provides support for this last explanation by showing that, in groups of meerkats (Suricata suricatta), animals guard from safe sites, and solitary individuals as well as group members spend part of their time on guard. Though individuals seldom take successive guarding bouts, there is no regular rota, and the provision of food increases contributions to guarding and reduces the latency between bouts by the same individual. PMID:10356387

  20. The Sentinel-2 Mission Products

    NASA Astrophysics Data System (ADS)

    Gascon, Ferran

    2012-04-01

    In the framework of the Global Monitoring for Environment and Security (GMES) programme, the European Space Agency (ESA) in partnership with the European Commission (EC) is developing the Sentinel-2 optical imaging mission devoted to the operational monitoring of land and coastal areas. This system will deliver a new generation of optical data products designed to directly feed downstream services acting in several domains such as land management, agricultural industry, forestry, food security, or disaster control management following floods, volcanic eruptions, landslides, etc. The Sentinel-2 mission designed to generate products with accurate radiometric and geometric performances (including multi-temporal imagery co-registration). To maximize the products suitability and readiness to downstream usage for the majority of applications, the Sentinel-2 PDGS will systematically generate and archive Level-1C products, which will provide Top of Atmosphere (TOA) reflectance images, orthorectified using a global DEM and UTM projection. A Level-1B product will also be available for expert users and will provide the radiometrically corrected pixels in sensor geometry with the geometric model appended. Finally, a complementary atmospheric correction and enhanced cloud screening algorithm is being prototyped in parallel with the goal of providing some initial capabilities to the users, by means of a specific software toolbox operated on their platforms, to translate the Level-1C TOA reflectance image into Bottom of Atmosphere (BOA) reflectance.

  1. The role of ultrasound and lymphoscintigraphy in the assessment of axillary lymph nodes in patients with breast cancer

    PubMed Central

    Dobruch-Sobczak, Katarzyna; Wareluk, Paweł; Gumińska, Anna; Białek, Ewa; Cacko, Marek; Królicki, Leszek

    2016-01-01

    Breast cancer is the most common malignancy and the leading cause of death due to cancer in European women. Mammography screening programs aimed to increase the detection of early cancer stages were implemented in numerous European countries. Recent data show a decrease in mortality due to breast cancer in many countries, particularly among young women. At the same time, the number of sentinel node biopsy procedures and breast-conserving surgeries has increased. Intraoperative sentinel lymph node biopsy preceded by lymphoscintigraphy is used in breast cancer patients with no clinical signs of lymph node metastasis. Due to the limited sensitivity and specificity of physical examination in detecting metastatic lesions, developing an appropriate diagnostic algorithm for the preoperative assessment of axillary lymph nodes seems to be a challenge. The importance of ultrasound in patient qualification for sentinel lymph-node biopsy has been discussed in a number of works. Furthermore, different lymphoscintigraphy protocols have been compared in the literature. The usefulness of novel radiopharmaceuticals as well as the methods of image acquisition in sentinel lymph node diagnostics have also been assessed. The aim of this article is to present, basing on current guidelines, literature data as well as our own experience, the diagnostic possibilities of axillary lymph node ultrasound in patient qualification for an appropriate treatment as well as the role of lymphoscintigraphy in sentinel lymph node biopsy. PMID:27103998

  2. Connecting Node

    NASA Technical Reports Server (NTRS)

    Johnson, Christopher J.; Raboin, Jasen L.; Spexarth, Gary R.

    2009-01-01

    A paper describes the Octanode, a connecting node that facilitates the integration of multiple docking mechanisms, hatches, windows, and internal and external systems with the use of flat surfaces. The Octanode is a 26- faced Great Rhombicuboctahedron Archi medean solid with six octagonshaped panels, eight hexagon-shaped panels, and 12 square panels using three unique, simple, flat shapes to construct a spherical approximation. Each flat shape can be constructed with a variety of material and manufacturing techniques, such as honeycomb composite panels or a pocketed skinstringer configuration, using conventional means. The flat shapes can be connected together and sealed to create a pressurizable volume by the use of any conventional means including welding or fastening devices and sealant. The node can then be connected to other elements to allow transfer between those elements, or it could serve as an airlock. The Octanode can be manufactured on the ground and can be integrated with subsystems including hatches and ports. The node can then be transported to its intended location, whether on orbit or on surface. Any of the flat panels could be replaced by curved ones, turning the node into a copula. Windows may be placed on flat panes with optimal viewing angles that are not blocked by large connecting nodes. The advantage of using flat panels to represent a spherical approximation is that this allows for easier integration of subsystems and design features.

  3. GLOBAL EMERGING INFECTIONS SENTINEL NETWORK (GEOSENTINEL)

    EPA Science Inventory

    GeoSentinel is a network of travel/tropical medicine clinics initiated in 1995 by the International Society of Travel Medicine (ISTM) and the Centers for Disease Control (CDC). GeoSentinel is based on the concept that these clinics are ideally situated to effectively detect geogr...

  4. Hyperspectral exploitation with plant sentinels

    NASA Astrophysics Data System (ADS)

    Shaw, Arnab K.; Medford, June; Antunes, Mauricio; McCormick, William S.; Wicker, Devert

    2007-04-01

    The primary goal of this paper is to develop Hyperspectral algorithms for early detection of a readout system used in conjunction with plants designed to de-green or discolor after detection of explosives, harmful chemicals, and environmental pollutants. Work in progress is aimed to develop a new class of biosensors or Plant Sentinels that can serve as inexpensive plant-based biological early-warning systems capable of detecting substances that are harmful to human or the environment [LoHe03]. The de-greening circuits in the laboratory plant, Arabidopsis, have been shown to induce rapid chlorophyll loss, thereby change color under the influence of synthetic estrogens. However, as of now, the bio de-greening phenomenon is detectable by human eyes or with a system (chlorophyll fluorescence) that works best in laboratory conditions. In order to make the plant sentinel system practically viable, we have developed automated monitoring scheme for early detection of the de-greening phenomenon. The automated detection capability would lead to practical applicability and wider usage. This paper presents novel and effective HSI-based algorithms for early detection of de-greening of plants and vegetation due to explosives or chemical agents. The image processing based automated degreening detector, presented in this paper will be capable of 24/7 monitoring of the plant sentinels and to detect minutest possible discoloration of the plant-sensors to serve as an early-warning system. We also present preliminary results on estimating the length of time that the explosive or chemical agent has been present.

  5. Fluorescence imaging to study cancer burden on lymph nodes

    NASA Astrophysics Data System (ADS)

    D'Souza, Alisha V.; Elliott, Jonathan T.; Gunn, Jason R.; Samkoe, Kimberley S.; Tichauer, Kenneth M.; Pogue, Brian W.

    2015-03-01

    Morbidity and complexity involved in lymph node staging via surgical resection and biopsy calls for staging techniques that are less invasive. While visible blue dyes are commonly used in locating sentinel lymph nodes, since they follow tumor-draining lymphatic vessels, they do not provide a metric to evaluate presence of cancer. An area of active research is to use fluorescent dyes to assess tumor burden of sentinel and secondary lymph nodes. The goal of this work was to successfully deploy and test an intra-nodal cancer-cell injection model to enable planar fluorescence imaging of a clinically relevant blue dye, specifically methylene blue along with a cancer targeting tracer, Affibody labeled with IRDYE800CW and subsequently segregate tumor-bearing from normal lymph nodes. This direct-injection based tumor model was employed in athymic rats (6 normal, 4 controls, 6 cancer-bearing), where luciferase-expressing breast cancer cells were injected into axillary lymph nodes. Tumor presence in nodes was confirmed by bioluminescence imaging before and after fluorescence imaging. Lymphatic uptake from the injection site (intradermal on forepaw) to lymph node was imaged at approximately 2 frames/minute. Large variability was observed within each cohort.

  6. Sentinel-2 diffuser on-ground calibration

    NASA Astrophysics Data System (ADS)

    Mazy, E.; Camus, F.; Chorvalli, V.; Domken, I.; Laborie, A.; Marcotte, S.; Stockman, Y.

    2013-10-01

    The Sentinel-2 multi-spectral instrument (MSI) will provide Earth imagery in the frame of the Global Monitoring for Environment and Security (GMES) initiative which is a joint undertaking of the European Commission and the Agency. MSI instrument, under Astrium SAS responsibility, is a push-broom spectro imager in 13 spectral channels in VNIR and SWIR. The instrument radiometric calibration is based on in-flight calibration with sunlight through a quasi Lambertian diffuser. The diffuser covers the full pupil and the full field of view of the instrument. The on-ground calibration of the diffuser BRDF is mandatory to fulfil the in-flight performances. The diffuser is a 779 x 278 mm2 rectangular flat area in Zenith-A material. It is mounted on a motorised door in front of the instrument optical system entrance. The diffuser manufacturing and calibration is under the Centre Spatial of Liege (CSL) responsibility. The CSL has designed and built a completely remote controlled BRDF test bench able to handle large diffusers in their mount. As the diffuser is calibrated directly in its mount with respect to a reference cube, the error budget is significantly improved. The BRDF calibration is performed directly in MSI instrument spectral bands by using dedicated band-pass filters (VNIR and SWIR up to 2200 nm). Absolute accuracy is better than 0.5% in VNIR spectral bands and 1% in SWIR spectral bands. Performances were cross checked with other laboratories. The first MSI diffuser for flight model was calibrated mid 2013 on CSL BRDF measurement bench. The calibration of the diffuser consists mainly in thermal vacuum cycles, BRDF uniformity characterisation and BRDF angular characterisation. The total amount of measurement for the first flight model diffuser corresponds to more than 17500 BRDF acquisitions. Performance results are discussed in comparison with requirements.

  7. Sentinel-5 Precursor Payload Data Ground Segment

    NASA Astrophysics Data System (ADS)

    Kiemle, S.; Knispel, R.; Schwinger, M.; Weiland, N.

    2012-11-01

    The Payload Data Ground Segment (PDGS) for the Sentinel-5 Precursor mission operating the TROPOMI instrument is currently being developed at DLR Oberpfaffenhofen. The PDGS covers the functions of payload data acquisition, level 0 to level 2 near real-time and offline processing, re-processing, short- and long-term archiving, product quality and service monitoring. A major challenge in the PDGS development is the handling of high data rates for processing, transmission and archiving, and the integration of several different processing systems.This contribution describes the Sentinel-5 Precursor PDGS concept and architecture, gives an overview on the system requirements and presents the current PDGS development status. The ESA Sentinel-5 Precursor to be launched in March 2015 is an important mission for the continuous operational remote sensing of the atmosphere filling the gap between the ENVISAT era and the GMES Sentinel 5 mission.

  8. Assessment of lymph node involvement in colorectal cancer.

    PubMed

    Ong, Mark L H; Schofield, John B

    2016-03-27

    Lymph node metastasis informs prognosis and is a key factor in deciding further management, particularly adjuvant chemotherapy. It is core to all contemporary staging systems, including the widely used tumor node metastasis staging system. Patients with node-negative disease have 5-year survival rates of 70%-80%, implying a significant minority of patients with occult lymph node metastases will succumb to disease recurrence. Enhanced staging techniques may help to identify this subset of patients, who might benefit from further treatment. Obtaining adequate numbers of lymph nodes is essential for accurate staging. Lymph node yields are affected by numerous factors, many inherent to the patient and the tumour, but others related to surgical and histopathological practice. Good lymph node recovery relies on close collaboration between surgeon and pathologist. The optimal extent of surgical resection remains a subject of debate. Extended lymphadenectomy, extra-mesenteric lymph node dissection, high arterial ligation and complete mesocolic excision are amongst the surgical techniques with plausible oncological bases, but which are not supported by the highest levels of evidence. With further development and refinement, intra-operative lymphatic mapping and sentinel lymph node biopsy may provide a guide to the optimum extent of lymphadenectomy, but in its present form, it is beset by false negatives, skip lesions and failures to identify a sentinel node. Once resected, histopathological assessment of the surgical specimen can be improved by thorough dissection techniques, step-sectioning of tissue blocks and immunohistochemistry. More recently, molecular methods have been employed. In this review, we consider the numerous factors that affect lymph node yields, including the impact of the surgical and histopathological techniques. Potential future strategies, including the use of evolving technologies, are also discussed. PMID:27022445

  9. Assessment of lymph node involvement in colorectal cancer

    PubMed Central

    Ong, Mark L H; Schofield, John B

    2016-01-01

    Lymph node metastasis informs prognosis and is a key factor in deciding further management, particularly adjuvant chemotherapy. It is core to all contemporary staging systems, including the widely used tumor node metastasis staging system. Patients with node-negative disease have 5-year survival rates of 70%-80%, implying a significant minority of patients with occult lymph node metastases will succumb to disease recurrence. Enhanced staging techniques may help to identify this subset of patients, who might benefit from further treatment. Obtaining adequate numbers of lymph nodes is essential for accurate staging. Lymph node yields are affected by numerous factors, many inherent to the patient and the tumour, but others related to surgical and histopathological practice. Good lymph node recovery relies on close collaboration between surgeon and pathologist. The optimal extent of surgical resection remains a subject of debate. Extended lymphadenectomy, extra-mesenteric lymph node dissection, high arterial ligation and complete mesocolic excision are amongst the surgical techniques with plausible oncological bases, but which are not supported by the highest levels of evidence. With further development and refinement, intra-operative lymphatic mapping and sentinel lymph node biopsy may provide a guide to the optimum extent of lymphadenectomy, but in its present form, it is beset by false negatives, skip lesions and failures to identify a sentinel node. Once resected, histopathological assessment of the surgical specimen can be improved by thorough dissection techniques, step-sectioning of tissue blocks and immunohistochemistry. More recently, molecular methods have been employed. In this review, we consider the numerous factors that affect lymph node yields, including the impact of the surgical and histopathological techniques. Potential future strategies, including the use of evolving technologies, are also discussed. PMID:27022445

  10. The SENTINEL-3 Mission: Overview and Status

    NASA Astrophysics Data System (ADS)

    Benveniste, J.; Mecklenburg, S.

    2015-12-01

    The Copernicus Programme, being Europe's Earth Observation and Monitoring Programme led by the European Union, aims to provide, on a sustainable basis, reliable and timely services related to environmental and security issues. The Sentinel-3 mission forms part of the Copernicus Space Component. Its main objectives, building on the heritage and experience of the European Space Agency's (ESA) ERS and ENVISAT missions, are to measure sea-surface topography, sea- and land-surface temperature and ocean- and land-surface colour in support of ocean forecasting systems, and for environmental and climate monitoring. The series of Sentinel-3 satellites will ensure global, frequent and near-real time ocean, ice and land monitoring, with the provision of observation data in routine, long term (up to 20 years of operations) and continuous fashion, with a consistent quality and a high level of reliability and availability. The Sentinel-3 missions will be jointly operated by ESA and EUMETSAT. ESA will be responsible for the operations, maintenance and evolution of the Sentinel-3 ground segment on land related products and EUMETSAT for the marine products. The Sentinel-3 ground segment systematically acquires, processes and distributes a set of pre-defined core data products. Sentinel-3A is foreseen to be launched at the beginning of November 2015. The paper will give an overview on the mission, its instruments and objectives, the data products provided, the mechanisms to access the mission's data, and if available first results.

  11. [Introduction of U.S. FDA mini-sentinel program].

    PubMed

    Xie, Yan-Ming; Liao, Xing; Shen, Hao

    2013-03-01

    In China, all of traditional Chinese medicine injections should pass clinical trials I, II and III for their safety and effectiveness before coming into the market. However, these clinical tests are mostly restricted to standard treatment for specific groups, and conducted in strict accordance with clinical trial protocols. In the real world, as there are more changes in the post-market clinical application of traditional Chinese medicine injections than in the experiment environment, regulatory bodies set stricter requirements for the post-market re-assessment on traditional Chinese medicine injections. Early-stage studies could only provide the most fundamental and restricted data of efficacy and safety of traditional Chinese medicine injections. In this essay, mini-sentinel program of U. S. FDA is introduced in order to provide reference for large-sample-size post-market clinical safety monitoring studies for traditional Chinese medicine injections. PMID:23724692

  12. Reconfigureable network node

    DOEpatents

    Vanderveen, Keith B.; Talbot, Edward B.; Mayer, Laurence E.

    2008-04-08

    Nodes in a network having a plurality of nodes establish communication links with other nodes using available transmission media, as the ability to establish such links becomes available and desirable. The nodes predict when existing communications links will fail, become overloaded or otherwise degrade network effectiveness and act to establish substitute or additional links before the node's ability to communicate with the other nodes on the network is adversely affected. A node stores network topology information and programmed link establishment rules and criteria. The node evaluates characteristics that predict existing links with other nodes becoming unavailable or degraded. The node then determines whether it can form a communication link with a substitute node, in order to maintain connectivity with the network. When changing its communication links, a node broadcasts that information to the network. Other nodes update their stored topology information and consider the updated topology when establishing new communications links for themselves.

  13. The Scientist as Sentinel (Invited)

    NASA Astrophysics Data System (ADS)

    Oreskes, N.

    2013-12-01

    Scientists have been warning the world for some time about the risks of anthropogenic interference in the climate system. But we struggle with how, exactly, to express that warning. The norms of scientific behavior enjoin us from the communication strategies normally associated with warnings. If a scientist sounds excited or emotional, for example, it is often assumed that he has lost his capac¬ity to assess data calmly and therefore his conclusions are suspect. If the scientist is a woman, the problem is that much worse. In a recently published article my colleagues and I have shown that scientists have systematically underestimated the threat of climate change (Brysse et al., 2012). We suggested that this occurs for norma¬tive reasons: The scientific values of rationality, dispassion, and self-restraint lead us to demand greater levels of evidence in support of surprising, dramatic, or alarming conclusions than in support of less alarming conclusions. We call this tendency 'err¬ing on the side of least drama.' However, the problem is not only that we err on the side of least drama in our assessment of evidence, it's also that we speak without drama, even when our conclusions are dramatic. We speak without the emotional cadence that people expect to hear when the speaker is worried. Even when we are worried, we don't sound as if we are. In short, we are trying to act as sentinels, but we lack the register with which to do so. Until we find those registers, or partner with colleagues who are able to speak in the cadences that communicating dangers requires, our warnings about climate change will likely continue to go substantially unheeded.

  14. Sentinel-1 Precise Orbit Calibration and Validation

    NASA Astrophysics Data System (ADS)

    Monti Guarnieri, Andrea; Mancon, Simone; Tebaldini, Stefano

    2015-05-01

    In this paper, we propose a model-based procedure to calibrate and validate Sentinel-1 orbit products by the Multi-Squint (MS) phase. The technique allows to calibrate an interferometric pair geometry by refining the slave orbit with reference to the orbit of a master image. Accordingly, we state the geometric model of the InSAR phase as function of positioning errors of targets and slave track; and the MS phase model as derivative of the InSAR phase geometric model with respect to the squint angle. In this paper we focus on the TOPSAR acquisition modes of Sentinel-1 (IW and EW) assuming at the most a linear error in the known slave trajectory. In particular, we describe a dedicated methodology to prevent InSAR phase artifacts on data acquired by the TOPSAR acquisition mode. Experimental results obtained by interferometric pairs acquired by Sentinel-1 sensor will be displayed.

  15. Tuberculosis axillary lymph node coexistent breast cancer in adjuvant treatment: case report

    PubMed Central

    Bromberg, Silvio Eduardo; do Amaral, Paulo Gustavo Tenório

    2015-01-01

    Coexistence of breast cancer and tuberculosis is rare. In most cases, involvement by tuberculosis occurs in axillary lymph nodes. We report a case of a 43-years-old patient who had undergone adenomastectomy and left sentinel lymph node biopsy due to a triple negative ductal carcinoma. At the end of adjuvant treatment, the patient had an atypical lymph node in the left axilla. Lymph node was excised, and after laboratory analysis, the diagnosis was ganglion tuberculosis. The patient underwent treatment for primary tuberculosis. The development of these two pathologies can lead to problems in diagnosis and treatment. An accurate diagnosis is important to avoid unnecessary surgical procedures. PMID:26018148

  16. SENTINEL-1 Image Matching Using Strong Scatters

    NASA Astrophysics Data System (ADS)

    Ghannadi, M. A.; Saadatseresht, M.; Motagh, M.

    2015-12-01

    The availability of new radar spaceborne sensors offers new interesting potentialities for the geomatics application: spatial and temporal change detection, generation of Digital Elevation Model(DEM) using radargrametry and interferometry. Since the start of the sentinel-1 mission to take images from different regions all over the world, the ability to use these images in variety domains has been treasured. This paper suggests a method for image matching using strong scatters. all the experiments are done on sentinel-1 stereo images from Jam, Bushehr, Iran.

  17. Cloud and Cloud Shadow Identification for MERIS and Sentinel-3/OLCI

    NASA Astrophysics Data System (ADS)

    Pringle, Nicholas; Vanhellemont, Quinten; Ruddick, Kevin

    2015-12-01

    Ocean colour remote sensing has become a well-established method for the monitoring of coastal waters. The MERIS chlorophyll product for turbid waters (algal_2) and the total suspended matter product (tsm) have been used in applications such as algal bloom detection, eutrophication monitoring, and coastal sediment transport. These MERIS L2 products are sometimes contaminated by cloud shadow pixels and the same problems are likely to occur in Sentinel-3. In order to avoid erroneous data passing quality control and being used in applications, an automated method for detecting and removing cloud and cloud shadow pixels is needed. With this in mind, we highlight the problems with MERIS in the past and show some results from applying detection methods to Landsat-8 data with the objective of using these methods for Sentinel-2 and -3 in the future.

  18. Forest Area Derivation from SENTINEL-1 Data

    NASA Astrophysics Data System (ADS)

    Dostálová, Alena; Hollaus, Markus; Milenković, Milutin; Wagner, Wolfgang

    2016-06-01

    The recently launched Sentinel-1A provides the high resolution Synthetic Aperture Radar (SAR) data with very high temporal coverage over large parts of European continent. Short revisit time and dual polarization availability supports its usability for forestry applications. The following study presents an analysis of the potential of the multi-temporal dual-polarization Sentinel-1A data for the forest area derivation using the standard methods based on Otsu thresholding and K-means clustering. Sentinel-1 data collected in winter season 2014-2015 over a test area in eastern Austria were used to derive forest area mask with spatial resolution of 10m and minimum mapping unit of 500 m2. The validation with reference forest mask derived from airborne full-waveform laser scanning data revealed overall accuracy of 92 % and kappa statistics of 0.81. Even better results can be achieved when using external mask for urban areas, which might be misclassified as forests when using the introduced approach based on SAR data only. The Sentinel-1 data and the described methods are well suited for forest change detection between consecutive years.

  19. Permian insect wing from antarctic sentinel mountains.

    PubMed

    Tasch, P; Riek, E F

    1969-06-27

    A homopterous insect wing was found in micaceous graywacke from the Polarstar Formation, Sentinel Mountains. The unusual venation is reminiscent of family Stenoviciidae known from the Permian and Triassic of Eastern Australia and elsewhere. This first documented account of Paleozoic insects in Antarctica bears on drift questions. PMID:17748532

  20. Superficial and deep lymph node dissection for stage III cutaneous melanoma: clinical outcome and prognostic factors

    PubMed Central

    2013-01-01

    Background The aims of this retrospective analysis were to evaluate the effect of combined superficial and deep groin dissection on disease-free and melanoma-specific survival, and to identify the most important factors for predicting the involvement of deep nodes according to clinically or microscopically detected nodal metastases. Methods Between January 1996 and December 2005, 133 consecutive patients with groin lymph node metastases underwent superficial and deep dissection at the National Cancer Institute, Naples. Lymph node involvement was clinically evident in 84 patients and detected by sentinel node biopsy in 49 cases. Results The 5-year disease-free survival was significantly better for patients with superficial lymph node metastases than for patients with involvement of both superficial and deep lymph nodes (34.9% vs. 19.0%; P = 0.001). The 5-year melanoma-specific survival was also significantly better for patients with superficial node metastases only (55.6% vs. 33.3%; P = 0.001). Conclusions Metastasis in the deep nodes is the strongest predictor of both disease-free and melanoma-specific survival. Deep groin dissection should be considered for all patients with groin clinical nodal involvement, but might be spared in patients with a positive sentinel node. Prospective studies will clarify the issue further. PMID:23379355

  1. Tumor implantation model for rapid testing of lymphatic dye uptake from paw to node in small animals

    NASA Astrophysics Data System (ADS)

    DSouza, Alisha V.; Elliott, Jonathan T.; Gunn, Jason R.; Barth, Richard J.; Samkoe, Kimberley S.; Tichauer, Kenneth M.; Pogue, Brian W.

    2015-03-01

    Morbidity and complexity involved in lymph node staging via surgical resection and biopsy calls for staging techniques that are less invasive. While visible blue dyes are commonly used in locating sentinel lymph nodes, since they follow tumor-draining lymphatic vessels, they do not provide a metric to evaluate presence of cancer. An area of active research is to use fluorescent dyes to assess tumor burden of sentinel and secondary lymph nodes. The goal of this work was to successfully deploy and test an intra-nodal cancer-cell injection model to enable planar fluorescence imaging of a clinically relevant blue dye, specifically methylene blue - used in the sentinel lymph node procedure - in normal and tumor-bearing animals, and subsequently segregate tumor-bearing from normal lymph nodes. This direct-injection based tumor model was employed in athymic rats (6 normal, 4 controls, 6 cancer-bearing), where luciferase-expressing breast cancer cells were injected into axillary lymph nodes. Tumor presence in nodes was confirmed by bioluminescence imaging before and after fluorescence imaging. Lymphatic uptake from the injection site (intradermal on forepaw) to lymph node was imaged at approximately 2 frames/minute. Large variability was observed within each cohort.

  2. Passing and Catching in Rugby.

    ERIC Educational Resources Information Center

    Namudu, Mike M.

    This booklet contains the fundamentals for rugby at the primary school level. It deals primarily with passing and catching the ball. It contains instructions on (1) holding the ball for passing, (2) passing the ball to the left--standing, (3) passing the ball to the left--running, (4) making a switch pass, (5) the scrum half's normal pass, (6) the…

  3. Message passing with a limited number of DMA byte counters

    DOEpatents

    Blocksome, Michael; Chen, Dong; Giampapa, Mark E.; Heidelberger, Philip; Kumar, Sameer; Parker, Jeffrey J.

    2011-10-04

    A method for passing messages in a parallel computer system constructed as a plurality of compute nodes interconnected as a network where each compute node includes a DMA engine but includes only a limited number of byte counters for tracking a number of bytes that are sent or received by the DMA engine, where the byte counters may be used in shared counter or exclusive counter modes of operation. The method includes using rendezvous protocol, a source compute node deterministically sending a request to send (RTS) message with a single RTS descriptor using an exclusive injection counter to track both the RTS message and message data to be sent in association with the RTS message, to a destination compute node such that the RTS descriptor indicates to the destination compute node that the message data will be adaptively routed to the destination node. Using one DMA FIFO at the source compute node, the RTS descriptors are maintained for rendezvous messages destined for the destination compute node to ensure proper message data ordering thereat. Using a reception counter at a DMA engine, the destination compute node tracks reception of the RTS and associated message data and sends a clear to send (CTS) message to the source node in a rendezvous protocol form of a remote get to accept the RTS message and message data and processing the remote get (CTS) by the source compute node DMA engine to provide the message data to be sent.

  4. Sentinel-1 Mission Overview and Implementation Status

    NASA Astrophysics Data System (ADS)

    Davidson, M.; Attema, E.; Snoeij, P.; Levrini, G.

    2009-04-01

    Sentinel-1 is an imaging radar mission at C-band consisting of a constellation of two satellites aimed at providing continuity of all-weather day-and-night supply of imagery for user services. Special emphasis is placed on services identified in ESA's GMES service elements program and on projects funded by the European Union Framework Programmes. Three priorities (fast-track services) for the mission have been identified by user consultation working groups of the European Union: Marine Core Services, Land Monitoring and Emergency Services. These cover applications such as: - Monitoring sea ice zones and the arctic environment - Surveillance of marine environment - Monitoring land surface motion risks - Mapping of land surfaces: forest, water and soil, agriculture - Mapping in support of humanitarian aid in crisis situations. The Sentinel 1 space segment will be designed and built by an industrial consortium with Thales Alenia Space Italia as prime contractor and EADS Astrium GmbH as C-SAR instrument responsible. Data products from current and previous ESA missions including ERS-1, ERS-2 and Envisat missions form the basis for many of the pilot GMES services. Consequently Sentinel-1 data maintain data quality levels of the Agency‘s previous SAR missions in terms of spatial resolution, sensitivity, accuracy, polarization and wavelength. Nonetheless, the Sentinel-1 synthetic aperture radar (SAR) constellation represents a completely new approach to SAR mission design by ESA in direct response to the operational needs for SAR data expressed under the EU-ESA Global Monitoring for Environment and Security (GMES) programme. The Sentinel-1 constellation is expected to provide near daily coverage over Europe and Canada, global coverage all independent of weather with delivery of radar data within 1 hour of acquisition - all vast improvements with respect to the existing SAR systems. The continuity of C-band SAR data combined with the greatly improved data provision is

  5. Sentinel-1 Support in the GAMMA Software

    NASA Astrophysics Data System (ADS)

    Wegmuller, Urs; Werner, Charles; Stroozzi, Tazio; Wiesmann, Andreas; Frey, Othmar; Santoro, Maurizio

    2015-05-01

    First results using the new Sentinel-1 SAR look very promising but the special interferometric wide-swath data acquired in the TOPS mode makes InSAR processing challenging. The steep azimuth spectra ramp in each burst results in very stringent co-registration requirements. Combining the data of the individual bursts and sub-swaths into consistent mosaics requires careful “book-keeping” in the handling of the data and meta data and the large file sizes and high data throughputs require also a good performance. Considering these challenges good support from software is getting increasingly important. In this contribution we describe the Sentinel-1 support in the GAMMA Software, a high-level software package used by researchers, service providers and operational users in their SAR, InSAR and PSI work.

  6. The Sentinel-3 Mission Performance Center

    NASA Astrophysics Data System (ADS)

    Bruniquel, J.; Labroue, S.; Femenias, P.; Goryl, P.; Bourg, L.; Rouffi, F.; Smith, D.; Quartly, G.; Bonekamp, H.

    2015-12-01

    As part of the Sentinel-3 mission and in order to ensure the highest quality of products, ESA in cooperation with EUMETSAT has set up the Sentinel-3 Mission Performance Centre (S-3 MPC). This facility is part of the Payload Data Ground Segment (PDGS) and aims at controlling the quality of all generated products, from L0 to L2. The S-3 MPC is composed of a Coordinating Centre (CC), where the core infrastructure is hosted, which is in charge of the main routine activities (especially the quality control of data) and the overall service management. Expert Support Laboratories (ESLs) are involved in calibration and validation activities and provide specific assessment of the products (e.g., analysis of trends, ad hoc analysis of anomalies, etc.). The S-3 MPC interacts with the Processing Archiving Centres (PACs) and the Marine centre at EUMETSAT.

  7. Fish and wildlife species as sentinels of environmental endocrine disruption

    USGS Publications Warehouse

    Sheffield, S.R.; Matter, J.M.; Rattner, B.A.; Guiney, P.D.

    1998-01-01

    This chapter provides an overview of the history and criteria for use of captive and free-ranging fish and wildlife (amphibians, reptiles, birds, and mammals) species as sentinels of potential environmental endocrine disruption. Biochemical, behavioral, physiological, immunological, genetic, reproductive, developmental, and ecological correlates of endocrine disruption in these sentinels are presented and reviewed. In addition, data needs to promote better use of sentinel species in the assessment of endocrine disruption are discussed.

  8. Persistent Scatterer Interferometry Using SENTINEL-1 Data

    NASA Astrophysics Data System (ADS)

    Crosetto, M.; Monserrat, O.; Devanthéry, N.; Cuevas-González, M.; Barra, A.; Crippa, B.

    2016-06-01

    This paper is focused on deformation monitoring using a Persistent Scatterer Interferometry technique and the interferometric SAR data acquired by the Sentinel-1 satellite of the European Space Agency. The first part of the paper describes the procedure used to process and analyze Sentinel-1 interferometric SAR data. Two main approaches are described. The first one is a simplified Persistent Scatterer Interferometry approach that exploits two key properties of the Sentinel-1 data: the high coherence of the 12-day interferograms and the reduced orbital tube. The second approach is a full Persistent Scatterer Interferometry approach, where a more sophisticate data treatment is employed. The second part of the paper illustrates the results obtained with the two processing approaches. Two case studies are described. The first one concerns landslide detection and monitoring. In this case, the simplified Persistent Scatterer Interferometry approach was used. The second one regards the deformation monitoring of an urban area. In this case, a full Persistent Scatterer Interferometry approach was used.

  9. The GMES Sentinels Flight Operations Segment

    NASA Astrophysics Data System (ADS)

    Bargellini, P.; Emanuelli, P. P.; Shurmer, I.; Marchese, F.; Morales, J.; Moeller, H. L.

    2010-12-01

    The Global Monitoring for Environment and Security (GMES) programme main objective is to support Europe's goals regarding sustainable development and global governance of the environment by providing timely and quality data, information, services and knowledge. To achieve this objective, the GMES programme features a Space Segment component comprising five Sentinels mission families. Scheduled for launch in 2012 and 2013, Sentinels 1, 2 and 3 represent the first step in the deployment of the GMES Space Segment. They are regarded as operational missions and as such require a high degree of reliability and availability also at the level of the ground segment while minimising the operational effort associated to the routine mission phase. This paper will describe the Operational Concept applied across the 3 missions highlighting the innovative aspects, in particular the automated payload mission planning and handling of user emergency orders. In addition, the approach applied for supporting TT&C station scheduling and orbit maintenance activities will be presented. Finally, a summary of the overall ground segment will be provided and the Sentinels Flight Operations Segment specific facilities, based on extensive use of ESA/ESOC ground software infrastructure, presented.

  10. Sentinel lesions of primary CNS lymphoma.

    PubMed Central

    Alderson, L; Fetell, M R; Sisti, M; Hochberg, F; Cohen, M; Louis, D N

    1996-01-01

    Some patients ultimately diagnosed with primary CNS lymphoma (PCNSL) have transient symptomatic contrast enhancing lesions. These "sentinel lesions" of PCNSL recede spontaneously or with corticosteroid treatment and present an important diagnostic dilemma because they show variable, but non-diagnostic histopathological features. Four previously healthy, immunocompetent patients aged 49 to 58 years had contrast enhancing intraparenchymal brain lesions. Before biopsy, three of the four were treated with corticosteroids. Initial biopsies showed demyelination with axonal sparing in two, non-specific inflammation in one, and normal brain in one. Infiltrating lymphocytes predominantly expressed T cell markers with rare B cells. All four patients recovered within two to four weeks after the initial biopsy and imaging studies showed resolution of the lesions. The CSF was normal in three of the four patients tested; oligoclonal bands were absent in both of the two tested. After seven to 11 months, each patient developed new symptomatic lesions in a different region of the brain, biopsy of which showed a B cell PCNSL. The mechanism of spontaneous involution of sentinel lesions is not understood, but may represent host immunity against the tumour. Sentinel lesions of PCNSL should be considered in patients with contrast enhancing focal parenchymal lesions that show non-specific or demyelinative histopathological changes. Close clinical and radiographic follow up is essential if PCNSL is to be diagnosed early in such patients. Images PMID:8558135

  11. Remarks on Sentinel-1 Avionic SW Qualification

    NASA Astrophysics Data System (ADS)

    Candia, Sante; Pascucci, Dario

    2013-08-01

    The GMES Sentinel-1 Earth Radar Observatory, a projects co-funded by the European Union and the European Space Agency (ESA), is a constellation of C-band radar satellites. The satellites have been conceived to be a continuous and reliable source of C-band SAR imagery for operational application such as mapping of global landmasses, coastal zones and monitoring of shipping routes. ESA is responsible for the development of the Sentinel-1 satellites that are built by an industrial consortium headed by Thales Alenia Space Italy (TASI) as Prime Contractor. TAS-I is also directly responsible for the production of the Spacecraft Bus and the Avionic S/S including the Avionic SW (ASW), which is characterized by: · The high performances of its attitude and orbit determination and control function; · Scheduling of the imaging activity on position basis with high geo-location performances; · High on board autonomy both in routine and contingency situations. This paper is focused on the Sentinel-1 Avionic SW, which has currently been qualified by TAS-I for Flight. It covers both the SW architecture and development process areas: · Avionic SW context; · Avionic SW architecture; · Flexibility of PUS-based on-board autonomy and FDIR; · Validation and Qualification activities;

  12. Optimization of a gamma imaging probe for axillary sentinel lymph mapping

    NASA Astrophysics Data System (ADS)

    Georgiou, M.; Loudos, G.; Stratos, D.; Papadimitroulas, P.; Liakou, P.; Georgoulias, P.

    2012-09-01

    Sentinel lymph node (SLN) mapping is a technique for assessing whether early-stage invasive breast cancer has metastasized, thus determining prognosis and treatment options. SLN identification is achieved using the blue-dye and radioactive colloids techniques, which are sometimes combined with lymphoscintigraphy. Furthermore, intra-operative gamma acoustic probes, as well as gamma imaging probes are used during surgery. The purpose of this study is the construction of a gamma probe for sentinel lymph node imaging and its optimization in terms of sensitivity with respect to spatial resolution. The reference probe has small field of view (2.5 × 2.5 cm2) and is based on a position sensitive photomultiplier tube (PSPMT) coupled to a pixellated CsI(Tl) scintillator. Following experimental validation, we simulated the system using the GATE Monte Carlo toolkit (GATE v6.1) and modeled various collimator geometries, in order to evaluate their performance and propose the optimal configuration. The constraints of the proposed gamma imaging probe are i) sensitivity close to 2 cps/kBq and ii) spatial resolution equal to 6 mm at 2 cm source-to-collimator distance and ~ 10 mm at 5 cm. An integrated structure that achieves those requirements is a tungsten collimator with 2 × 2 mm2square holes, 16 mm thickness, 0.15 mm septa, where each CsI(Tl) 2 × 2 × 5 mm3 crystal pixel is placed inside the collimator.

  13. Modular sensor network node

    DOEpatents

    Davis, Jesse Harper Zehring; Stark, Jr., Douglas Paul; Kershaw, Christopher Patrick; Kyker, Ronald Dean

    2008-06-10

    A distributed wireless sensor network node is disclosed. The wireless sensor network node includes a plurality of sensor modules coupled to a system bus and configured to sense a parameter. The parameter may be an object, an event or any other parameter. The node collects data representative of the parameter. The node also includes a communication module coupled to the system bus and configured to allow the node to communicate with other nodes. The node also includes a processing module coupled to the system bus and adapted to receive the data from the sensor module and operable to analyze the data. The node also includes a power module connected to the system bus and operable to generate a regulated voltage.

  14. No Pass, No Drive?

    ERIC Educational Resources Information Center

    Zirkel, Perry A.

    2001-01-01

    Discusses basis for Kentucky appellate court decision that state's no-pass, no-drive statute did not violate due-process and equal-protection clauses of the Kentucky and federal constitutions, but did violate the federal Family Education Rights and Privacy Act, but nevertheless did not invalidate the statute. Explains why the decision is…

  15. PASS and Reading Achievement.

    ERIC Educational Resources Information Center

    Kirby, John R.

    Two studies examined the effectiveness of the PASS (Planning, Attention, Simultaneous, and Successive cognitive processes) theory of intelligence in predicting reading achievement scores of normally achieving children and distinguishing children with reading disabilities from normally achieving children. The first study dealt with predicting…

  16. Diffusion on a tree with stochastically gated nodes

    NASA Astrophysics Data System (ADS)

    Bressloff, Paul C.; Lawley, Sean D.

    2016-06-01

    We consider diffusion on a tree with nodes that randomly switch between allowing and prohibiting particles to pass. We find exact expressions for various splitting probabilities and mean first passage times for a single diffusing particle and show how the many parameters in the problem, such as the node gating statistics and tree topology, contribute to these exit statistics. We also consider a concentration of particles that can always pass through interior branch nodes and determine how an intermittent source at one end of the tree affects the flux at the other end. The latter problem is motivated by applications to insect respiration.

  17. Scalable Node Monitoring

    SciTech Connect

    Drotar, Alexander P.; Quinn, Erin E.; Sutherland, Landon D.

    2012-07-30

    Project description is: (1) Build a high performance computer; and (2) Create a tool to monitor node applications in Component Based Tool Framework (CBTF) using code from Lightweight Data Metric Service (LDMS). The importance of this project is that: (1) there is a need a scalable, parallel tool to monitor nodes on clusters; and (2) New LDMS plugins need to be able to be easily added to tool. CBTF stands for Component Based Tool Framework. It's scalable and adjusts to different topologies automatically. It uses MRNet (Multicast/Reduction Network) mechanism for information transport. CBTF is flexible and general enough to be used for any tool that needs to do a task on many nodes. Its components are reusable and 'EASILY' added to a new tool. There are three levels of CBTF: (1) frontend node - interacts with users; (2) filter nodes - filters or concatenates information from backend nodes; and (3) backend nodes - where the actual work of the tool is done. LDMS stands for lightweight data metric servies. It's a tool used for monitoring nodes. Ltool is the name of the tool we derived from LDMS. It's dynamically linked and includes the following components: Vmstat, Meminfo, Procinterrupts and more. It works by: Ltool command is run on the frontend node; Ltool collects information from the backend nodes; backend nodes send information to the filter nodes; and filter nodes concatenate information and send to a database on the front end node. Ltool is a useful tool when it comes to monitoring nodes on a cluster because the overhead involved with running the tool is not particularly high and it will automatically scale to any size cluster.

  18. Detection of melanoma metastases in resected human lymph nodes by noninvasive multispectral photoacoustic imaging.

    PubMed

    Langhout, Gerrit Cornelis; Grootendorst, Diederik Johannes; Nieweg, Omgo Edo; Wouters, Michel Wilhelmus Jacobus Maria; van der Hage, Jos Alexander; Jose, Jithin; van Boven, Hester; Steenbergen, Wiendelt; Manohar, Srirang; Ruers, Theodoor Jacques Marie

    2014-01-01

    Objective. Sentinel node biopsy in patients with cutaneous melanoma improves staging, provides prognostic information, and leads to an increased survival in node-positive patients. However, frozen section analysis of the sentinel node is not reliable and definitive histopathology evaluation requires days, preventing intraoperative decision-making and immediate therapy. Photoacoustic imaging can evaluate intact lymph nodes, but specificity can be hampered by other absorbers such as hemoglobin. Near infrared multispectral photoacoustic imaging is a new approach that has the potential to selectively detect melanin. The purpose of the present study is to examine the potential of multispectral photoacoustic imaging to identify melanoma metastasis in human lymph nodes. Methods. Three metastatic and nine benign lymph nodes from eight melanoma patients were scanned ex vivo using a Vevo LAZR(©) multispectral photoacoustic imager and were spectrally analyzed per pixel. The results were compared to histopathology as gold standard. Results. The nodal volume could be scanned within 20 minutes. An unmixing procedure was proposed to identify melanoma metastases with multispectral photoacoustic imaging. Ultrasound overlay enabled anatomical correlation. The penetration depth of the photoacoustic signal was up to 2 cm. Conclusion. Multispectral three-dimensional photoacoustic imaging allowed for selective identification of melanoma metastases in human lymph nodes. PMID:25028587

  19. Message passing in PUMA

    SciTech Connect

    Maccabe, A.B. |; Wheat, S.R.

    1993-05-01

    This paper provides an overview of the message passing primitives provided by PUMA (Performance-oriented, User-managed Messaging Architecture). Message passing in PUMA is based on the concept of a portal--an opening in the address space of an application process. Once an application process has established a portal, other processes can write values into the memory associated with the portal using a simple send operation. Because messages are written directly into the address space of the receiving process, there is not need to buffer messages in the PUMA kernel. This simplifies the design of the kernel, increasing its reliability and portability. Moreover, because messages are mapped directly into the address space of the application process, the application can manage the messages that it receives without needing direct support from the kernel.

  20. Potential of Sentinel Satellites for Schistosomiasis Monitoring

    NASA Astrophysics Data System (ADS)

    Li, C.-R.; Tang, L.-L.; Niu, H.-B.; Zhou, X.-N.; Liu, Z.-Y.; Ma, L.-L.; Zhou, Y.-S.

    2012-04-01

    densities is developed. The new model is validated with field data of Dongting Lake and the dynamic monitoring of schistosomiasis breeding in Dongting Lake region is presented. Finally, emphasis are placed on analyzing the potential of Sentinel satellites for schistosomiasis monitoring. The requirements of optical high resolution data on spectral resolution, spatial resolution, radiometric resolution/accuracy, as well as the requirements of synthetic aperture radar data on operation frequency, spatial resolution, polarization, radiometric accuracy, repeat cycle are presented and then compared with the parameters of Sentinel satellites. The parameters of Sentinel satellites are also compared with those of available remote satellites, such as Envisat, Landsat, whose data are being used for schistosomiasis monitoring. The application potential of Sentinel satellites for the schistosomiasis monitoring will be concluded in the end, which will benefit for the mission operation, model development, etc.

  1. Protocol for multiple node network

    NASA Technical Reports Server (NTRS)

    Kirkham, Harold (Inventor)

    1995-01-01

    The invention is a multiple interconnected network of intelligent message-repeating remote nodes which employs an antibody recognition message termination process performed by all remote nodes and a remote node polling process performed by other nodes which are master units controlling remote nodes in respective zones of the network assigned to respective master nodes. Each remote node repeats only those messages originated in the local zone, to provide isolation among the master nodes.

  2. Protocol for multiple node network

    NASA Technical Reports Server (NTRS)

    Kirkham, Harold (Inventor)

    1994-01-01

    The invention is a multiple interconnected network of intelligent message-repeating remote nodes which employs an antibody recognition message termination process performed by all remote nodes and a remote node polling process performed by other nodes which are master units controlling remote nodes in respective zones of the network assigned to respective master nodes. Each remote node repeats only those messages originated in the local zone, to provide isolation among the master nodes.

  3. Continuous monitoring of Greenland and Antarctic ice sheet velocities using Sentinel-1 SAR

    NASA Astrophysics Data System (ADS)

    Wuite, Jan; Nagler, Thomas; Hetzenecker, Markus; Blumthaler, Ursula; Rott, Helmut

    2016-04-01

    The Sentinel-1 mission has opened up new opportunities for regular monitoring of glacier and ice sheet velocities at high spatial and temporal resolution. From January to March 2015 the first ice sheet wide campaign on Greenland was completed resulting in a nearly complete ice velocity map. Later that year the first Antarctic campaign commenced covering most of the continent outside the polar gap. Besides ice sheet wide campaigns the Sentinel-1 acquisition plan allows for nearly continuous monitoring of the Greenland ice sheet margin and several key regions in Antarctica at 12-day intervals. This offers the unique capability of operational monitoring of short-term and seasonal velocity fluctuations as well as year-to-year variations for large regions. The quantity of data thus becoming available is unprecedented and requires new approaches for efficient processing and data analysis. Sentinel-1 carries a C-band synthetic aperture radar instrument providing high-resolution SAR images. Data is acquired across 250 km swaths at a spatial resolution of about 5 m x 20 m. We use repeat pass SLC images of Sentinel-1 acquired in Greenland and Antarctica to obtain ice flow velocity. We apply an iterative offset tracking approach, permitting to acquire the full range of velocities in a single swath while keeping the matching window at a minimum. We present the first ice sheet wide velocity maps of Greenland and Antarctica derived from Sentinel-1 SAR data acquired in 2015. Results are compared with ice flow velocity fields derived from other sensors, including ALOS PALSAR and the TerraSAR-X mission. Additionally we present velocity time series with 12-day intervals of major outlet glaciers of the ice sheets spanning well over a year. Velocity time-series production has been automated using a set of newly developed tools allowing for fast generation of (near real-time) center-line and gate velocity profiles that are stored in a database. Other functionalities include discharge

  4. The role of lymphoscintigraphy in the detection of lymph node drainage in melanoma.

    PubMed

    Uren, Roger F; Thompson, John F; Howman-Giles, Robert; Chung, David K V

    2006-04-01

    Lymphatic drainage of the skin cannot be predicted based on clinical guidelines developed more than 100 years ago. Approximately 30% of patients experience drainage from the skin to unexpected lymph node sites rather than those specified by these guidelines, and therefore these outdated assumptions should no longer be used to plan surgery. A possible survival benefit has been shown for the early detection and surgical removal of metastatic disease in the draining lymph nodes, and therefore, clinicians must obtain accurate lymphatic mapping for each patient who has intermediate thickness melanoma to plan appropriate surgical therapy. Lymphoscintigraphy can be used to accurately define the precise position of each true sentinel node in every patient, whether these nodes lie in a standard node field or in an unusual location. In this way, lymphoscintigraphy has a direct beneficial impact on the surgical management of patients who have melanoma. PMID:16632215

  5. HiSentinel: A Stratospheric Airship

    NASA Astrophysics Data System (ADS)

    Smith, I.; Lew, T.; Perry, W.; Smith, M.

    On December 4 2005 a team led by Southwest Research Institute SwRI successfully demonstrated powered flight of the HiSentinel stratospheric airship at an altitude of 74 000 feet The development team of Aerostar International the Air Force Research Laboratory AFRL and SwRI launched the airship from Roswell N M for a five-hour technology demonstration flight The 146-foot-long airship carried a 60-pound equipment pod and propulsion system when it became only the second airship in history to achieve powered flight in the stratosphere Designed for launch from remote sites these airships do not require large hangars or special facilities Unlike most stratospheric airship concepts HiSentinel is launched flaccid with the hull only partially inflated with helium As the airship rises the helium expands until it completely inflates the hull to the rigid aerodynamic shape required for operation A description of previous Team development results of the test flight plans for future development and applicability to future science missions will be presented

  6. Sentinel-2/MSI absolute calibration: first results

    NASA Astrophysics Data System (ADS)

    Lonjou, V.; Lachérade, S.; Fougnie, B.; Gamet, P.; Marcq, S.; Raynaud, J.-L.; Tremas, T.

    2015-10-01

    Sentinel-2 is an optical imaging mission devoted to the operational monitoring of land and coastal areas. It is developed in partnership between the European Commission and the European Space Agency. The Sentinel-2 mission is based on a satellites constellation deployed in polar sun-synchronous orbit. It will offer a unique combination of global coverage with a wide field of view (290km), a high revisit (5 days with two satellites), a high resolution (10m, 20m and 60m) and multi-spectral imagery (13 spectral bands in visible and shortwave infra-red domains). CNES is involved in the instrument commissioning in collaboration with ESA. This paper reviews all the techniques that will be used to insure an absolute calibration of the 13 spectral bands better than 5% (target 3%), and will present the first results if available. First, the nominal calibration technique, based on an on-board sun diffuser, is detailed. Then, we show how vicarious calibration methods based on acquisitions over natural targets (oceans, deserts, and Antarctica during winter) will be used to check and improve the accuracy of the absolute calibration coefficients. Finally, the verification scheme, exploiting photometer in-situ measurements over Lacrau plain, is described. A synthesis, including spectral coherence, inter-methods agreement and temporal evolution, will conclude the paper.

  7. Lakes as sentinels of climate change

    PubMed Central

    Adrian, Rita; O’Reilly, Catherine M.; Zagarese, Horacio; Baines, Stephen B.; Hessen, Dag O.; Keller, Wendel; Livingstone, David M.; Sommaruga, Ruben; Straile, Dietmar; Van Donk, Ellen; Weyhenmeyer, Gesa A.; Winder, Monika

    2010-01-01

    While there is a general sense that lakes can act as sentinels of climate change, their efficacy has not been thoroughly analyzed. We identified the key response variables within a lake that act as indicators of the effects of climate change on both the lake and the catchment. These variables reflect a wide range of physical, chemical, and biological responses to climate. However, the efficacy of the different indicators is affected by regional response to climate change, characteristics of the catchment, and lake mixing regimes. Thus, particular indicators or combinations of indicators are more effective for different lake types and geographic regions. The extraction of climate signals can be further complicated by the influence of other environmental changes, such as eutrophication or acidification, and the equivalent reverse phenomena, in addition to other land-use influences. In many cases, however, confounding factors can be addressed through analytical tools such as detrending or filtering. Lakes are effective sentinels for climate change because they are sensitive to climate, respond rapidly to change, and integrate information about changes in the catchment. PMID:20396409

  8. Use of sentinel mallards for epizootiologic studies of avian botulism

    USGS Publications Warehouse

    Rocke, T.E.; Brand, C.J.

    1994-01-01

    Captive-reared mallards (Anas platyrhynchos) were used as sentinels to study the epizootiology of avian botulism at the Sacramento National Wildlife Refuge, Willows, California (USA) from 1986 to 1989. Sentinel mallards were wing-clipped, and 40 to 50 birds were confined in 1.6-ha enclosures in 11 selected wetlands (pools). Enclosures were searched intensively three to four times weekly from July through October. Sick and dead wild and sentinel birds were collected, necropsied, and tested for type C botulism toxin. Botulism epizootics occurred in sentinel mallards in 1986, 1987, and 1989, but only a few isolated cases of botulism were detected in 1988. In most epizootics, botulism also was detected simultaneously in wild birds using the same pool outside the enclosure. Epizootics in sentinels were initiated and perpetuated in the absence of vertebrate carcasses. A sex-specific trend in the probability of intoxication was detected, with males contracting botulism at a higher rate than females. Daily mortality rates of sentinels during botulism epizootics ranged from 0.0006 to 0.0600, with a mean of 0.0190. These rates would result in the daily loss of 0.6 to 60 birds per thousand at risk. The use of sentinel birds provided an effective means of gathering site-specific epizootiologic data.

  9. Congress passes space year

    NASA Astrophysics Data System (ADS)

    The year 1992 will mark the 500th anniversary of Christopher Columbus' arrival in America and the 35th anniversary of both the International Geophysical Year and the launch of Sputnik. The U.S. Senate passed a joint resolution (S.J.Res. 177) on November 21 recommending that the President endorse an International Space Year (ISY) in 1992. A similar resolution introduced in the House of Representatives was incorporated into the conference report (House Report 99-379) accompanying the authorization bill for the National Aeronautics and Space Administration (NASA) and approved by both houses, also on November 21. As Eos went to press, the NASA authorization bill (H.R. 1714) awaited President Ronald Reagan's signature.

  10. Education Bill passes

    NASA Astrophysics Data System (ADS)

    Richman, Barbara T.

    On March 2 the U.S. House of Representatives passed a bill authorizing $425 million for science and mathematics education in fiscal 1984; the authorization is $350 million more than President Ronald Reagan requested in his budget proposal (Eos, February 15, 1983, p. 65).H.R. 1310 allocates $295 million to the Department of Education not only to improve precollege instruction in science and math, but to beef up foreign language training to aid in improving international communication among scientists. The bill also allots $130 million to the National Science Foundation for a variety of programs, the lion's share of which aims to upgrade research equipment at colleges and universities. It is hoped that industry will match the $100 million targeted for this program.

  11. Comparison between Ultrasound and Pathologic Status of Axillary Lymph Nodes in Clinically Node-negative Breast Cancer Patients.

    PubMed

    Bailey, Amanda; Layne, Ginger; Shahan, Cimmie; Zhang, Jianjun; Wen, Siji; Radis, Sarah; Richmond, Bryan; Partin, Jessica; Hazard, Hannah

    2015-09-01

    Sentinel lymph node biopsy (SLNB) is the standard of care for axillary staging in clinically node-negative breast cancer patients. Ultrasound (US) has shown promise when used to assess axillary lymph nodes preoperatively, thus aiding surgical decision making. We examined the correlation between preoperative US and SLNB results to further clarify the role of US in clinicopathologic staging of breast cancer when the axilla is clinically negative on physical examination. Our institutional cancer registry was used to identify clinically node-negative patients diagnosed with breast cancer from January 1, 2009 to December 31, 2012. Variables including age, body mass index, date of surgery, date of diagnosis, US results, US-directed biopsy results, SLNB results, and final pathology were recorded. Incomplete charts were excluded. In all, 249 patients were included. Sensitivity/specificity of US in the clinically negative axilla were 7.4 per cent and 91.8 per cent, respectively. The false-positive rate was 80 per cent, whereas the negative predictive value was 78 per cent. The effect of time from diagnosis/US to SLNB, interpreting radiologist, year in which US was performed, and body mass index were not statistically significant. US in the clinically node-negative patient, although useful when it leads to a positive needle biopsy result, is unlikely to replace SLNB owing to its low sensitivity and a high false-positive rate. Further prospective study into the role of US in the evaluation of the clinically negative axilla is warranted. PMID:26350662

  12. Error, Power, and Blind Sentinels: The Statistics of Seagrass Monitoring

    PubMed Central

    Schultz, Stewart T.; Kruschel, Claudia; Bakran-Petricioli, Tatjana; Petricioli, Donat

    2015-01-01

    We derive statistical properties of standard methods for monitoring of habitat cover worldwide, and criticize them in the context of mandated seagrass monitoring programs, as exemplified by Posidonia oceanica in the Mediterranean Sea. We report the novel result that cartographic methods with non-trivial classification errors are generally incapable of reliably detecting habitat cover losses less than about 30 to 50%, and the field labor required to increase their precision can be orders of magnitude higher than that required to estimate habitat loss directly in a field campaign. We derive a universal utility threshold of classification error in habitat maps that represents the minimum habitat map accuracy above which direct methods are superior. Widespread government reliance on blind-sentinel methods for monitoring seafloor can obscure the gradual and currently ongoing losses of benthic resources until the time has long passed for meaningful management intervention. We find two classes of methods with very high statistical power for detecting small habitat cover losses: 1) fixed-plot direct methods, which are over 100 times as efficient as direct random-plot methods in a variable habitat mosaic; and 2) remote methods with very low classification error such as geospatial underwater videography, which is an emerging, low-cost, non-destructive method for documenting small changes at millimeter visual resolution. General adoption of these methods and their further development will require a fundamental cultural change in conservation and management bodies towards the recognition and promotion of requirements of minimal statistical power and precision in the development of international goals for monitoring these valuable resources and the ecological services they provide. PMID:26367863

  13. Error, Power, and Blind Sentinels: The Statistics of Seagrass Monitoring.

    PubMed

    Schultz, Stewart T; Kruschel, Claudia; Bakran-Petricioli, Tatjana; Petricioli, Donat

    2015-01-01

    We derive statistical properties of standard methods for monitoring of habitat cover worldwide, and criticize them in the context of mandated seagrass monitoring programs, as exemplified by Posidonia oceanica in the Mediterranean Sea. We report the novel result that cartographic methods with non-trivial classification errors are generally incapable of reliably detecting habitat cover losses less than about 30 to 50%, and the field labor required to increase their precision can be orders of magnitude higher than that required to estimate habitat loss directly in a field campaign. We derive a universal utility threshold of classification error in habitat maps that represents the minimum habitat map accuracy above which direct methods are superior. Widespread government reliance on blind-sentinel methods for monitoring seafloor can obscure the gradual and currently ongoing losses of benthic resources until the time has long passed for meaningful management intervention. We find two classes of methods with very high statistical power for detecting small habitat cover losses: 1) fixed-plot direct methods, which are over 100 times as efficient as direct random-plot methods in a variable habitat mosaic; and 2) remote methods with very low classification error such as geospatial underwater videography, which is an emerging, low-cost, non-destructive method for documenting small changes at millimeter visual resolution. General adoption of these methods and their further development will require a fundamental cultural change in conservation and management bodies towards the recognition and promotion of requirements of minimal statistical power and precision in the development of international goals for monitoring these valuable resources and the ecological services they provide. PMID:26367863

  14. Animal Sentinels for Environmental and Public Health

    PubMed Central

    Reif, John S.

    2011-01-01

    Studies of the effects of environmental exposures on domestic and wild animals can corroborate or inform epidemiologic studies in humans. Animals may be sensitive indicators of environmental hazards and provide an early warning system for public health intervention, as exemplified by the iconic canary in the coal mine. This article illustrates the application of animal sentinel research to elucidate the effects of exposure to traditional and emerging contaminants on human health. Focusing on environmental issues at the forefront of current public health research, the article describes exposures to community air pollution, environmental tobacco smoke, and pesticides and associations with cancer, reproductive outcomes, and infectious diseases. Finally, it covers the role of marine mammals in monitoring the health of the oceans and humans. PMID:21563712

  15. Sentinels of the Sun: Forecasting Space Weather

    NASA Astrophysics Data System (ADS)

    Poland, Arthur I.

    2006-08-01

    The story of humanity's interest in space weather may go back to prehistoric times when people at high latitudes noticed the northern lights. Interest became more acute after the development of electrical technologies such as the telegraph, and certainly during World War II when shortwave radio communication came into practical use. Solar observing actually began to be supported by the military, with the observatory at Climax, Colorado being established to monitor the Sun during the war. With the advent of satellites and manned space travel to the Moon, space weather became a seriously funded endeavor both for basic research and forecasting. In the book, Sentinels of the Sun: Forecasting Space Weather, Barbara Poppe does an excellent job of telling this story for the nonprofessional. Moreover, as a professional who has studied space weather since before humans landed on the Moon, I found the book to be a very enjoyable read.

  16. Monitoring HIV through sentinel surveillance in Morocco.

    PubMed

    Elharti, E; Zidouh, A; Mengad, R; Bennani, O; Elaouad, R

    2002-01-01

    HIV sentinel surveillance was performed in five provinces of Morocco in 1993, expanded to 10 provinces in 1996. The activity was done by unlinked anonymous testing procedures. We analysed the data from 1993 to 1999. The groups studied were sexually transmitted infections, clinic attendees, pregnant women and patients with pulmonary tuberculosis. The results show that overall HIV prevalence rate over the whole period in 10 cities was 0.10% (45/44,233). Casablanca had a significantly high rate with 0.39% (10/2567). The patients with pulmonary tuberculosis displayed the highest prevalence with 0.36% (9/2530). These data confirm the assumption that the HIV epidemic is low in Morocco. However, the increase of HIV prevalence lately calls for reinforcing preventive measures to limit its spread. PMID:15330569

  17. Rugged: an operational, open-source solution for Sentinel-2 mapping

    NASA Astrophysics Data System (ADS)

    Maisonobe, Luc; Seyral, Jean; Prat, Guylaine; Guinet, Jonathan; Espesset, Aude

    2015-10-01

    When you map the entire Earth every 5 days with the aim of generating high-quality time series over land, there is no room for geometrical error: the algorithms have to be stable, reliable, and precise. Rugged, a new open-source library for pixel geolocation, is at the geometrical heart of the operational processing for Sentinel-2. Rugged performs sensor-to-terrain mapping taking into account ground Digital Elevation Models, Earth rotation with all its small irregularities, on-board sensor pixel individual lines-of-sight, spacecraft motion and attitude, and all significant physical effects. It provides direct and inverse location, i.e. it allows the accurate computation of which ground point is viewed from a specific pixel in a spacecraft instrument, and conversely which pixel will view a specified ground point. Direct and inverse location can be used to perform full ortho-rectification of images and correlation between sensors observing the same area. Implemented as an add-on for Orekit (Orbits Extrapolation KIT; a low-level space dynamics library), Rugged also offers the possibility of simulating satellite motion and attitude auxiliary data using Orekit's full orbit propagation capability. This is a considerable advantage for test data generation and mission simulation activities. Together with the Orfeo ToolBox (OTB) image processing library, Rugged provides the algorithmic core of Sentinel-2 Instrument Processing Facilities. The S2 complex viewing model - with 12 staggered push-broom detectors and 13 spectral bands - is built using Rugged objects, enabling the computation of rectification grids for mapping between cartographic and focal plane coordinates. These grids are passed to the OTB library for further image resampling, thus completing the ortho-rectification chain. Sentinel-2 stringent operational requirements to process several terabytes of data per week represented a tough challenge, though one that was well met by Rugged in terms of the robustness and

  18. Position determine system for lymph node relating breast cancer using a high- Tc SQUID

    NASA Astrophysics Data System (ADS)

    Tanaka, Saburo; Ota, Hajime; Kondo, Yoichi; Tamaki, Yasuhiro; Noguchi, Shinzaburo; Hasegawa, Masakatsu

    2002-03-01

    The performance of a lymph-node detection system used with a high- Tc superconducting quantum interference device was investigated. Ultra-small iron oxide particles containing 360 pg in weight of iron could be detected at a distance of 1 mm using Helmholtz coils. When a pair of angled field coils, which were of a more practical design, were used this value was increased to 2.8 ng. This value is still large enough to apply the technique for sentinel-node biopsy and lymphatic mapping.

  19. Image of tumor metastasis and inflammatory lymph node enlargement by contrast-enhanced ultrasonography

    PubMed Central

    Aoki, Takaya; Moriyasu, Fuminori; Yamamoto, Kei; Shimizu, Masafumi; Yamada, Masahiko; Imai, Yasuharu

    2011-01-01

    AIM: To compare the difference between tumor-induced lymph node enlargement and inflammation-induced lymph node enlargement by contrast-enhanced ultrasonography and pathological findings. METHODS: A model of tumor-induced lymph node metastasis was prepared by embedding a VX2 tumor into the hind paws of white rabbits. A model of inflammation-induced enlargement was prepared by injecting a suspension of Escherichia coli into separate hind paws of white rabbits. Then, a solution of Sonazoid™ (GE Healthcare, Oslo, Norway) was injected subcutaneously in the proximity of the lesion followed by contrast-enhanced ultrasonography of the enlarged popliteal lymph nodes. RESULTS: In the contrast-enhanced ultrasonography of the tumor-induced metastasis model, the sentinel lymph node was imaged. An area of filling defect was observed in that enlarged lymph node. In the histology examination, the area of filling defect corresponded to the metastatic lesion of the tumor. Contrast-enhanced ultrasonography of the model on inflammation-induced lymph node enlargement, and that of the acute inflammation model performed 3-7 d later, revealed dense staining that was comparatively uniform. The pathological findings showed acute lymphadenitis mainly due to infiltration of inflammatory cells. Contrast-enhanced ultrasonography that was performed 28 d post-infection in the acute inflammation model showed speckled staining. Inflammation-induced cell infiltration and fiberization, which are findings of chronic lymphadenitis, were seen in the pathological findings. CONCLUSION: Sentinel lymph node imaging was made possible by subcutaneous injection of Sonazoid™. Contrast-enhanced ultrasonography was suggested to be useful in differentiating tumor-induced enlargement and inflammation-induced enlargement of lymph nodes. PMID:22224178

  20. Nonimage-guided fine needle aspiration biopsy of palpable axillary lymph nodes in breast cancer patients.

    PubMed

    Marti, Jennifer L; Ayo, Diego; Levine, Pascale; Hernandez, Osvaldo; Rescigno, John; Axelrod, Deborah M

    2012-01-01

    We report the utility of office-based, nonimaged guided fine needle aspiration of palpable axillary lymph nodes in breast cancer patients. We examine the sensitivity and specificity of this procedure, and examine factors associated with a positive fine needle aspiration biopsy result. Although the utility of ultrasound-guided fine needle aspiration biopsy (FNA) of axillary lymph nodes is well established, there is little data on nonimage guided office-based FNA of palpable axillary lymphadenopathy. We investigated the sensitivity and specificity of nonimage-guided FNA of axillary lymphadenopathy in patients presenting with breast cancer, and report factors associated with a positive FNA result. Retrospective study of 94 patients who underwent office-based FNA of palpable axillary lymph nodes between 2004 and 2008 was conducted. Cytology results were compared with pathology after axillary sentinel node or lymph node dissection. Nonimage-guided axillary FNA was 86% sensitive and 100% specific. On univariate analysis, patients with positive FNA cytology had larger breast tumors (p = 0.007), more pathologic positive lymph nodes (p < 0.0001), and were more likely to present with a palpable breast mass (p = 0.006) or with radiographic lymphadenopathy (p = 0.002). FNA-positive patients had an increased presence of lymphovascular invasion (p = 0.001), higher stage of disease (p < 0.001), higher N stage (p < 0.0001), and higher rate of HER2/neu expression (p = 0.008). On multivariate analysis, radiographic lymphadenopathy (p = 0.03) and number of positive lymph nodes (p = 0.04) were associated with a positive FNA result. Nonimage-guided FNA of palpable axillary lymphadenopathy in breast cancer patients is an inexpensive, sensitive, and specific test. Prompt determination of lymph node positivity benefits select patients, permitting avoidance of axillary ultrasound, sentinel lymph node biopsy, or delay in receiving neoadjuvant therapy. This results in time and cost savings

  1. Processing Sentinel-2 data with ATCOR

    NASA Astrophysics Data System (ADS)

    Pflug, Bringfried; Makarau, Aliaksei; Richter, Rudolf

    2016-04-01

    Atmospheric correction of satellite images is necessary for many applications of remote sensing. Among them are applications for agriculture, forestry, land cover and land cover change, urban mapping, emergency and inland water. ATCOR is a widely used atmospheric correction tool which can process data of many optical satellite sensors, for instance Landsat, Sentinel-2, SPOT and RapidEye. ATCOR includes a terrain and adjacency correction of satellite images and several special algorithms like haze detection, haze correction, cirrus correction, de-shadowing and empirical methods for BRDF correction. The atmospheric correction tool ATCOR starts with an estimation of the vertical column Aerosol Optical Thickness (AOT550) at 550 nm. The mean uncertainty of the ATCOR-AOT550-estimation was estimated using Landsat and RapidEye data by direct comparison with sunphotometer data as a reference. For Landsat and RapidEye the uncertainty is ΔAOT550nm ≈ 0.03±0.02 for cloudless conditions with a cloud+haze fraction below 1%. Inclusion of cloudy and hazy satellite images into the analysis results in mean ΔAOT550nm ≈ 0.04±0.03 for both RapidEye and Landsat imagery. About 1/3 of the samples perform with the AOT uncertainty better than 0.02 and about 2/3 perform with AOT uncertainty better than 0.05. An accuracy of the retrieved surface reflectance of ±2% (for reflectance <10%) and ±4% reflectance units (for reflectance > 40%) can be achieved for flat terrain, and avoiding the specular and backscattering regions. ATCOR also supports the processing of Sentinel-2 data. First results of processing S2 data and a comparison with AERONET AOT values will be presented.

  2. Women with Breast Cancer Micrometastases in Their Sentinel Lymph Nodes May Not Need Axillary Dissection

    MedlinePlus

    ... and data sets for researchers Research by Cancer Type Find research about a specific cancer type Progress Annual Report ... Laws Careers Visitor Information Search Search Home Cancer Types Breast Cancer Research Breast Cancer Patient Breast Cancer Treatment Male Breast ...

  3. Sentinel nodes scintigraphy of the internal mammary chain in breast cancer

    NASA Astrophysics Data System (ADS)

    Paganelli, Giovanni; Viale, Giuseppe; Veronesi, Umberto

    2003-01-01

    Internal mammary chain lymphnodes (IMNs) were studied by lymphoscintigraphy and biopsy in 100 breast cancer patients to assess: (i) if a deep injection can visualize the IMNs in a high percentage of cases (ii) to determine how often IMNs are metastatic. More than 60% of patients showed IMNs uptake. Surgical sampling proved simple and risks insignificant. Five positive IMN cases migrated from NO/N1 to N3, prompting treatment modification. It is unclear whether this additional information can lead to better survival.

  4. Anal metastasis as the sentinel and isolated presentation of invasive ductal breast carcinoma.

    PubMed

    Rengifo, C; Titi, S; Walls, J

    2016-05-01

    Breast cancer currently affects 1 in 8 women in the UK during their lifetime. Common sites for breast cancer metastasis include the axillary lymph nodes, bones, lung, liver, brain, soft tissue and adrenal glands. There is well documented evidence detailing breast metastasis to the gastrointestinal tract but anal metastasis is exceptionally rare. We present the case of a 78-year-old woman with an anal metastasis as the sentinel and isolated presentation of an invasive ductal breast carcinoma. As advances in the treatment of breast cancer improve, and with an ageing and expanding population, there will be an increasing number of cancer survivors, and more of these unusual presentations may be encountered in the future. PMID:27087339

  5. 7. YOSEMITE VALLEY SHUTTLE BUS AT SENTINEL BRIDGE SHUTTLE BUS ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    7. YOSEMITE VALLEY SHUTTLE BUS AT SENTINEL BRIDGE SHUTTLE BUS AND PARKING LOT AREA. LOOKING WNW. GIS: N-37 40 36.2 / W-119 44 45.0 - Yosemite National Park Roads & Bridges, Yosemite Village, Mariposa County, CA

  6. 5. GLACIER POINT ROAD VIEW AT SENTINEL DOME PARKING AREA. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    5. GLACIER POINT ROAD VIEW AT SENTINEL DOME PARKING AREA. LOOKING E. GIS: N-37 42 43.8 / W-119 35 12.1 - Glacier Point Road, Between Chinquapin Flat & Glacier Point, Yosemite Village, Mariposa County, CA

  7. Copernicus POD Service: Orbit Determination of the Sentinel Satellites

    NASA Astrophysics Data System (ADS)

    Peter, Heike; Fernández, Jaime; Ayuga, Francisco; Féménias, Pierre

    2016-04-01

    The Copernicus POD (Precise Orbit Determination) Service is part of the Copernicus Processing Data Ground Segment (PDGS) of the Sentinel-1, -2 and -3 missions. A GMV-led consortium is operating the Copernicus POD Service being in charge of generating precise orbital products and auxiliary data files for their use as part of the processing chains of the respective Sentinel PDGS. Sentinel-1A was launched in April 2014 while Sentinel-2A was on June 2015 and both are routinely operated since then. Sentinel-3A is expected to be launched in February 2016 and Sentinel-1B is planned for spring 2016. Thus the CPOD Service will be operating three to four satellites simultaneously in spring 2016. The satellites of the Sentinel-1, -2, and -3 missions are all equipped with dual frequency high precision GPS receivers delivering the main observables for POD. Sentinel-3 satellites will additionally be equipped with a laser retro reflector for Satellite Laser Ranging and a receiver for DORIS tracking. All three types of observables (GPS, SLR and DORIS) will be used routinely for POD. The POD core of the CPOD Service is NAPEOS (Navigation Package for Earth Orbiting Satellites) the leading ESA/ESOC software for precise orbit determination. The careful selection of models and inputs is important to achieve the different but very demanding requirements in terms of orbital accuracy and timeliness for the Sentinel -1, -2 & -3 missions. The three missions require orbital products with various latencies from 30 minutes up to 20-30 days. The accuracy requirements are also different and partly very challenging, targeting 5 cm in 3D for Sentinel-1 and 2-3 cm in radial direction for Sentinel-3. Although the characteristics and the requirements are different for the three missions the same core POD setup is used to the largest extent possible. This strategy facilitates maintenance of the complex system of the CPOD Service. Updates in the dynamical modelling of the satellite orbits, e

  8. Animals as sentinels of human health hazards of environmental chemicals.

    PubMed Central

    van der Schalie, W H; Gardner, H S; Bantle, J A; De Rosa, C T; Finch, R A; Reif, J S; Reuter, R H; Backer, L C; Burger, J; Folmar, L C; Stokes, W S

    1999-01-01

    A workshop titled "Using Sentinel Species Data to Address the Potential Human Health Effects of Chemicals in the Environment," sponsored by the U.S. Army Center for Environmental Health Research, the National Center for Environmental Assessment of the EPA, and the Agency for Toxic Substances and Disease Registry, was held to consider the use of sentinel and surrogate animal species data for evaluating the potential human health effects of chemicals in the environment. The workshop took a broad view of the sentinel species concept, and included mammalian and nonmammalian species, companion animals, food animals, fish, amphibians, and other wildlife. Sentinel species data included observations of wild animals in field situations as well as experimental animal data. Workshop participants identified potential applications for sentinel species data derived from monitoring programs or serendipitous observations and explored the potential use of such information in human health hazard and risk assessments and for evaluating causes or mechanisms of effect. Although it is unlikely that sentinel species data will be used as the sole determinative factor in evaluating human health concerns, such data can be useful as for additional weight of evidence in a risk assessment, for providing early warning of situations requiring further study, or for monitoring the course of remedial activities. Attention was given to the factors impeding the application of sentinel species approaches and their acceptance in the scientific and regulatory communities. Workshop participants identified a number of critical research needs and opportunities for interagency collaboration that could help advance the use of sentinel species approaches. PMID:10090711

  9. [Ingenuity of Lymph Node Dissection Reduction for Minimally Invasive Lung Cancer Surgery].

    PubMed

    Konno, Hayato; Minamiya, Yoshihiro

    2016-07-01

    Systematic lymph node dissection in radical operation for lung cancer is recognized as an operative procedure which is accurate staging. In clinical early-stage non-small cell lung cancer (NSCLC), if the nodes are negative, complete mediastinal lymph node dissection might be omitted. Selective mediastinal dissection for clinico-surgical stage I NSCLC proved to be as effective as complete dissection. When lymph node metastasis was observed, segmentectomy was converted to lobectomy. Sentinel node( SN) identification is useful to determine the final indication of minimally invasive surgery by targeting the lymph nodes needed for intraoperative frozen section diagnosis. Many evidences suggest that prognosis of NSCLC with lymph node micrometastases (LNMM) is poor compared with those without LNMM. Evaluation of micrometastases of all dissected lymph nodes may be substituted by evaluating micrometastases of SNs. SN identification is important to the efficiency of micrometastases detection of intraoperative diagnosis. To perform a minimally invasive surgery, evaluation of lymph nodes micrometastases in SN is required. PMID:27440033

  10. Lymph node culture

    MedlinePlus

    Culture - lymph node ... or viruses grow. This process is called a culture. Sometimes, special stains are also used to identify specific cells or microorganisms before culture results are available. If needle aspiration does not ...

  11. Degree Distribution of Position-Dependent Ball-Passing Networks in Football Games

    NASA Astrophysics Data System (ADS)

    Narizuka, Takuma; Yamamoto, Ken; Yamazaki, Yoshihiro

    2015-08-01

    We propose a simple stochastic model describing the position-dependent ball-passing network in football (soccer) games. In this network, a player in a certain area in a divided field is a node, and a pass between two nodes corresponds to an edge. Our stochastic process model is characterized by the consecutive choice of a node depending on its intrinsic fitness. We derive an explicit expression for the degree distribution and find that the derived distribution reproduces that for actual data reasonably well.

  12. Human and Animal Sentinels for Shared Health Risks

    PubMed Central

    Rabinowitz, Peter; Scotch, Matthew; Conti, Lisa

    2009-01-01

    Summary The tracking of sentinel health events in humans in order to detect and manage disease risks facing a larger population is a well accepted technique applied to influenza, occupational conditions, and emerging infectious diseases. Similarly, animal health professionals routinely track disease events in sentinel animal colonies and sentinel herds. The use of animals as sentinels for human health threats, or of humans as sentinels for animal disease risk, dates back at least to the era when coal miners brought caged canaries into mines to provide early warning of toxic gases. Yet the full potential of linking animal and human health information to provide warning of such “shared risks” from environmental hazards has not been realized. Reasons appear to include the professional segregation of human and animal health communities, the separation of human and animal surveillance data, and evidence gaps in the linkages between human and animal responses to environmental health hazards. The One Health initiative and growing international collaboration in response to pandemic threats, coupled with development the fields of informatics and genomics, hold promise for improved sharing of knowledge about sentinel events in order to detect and reduce environmental health threats shared between species. PMID:20148187

  13. Assessment of the Geometric Quality of SENTINEL-2 Data

    NASA Astrophysics Data System (ADS)

    Pandžic, M.; Mihajlovic, D.; Pandžic, J.; Pfeifer, N.

    2016-06-01

    High resolution (10 m and 20 m) optical imagery satellite Sentinel-2 brings a new perspective to Earth observation. Its frequent revisit time enables monitoring the Earth surface with high reliability. Since Sentinel-2 data is provided free of charge by the European Space Agency, its mass use for variety of purposes is expected. Quality evaluation of Sentinel-2 data is thus necessary. Quality analysis in this experiment is based on comparison of Sentinel-2 imagery with reference data (orthophoto). From the possible set of features to compare (point features, texture lines, objects, etc.) line segments were chosen because visual analysis suggested that scale differences matter least for these features. The experiment was thus designed to compare long line segments (e.g. airstrips, roads, etc.) in both datasets as the most representative entities. Edge detection was applied to both images and corresponding edges were manually selected. The statistical parameter which describes the geometrical relation between different images (and between datasets in general) covering the same area is calculated as the distance between corresponding curves in two datasets. The experiment was conducted for two different test sites, Austria and Serbia. From 21 lines with a total length of ca. 120 km the average offset of 6.031 m (0.60 pixel of Sentinel-2) was obtained for Austria, whereas for Serbia the average offset of 12.720 m (1.27 pixel of Sentinel-2) was obtained out of 10 lines with a total length of ca. 38 km.

  14. Sentinel-2 radiometric image quality commissioning: first results

    NASA Astrophysics Data System (ADS)

    Lachérade, S.; Lonjou, V.; Farges, M.; Gamet, P.; Marcq, S.; Raynaud, J.-L.; Trémas, T.

    2015-10-01

    In partnership with the European Commission and in the frame of the Copernicus program, the European Space Agency (ESA) is developing the Sentinel-2 optical imaging mission devoted to the operational monitoring of land and coastal areas. The Sentinel-2 mission is based on a satellites constellation deployed in polar sun-synchronous orbit. Sentinel-2 offers a unique combination of global coverage with a wide field of view (290km), a high revisit (5 days with two satellites), a high spatial resolution (10m, 20m and 60m) and multi-spectral imagery (13 spectral bands in visible and shortwave infrared domains). The first satellite, Sentinel-2A, has been launched in June 2015. The Sentinel-2A Commissioning Phase starts immediately after the Launch and Early Orbit Phase and continues until the In-Orbit Commissioning Review which is planned three months after the launch. The Centre National d'Etudes Spatiales (CNES) supports ESA/ESTEC to insure the Calibration/Validation commissioning phase during the first three months in flight. This paper provides first an overview of the Sentinel-2 system and a description of the products delivered by the ground segment associated to the main radiometric specifications to achieve. Then the paper focuses on the preliminary radiometric results obtained during the in-flight commissioning phase. The radiometric methods and calibration sites used in the CNES image quality center to reach the specifications of the sensor are described. A status of the Sentinel-2A radiometric performances at the end of the first three months after the launch is presented. We will particularly address in this paper the results in term of absolute calibration, pixel to pixel relative sensitivity and MTF estimation.

  15. The Sentinel-4 Mission: Instrument Description and Atmospheric Composition Products

    NASA Astrophysics Data System (ADS)

    Veihelmann, B.; Ingmann, P.; Bazalgette Courreges-Lacoste, G.; Ahlers, B.; Stark, H.; Meijer, Y.

    2012-04-01

    Sentinel-4 (S4) is an operational satellite mission providing atmospheric composition data on a European basis with a fast (hourly) revisit time. The S4 mission is defined as an Ultra-violet Visible Near-infrared (UVN) spectrometer on the geostationary Meteosat Third Generation-Sounder (MTG-S) platforms together with utilisation of subsets of data from the MTG-Infra-Red Sounder onboard the same platforms and from the MTG-Flexible Combined Imager onboard the MTG-Imager (MTG-I) platforms. Key features of the S4/UVN instrument are the spectral range from 305 nm to 500 nm with a spectral resolution of 0.5 nm for the UV visible, and 750 nm to 770 nm with a spectral resolution of 0.12 nm in the Near-Infared, in combination with a low polarization sensitivity and a high radiometric accuracy (3% absolute, 0.05% relative spectral). The instrument shall observe Europe with a spatial sampling distance of 8 km at 45°N with a revisit time of 1 hour. The expected launch date of the first MTG-S platform is 2019, and the expected lifetime is 15 years (two S4/UVN instruments in sequence on two MTG-S platforms). The Sentinel-4 mission, together with Sentinel-5 and the Sentinel-5 Precursor missions, is part of the Global Monitoring for Environment and Security (GMES) space component. The primary objective of the Sentinel-4 mission is the observation of the diurnal cycle of tropospheric species in support of the air quality applications of GMES Atmosphere Services. The main target species of the Sentinel-4/UVN instrument are NO2, O3, HCHO, SO2, and aerosols. The presentation focuses on the Sentinel-4/UVN instrument and the atmospheric composition products.

  16. Iterative pass optimization of sequence data

    NASA Technical Reports Server (NTRS)

    Wheeler, Ward C.

    2003-01-01

    The problem of determining the minimum-cost hypothetical ancestral sequences for a given cladogram is known to be NP-complete. This "tree alignment" problem has motivated the considerable effort placed in multiple sequence alignment procedures. Wheeler in 1996 proposed a heuristic method, direct optimization, to calculate cladogram costs without the intervention of multiple sequence alignment. This method, though more efficient in time and more effective in cladogram length than many alignment-based procedures, greedily optimizes nodes based on descendent information only. In their proposal of an exact multiple alignment solution, Sankoff et al. in 1976 described a heuristic procedure--the iterative improvement method--to create alignments at internal nodes by solving a series of median problems. The combination of a three-sequence direct optimization with iterative improvement and a branch-length-based cladogram cost procedure, provides an algorithm that frequently results in superior (i.e., lower) cladogram costs. This iterative pass optimization is both computation and memory intensive, but economies can be made to reduce this burden. An example in arthropod systematics is discussed. c2003 The Willi Hennig Society. Published by Elsevier Science (USA). All rights reserved.

  17. Iterative pass optimization of sequence data.

    PubMed

    Wheeler, Ward C

    2003-06-01

    The problem of determining the minimum-cost hypothetical ancestral sequences for a given cladogram is known to be NP-complete. This "tree alignment" problem has motivated the considerable effort placed in multiple sequence alignment procedures. Wheeler in 1996 proposed a heuristic method, direct optimization, to calculate cladogram costs without the intervention of multiple sequence alignment. This method, though more efficient in time and more effective in cladogram length than many alignment-based procedures, greedily optimizes nodes based on descendent information only. In their proposal of an exact multiple alignment solution, Sankoff et al. in 1976 described a heuristic procedure--the iterative improvement method--to create alignments at internal nodes by solving a series of median problems. The combination of a three-sequence direct optimization with iterative improvement and a branch-length-based cladogram cost procedure, provides an algorithm that frequently results in superior (i.e., lower) cladogram costs. This iterative pass optimization is both computation and memory intensive, but economies can be made to reduce this burden. An example in arthropod systematics is discussed. PMID:12901382

  18. Annexin A8 is a novel molecular marker for detecting lymph node metastasis in oral squamous cell carcinoma

    PubMed Central

    Goda, Hiroyuki; Iwamoto, Kazuki; Tokuzen, Norihiko; Hamakawa, Hiroyuki

    2016-01-01

    Cervical lymph node metastasis is an important prognostic factor in oral squamous cell carcinoma (OSCC), but its accurate assessment after sentinel node biopsy or neck dissection is often limited to the histopathological examination of only one or two sections. Previous our study showed the usefulness of the reverse transcription loop-mediated isothermal amplification (RT-LAMP) targeting keratin 19 (KRT19) mRNA for the genetic detection of lymph node metastasis, but the sensitivity was insufficient. Here, we have attempted to identify novel molecular markers for OSCC cells in lymph nodes. We performed microarray analysis to identify genes overexpressed in 7 metastatic lymph nodes from OSCC patients, compared to 1 normal lymph node and 5 salivary glands from non-cancer patients. We then used real-time quantitative RT-PCR (qRT-PCR) and RT-LAMP to compare the expression of these genes in newly resected metastatic and normal lymph nodes. Of 4 genes identified by microarray analysis, annexin A8 (ANXA8) and desmoglein 3 mRNA were detected by qRT-PCR in metastatic lymph nodes but not in normal lymph nodes. Furthermore, ANXA8 mRNA expression was detected in all KRT19-negative metastatic lymph nodes. Both KRT19 and ANXA8 mRNA may be useful markers for detecting lymph node metastases in OSCC patients. PMID:26700817

  19. Partitioning networks into communities by message passing.

    PubMed

    Lai, Darong; Nardini, Christine; Lu, Hongtao

    2011-01-01

    Community structures are found to exist ubiquitously in a number of systems conveniently represented as complex networks. Partitioning networks into communities is thus important and crucial to both capture and simplify these systems' complexity. The prevalent and standard approach to meet this goal is related to the maximization of a quality function, modularity, which measures the goodness of a partition of a network into communities. However, it has recently been found that modularity maximization suffers from a resolution limit, which prevents its effectiveness and range of applications. Even when neglecting the resolution limit, methods designed for detecting communities in undirected networks cannot always be easily extended, and even less directly applied, to directed networks (for which specifically designed community detection methods are very limited). Furthermore, real-world networks are frequently found to possess hierarchical structure and the problem of revealing such type of structure is far from being addressed. In this paper, we propose a scheme that partitions networks into communities by electing community leaders via message passing between nodes. Using random walk on networks, this scheme derives an effective similarity measure between nodes, which is closely related to community memberships of nodes. Importantly, this approach can be applied to a very broad range of networks types. In fact, the successful validation of the proposed scheme on real and synthetic networks shows that this approach can effectively (i) address the problem of resolution limit and (ii) find communities in both directed and undirected networks within a unified framework, including revealing multiple levels of robust community partitions. PMID:21405752

  20. Satellites as Sentinels for Environment & Health

    NASA Technical Reports Server (NTRS)

    Maynard, Nancy G.

    2002-01-01

    Satellites as Sentinels for Environment & Health Remotely-sensed data and observations are providing powerful new tools for addressing human and ecosystem health by enabling improved understanding of the relationships and linkages between health-related environmental parameters and society as well as techniques for early warning of potential health problems. NASA Office of Earth Science Applications Program has established a new initiative to utilize its data, expertise, and observations of the Earth for public health applications. In this initiative, lead by Goddard Space Flight Center, remote sensing, geographic information systems, improved computational capabilities, and interdisciplinary research between the Earth and health science communities are being combined in rich collaborative efforts resulting in more rapid problem-solving, early warning, and prevention in global health issues. This presentation provides a number of recent examples of applications of advanced remote sensing and other technologies to health.and security issues related to the following: infectious and vector-borne diseases; urban, regional and global air pollution; African and Asian airborne dust; heat stress; UV radiation; water-borne disease; extreme weather; contaminant pathways (ocean, atmosphere, ice)

  1. Satellites as Sentinels for Climate and Health

    NASA Technical Reports Server (NTRS)

    Maynard, Nancy G.

    2003-01-01

    Remotely-sensed data and observations are providing powerful new tools for addressing climate and environment-related human health problems through increased capabilities for monitoring, risk mapping, and surveillance of parameters useful to such problems as vector- borne and infectious diseases, air and water quality,. harmful algal blooms, W radiation, contaminant and pathogen transport in air and water, and thermal stress. Remote sensing, geographic information systems (GIs), global positioning systems (GPS), improved computation capabilities, and interdisciplinary research between the Earth and health science communities, together with local knowledge, are being combined in rich collaborative efforts resulting in more rapid problem-solving, early warning, and prevention in global climate and health issues. These collaborative efforts are enabling increased understanding of the relationships among changes in temperature, rainfall, wind, soil moisture, solar radiation, vegetation, and the patterns of extreme weather events and health issues. This increased understanding and improved information and data sharing, in turn, empowers local health and environmental decision-makers to better predict climate-related health problems, decrease vulnerability, take preventive measures, and improve response actions. This paper provides a number of recent examples of how satellites - from their unique vantage point in space - can serve as sentinels for climate and health.

  2. Avian wildlife as sentinels of ecosystem health.

    PubMed

    Smits, Judit E G; Fernie, Kimberly J

    2013-05-01

    Birds have been widely used as sentinels of ecosystem health reflecting changes in habitat quality, increased incidence of disease, and exposure to and effects of chemical contaminants. Numerous studies addressing these issues focus on the breeding period, since hormonal, behavioural, reproductive, and developmental aspects of the health can be observed over a relatively short time-span. Many body systems within individuals are tightly integrated and interdependent, and can be affected by contaminant chemicals, disease, and habitat changes in complex ways. Animals higher in the food web will reflect cumulative effects of multiple stressors. Such features make birds ideal indicators for assessing environmental health in areas of environmental concern. Five case studies are presented, highlighting the use of different species which have provided insight into ecosystem sustainability, including (i) the consequences of anthropogenic disturbances of sagebrush habitat on the greater northern sage grouse Centrocercus urophasianus; (ii) the high prevalence of disease in very specific passerine species in the Canary Islands closely paralleling deterioration of formerly productive desert habitat and ensuing interspecific stressors; (iii) fractures, abnormal bone structure, and associated biochemical aberrations in nestling storks exposed to acidic tailings mud from a dyke rupture at an iron pyrite mine near Sevilla, Spain; (iv) newly presented data demonstrating biochemical changes in nestling peregrine falcons Falco peregrinus and associations with exposure to major chemical classes in the Great Lakes Basin of Canada; and (v) the variability in responses of tree swallows Tachycineta bicolor to contaminants, biological and meteorological challenges when breeding in the Athabasca oil sands. PMID:23260372

  3. The ACL Message Passing Library

    SciTech Connect

    Painter, J.; McCormick, P.; Krogh, M.; Hansen, C.; Colin de Verdiere, G.

    1995-09-01

    This paper presents the ACL (Advanced Computing Lab) Message Passing Library. It is a high throughput, low latency communications library, based on Thinking Machines Corp.`s CMMD, upon which message passing applications can be built. The library has been implemented on the Cray T3D, Thinking Machines CM-5, SGI workstations, and on top of PVM.

  4. Multiple pass laser amplifier system

    DOEpatents

    Brueckner, Keith A.; Jorna, Siebe; Moncur, N. Kent

    1977-01-01

    A laser amplification method for increasing the energy extraction efficiency from laser amplifiers while reducing the energy flux that passes through a flux limited system which includes apparatus for decomposing a linearly polarized light beam into multiple components, passing the components through an amplifier in delayed time sequence and recombining the amplified components into an in phase linearly polarized beam.

  5. Intrathymic lymph nodes in humans.

    PubMed

    Tanegashima, A; Ushiyama, I; Kikui, Y; Yamamoto, H

    2001-04-01

    An unusual lymph node exists in the centre of the human thymus. This lymph node, which we call an intrathymic lymph node (ITLN), possesses some interesting morphological characteristics. In ontogeny, this node seems to appear at the latter half of fetal period. The function of the ITLN is still unknown, but it is assumed that it may play a different role in the immune system than other peripheral lymph nodes by its characteristics. PMID:11327211

  6. Intrathymic lymph nodes in humans

    PubMed Central

    TANEGASHIMA, A.; USHIYAMA, I.; KIKUI, Y.; YAMAMOTO, H.

    2001-01-01

    An unusual lymph node exists in the centre of the human thymus. This lymph node, which we call an intrathymic lymph node (ITLN), possesses some interesting morphological characteristics. In ontogeny, this node seems to appear at the latter half of fetal period. The function of the ITLN is still unknown, but it is assumed that it may play a different role in the immune system than other peripheral lymph nodes by its characteristics. PMID:11327211

  7. Marine mammals as sentinel species for oceans and human health.

    PubMed

    Bossart, G D

    2011-05-01

    The long-term consequences of climate change and potential environmental degradation are likely to include aspects of disease emergence in marine plants and animals. In turn, these emerging diseases may have epizootic potential, zoonotic implications, and a complex pathogenesis involving other cofactors such as anthropogenic contaminant burden, genetics, and immunologic dysfunction. The concept of marine sentinel organisms provides one approach to evaluating aquatic ecosystem health. Such sentinels are barometers for current or potential negative impacts on individual- and population-level animal health. In turn, using marine sentinels permits better characterization and management of impacts that ultimately affect animal and human health associated with the oceans. Marine mammals are prime sentinel species because many species have long life spans, are long-term coastal residents, feed at a high trophic level, and have unique fat stores that can serve as depots for anthropogenic toxins. Marine mammals may be exposed to environmental stressors such as chemical pollutants, harmful algal biotoxins, and emerging or resurging pathogens. Since many marine mammal species share the coastal environment with humans and consume the same food, they also may serve as effective sentinels for public health problems. Finally, marine mammals are charismatic megafauna that typically stimulate an exaggerated human behavioral response and are thus more likely to be observed. PMID:21160025

  8. Sentinel Events in Ophthalmology: Experience from Hong Kong

    PubMed Central

    Mak, Shiu Ting

    2015-01-01

    Purpose. To arouse ophthalmologists' awareness in patient safety by reviewing sentinel events in Ophthalmology submitted to a web-based incident reporting system involving all public hospitals in Hong Kong. Methods. Sentinel events in Ophthalmology reported from November 2007 to October 2014 were identified and classified into different categories for further presentation and analysis. Key contributing factors attributing to the occurrence of the incidents were described. Suggestions aiming to prevent future occurrence of similar events were made. Relevant literature and case law were discussed. Results. Twelve sentinel events were included in this observational case series. They were classified into 4 main categories, namely “wrong eye” (5 cases, 41%), “wrong prescription” (3 cases, 25%), “wrong patient and surgery” (2 cases, 17%), and “retained surgical items” (2 cases, 17%). The key contributing factor leading to the occurrence of the incidents was largely human error. Increased staff awareness and proper time-out procedures were recommended to help prevent occurrence of these errors. Conclusion. Sentinel events in Ophthalmology do occur. Many of these incidents were attributed to human error. Surgeon's awareness and willingness to prevent occurrence of sentinel events are warranted. PMID:25821586

  9. Axillary ultrasound and fine-needle aspiration in preoperative staging of axillary lymph nodes in patients with invasive breast cancer*

    PubMed Central

    Rocha, Rafael Dahmer; Girardi, André Ricardo; Pinto, Renata Reis; de Freitas, Viviane Aguilera Rolim

    2015-01-01

    Objective To propose an algorithm to determine the necessity for ultrasonography-guided fine-needle aspiration (US-FNA) in preoperative axillary lymph node staging of patients with invasive breast cancer. Materials and Methods Prospective study developed at National Cancer Institute. The study sample included 100 female patients with breast cancer referred for axillary staging by US-FNA. Results The overall US-FNA sensitivity was set at 79.4%. The positive predictive value was calculated to be 100%, and the negative predictive value, 69.5%. The US-FNA sensitivity for lymph nodes with normal sonographic features was 0%, while for indeterminate lymph nodes it was 80% and, for suspicious lymph nodes, 90.5%. In the assessment of invasive breast tumors stages T1, T2 and T3, the sensitivity was respectively 69.6%, 83.7% and 100%. US-FNA could avoid sentinel node biopsy in 54% of cases. Conclusion Axillary ultrasonography should be included in the preoperative staging of all patients with invasive breast cancer. The addition of US-FNA in cases of lymph nodes suspicious for malignancy may prevent more than 50% of sentinel lymphadenectomies, significantly shortening the time interval to definitive therapy. PMID:26811550

  10. XQL and Proximal Nodes.

    ERIC Educational Resources Information Center

    Baeza-Yates, Ricardo; Navarro, Gonzalo

    2002-01-01

    Discussion of models that have been developed to structure text documents for information retrieval focuses on XML and its proposed query language XQL. Considers efficiency of the query engine and shows that an already existing model, Proximal Nodes, can be used as an efficient query engine behind an XQL front-end. (Author/LRW)

  11. Getting ready for the arrival of Sentinel data

    NASA Astrophysics Data System (ADS)

    Aschbacher, Josef; Milagro Perez, Maria Pilar

    2013-04-01

    The European Union (EU) and the European Space Agency (ESA) have developed the Global Monitoring for Environment and Security (GMES), being renamed to Copernicus, programme as Europe's answer to the vital need for joined-up data about our climate, environment and security. Through a unique combination of satellite, atmospheric and Earth-based monitoring systems, the initiative will provide new insight into the state of the land, sea and air, providing policymakers, scientists, businesses and the public with accurate and timely information. GMES capabilities include monitoring and forecasting of climatic change, flood risks, soil and coastal erosion, crop and fish resources, air pollution, greenhouse gases, iceberg distribution and snow cover, among others. To accomplish this, GMES has been divided into three main components: Space, In-situ and Services. The Space Component, led by ESA, comprises five types of new dedicated satellites called Sentinels. These missions carry a range of technologies, such as radar and multi-spectral imaging instruments for land, ocean and atmospheric monitoring. While the Sentinel satellites are currently being developed by ESA specifically to meet the needs of GMES, the Contributing Missions, operated by national agencies or commercial entities, are already providing a wealth of data for GMES services, and will continue to deliver complementary data after the Sentinels are in orbit. An integrated Ground Segment ensures access to Sentinels and Contributing Missions data. Access to Sentinel data is governed by the Sentinel data policy, which is part of a wider GMES data and information access policy. The Sentinel data policy envisages free and open access, subject to restrictions only if security or other European interests need to be preserved. As regards the Contributing Missions, the data policy of the mission owners will be respected for the purpose of providing data to GMES service users. The first in the fleet of dedicated

  12. Nodal lymph flow quantified with afferent vessel input function allows differentiation between normal and cancer-bearing nodes

    PubMed Central

    DSouza, Alisha V.; Elliott, Jonathan T.; Gunn, Jason R.; Barth, Richard J.; Samkoe, Kimberley S.; Tichauer, Kenneth M.; Pogue, Brian W.

    2015-01-01

    Morbidity and complexity involved in lymph node staging via surgical resection and biopsy could ideally be improved using node assay techniques that are non-invasive. While visible blue dyes are often used to locate the sentinel lymph nodes from draining lymphatic vessels near a tumor, they do not provide an in situ metric to evaluate presence of cancer. In this study, the transport kinetics of methylene blue were analyzed to determine the potential for better in situ information about metastatic involvement in the nodes. A rat model with cancer cells in the axillary lymph nodes was used, with methylene blue injection to image the fluorescence kinetics. The lymphatic flow from injection sites to nodes was imaged and the relative kinetics from feeding lymphatic ducts relative to lymph nodes was quantified. Large variability existed in raw fluorescence and transport patterns within each cohort resulting in no systematic difference between average nodal uptake in normal, sham control and cancer-bearing nodes. However, when the signal from the afferent lymph vessel fluorescence was used to normalize the signal of the lymph nodes, the high signal heterogeneity was reduced. Using a model, the lymph flow through the nodes (FLN) was estimated to be 1.49 ± 0.64 ml/g/min in normal nodes, 1.53 ± 0.45 ml/g/min in sham control nodes, and reduced to 0.50 ± 0.24 ml/g/min in cancer-cell injected nodes. This summarizes the significant difference (p = 0.0002) between cancer-free and cancer-bearing nodes in normalized flow. This process of normalized flow imaging could be used as an in situ tool to detect metastatic involvement in nodes. PMID:25909014

  13. Soil moisture retrieval from Sentinel-1 satellite data

    NASA Astrophysics Data System (ADS)

    Benninga, Harm-Jan; van der Velde, Rogier; Su, Zhongbo

    2016-04-01

    Reliable up-to-date information on the current water availability and models to evaluate management scenarios are indispensable for skilful water management. The Sentinel-1 radar satellite programme provides an opportunity to monitor water availability (as surface soil moisture) from space on an operational basis at unprecedented fine spatial and temporal resolutions. However, the influences of soil roughness and vegetation cover complicate the retrieval of soil moisture states from radar data. In this contribution, we investigate the sensitivity of Sentinel-1 radar backscatter to soil moisture states and vegetation conditions. The analyses are based on 105 Sentinel-1 images in the period from October 2014 to January 2016 covering the Twente region in the Netherlands. This area is almost flat and has a heterogeneous landscape, including agricultural (mainly grass, cereal and corn), forested and urban land covers. In-situ measurements at 5 cm depth collected from the Twente soil moisture monitoring network are used as reference. This network consists of twenty measurement stations (most of them at agricultural fields) distributed across an area of 50 km × 40 km. The Normalized Difference Vegetation Index (NDVI) derived from optical images is adopted as proxy to represent seasonal variability in vegetation conditions. The results from this sensitivity study provide insight into the potential capability of Sentinel-1 data for the estimation of soil moisture states and they will facilitate the further development of operational retrieval methods. An operationally applicable soil moisture retrieval method requires an algorithm that is usable without the need for area specific model calibration with detailed field information (regarding roughness and vegetation). Because it is not yet clear which method provides the most reliable soil moisture retrievals from Sentinel-1 data, multiple soil moisture retrieval methods will be studied in which the fine spatiotemporal

  14. Whole Proteome Analysis of Mouse Lymph Nodes in Cutaneous Anthrax

    PubMed Central

    Zhou, Weidong; Mueller, Claudius; Liotta, Lance; Popov, Serguei G.

    2014-01-01

    This study aimed to characterize a soluble proteome of popliteal lymph nodes during lymphadenitis induced by intradermal injection of Bacillus anthracis Sterne spores in mice using tandem LC-MS/MS and reverse-phase protein microarray with antibodies specific to epitopes of phosphorylated proteins. More than 380 proteins were detected in the normal intra-nodal lymph, while the infectious process resulted in the profound changes in the protein abundances and appearance of 297 unique proteins. These proteins belong to an array of processes reflecting response to wounding, inflammation and perturbations of hemostasis, innate immune response, coagulation and fibrinolysis, regulation of body fluid levels and vascular disturbance among others. Comparison of lymph and serum revealed 83 common proteins. Also, using 71 antibodies specific to total and phosphorylated forms of proteins we carried initial characterization of circulating lymph phosphoproteome which brought additional information regarding signaling pathways operating in the lymphatics. The results demonstrate that the proteome of intra-nodal lymph serves as a sensitive sentinel of the processes occurring within the lymph nodes during infection. The acute innate response of the lymph nodes to anthrax is accompanied by cellular damage and inflammation with a large number of up- and down-regulated proteins many of which are distinct from those detected in serum. MS data are available via ProteomeXchange with identifier PXD001342. PMID:25329596

  15. The lymph node neutrophil.

    PubMed

    Hampton, Henry R; Chtanova, Tatyana

    2016-04-01

    Secondary lymphoid organs provide a specialized microenvironment tailored to foster communication between cells of the innate and adaptive immune systems. These interactions allow immune cells to coordinate multilayered defense against pathogens. Until recently dendritic cells and macrophages were thought to comprise the main innate immune cell subsets responsible for delivering signals that drive the adaptive immune response, while the function of neutrophils was largely confined to the innate immune system. However, the discovery of neutrophils in lymph nodes has raised the question of whether neutrophils might play a more extensive role not only in innate immunity per se, but also in coordinating the interactions between innate and adaptive immune responses. In this review we discuss the mechanisms and consequences of neutrophil recruitment to lymph nodes and how this recruitment influences subsequent immune responses both in situ and at distant sites. PMID:27025975

  16. One node driving synchronisation

    NASA Astrophysics Data System (ADS)

    Wang, Chengwei; Grebogi, Celso; Baptista, Murilo S.

    2015-12-01

    Abrupt changes of behaviour in complex networks can be triggered by a single node. This work describes the dynamical fundamentals of how the behaviour of one node affects the whole network formed by coupled phase-oscillators with heterogeneous coupling strengths. The synchronisation of phase-oscillators is independent of the distribution of the natural frequencies, weakly depends on the network size, but highly depends on only one key oscillator whose ratio between its natural frequency in a rotating frame and its coupling strength is maximum. This result is based on a novel method to calculate the critical coupling strength with which the phase-oscillators emerge into frequency synchronisation. In addition, we put forward an analytical method to approximately calculate the phase-angles for the synchronous oscillators.

  17. One node driving synchronisation

    PubMed Central

    Wang, Chengwei; Grebogi, Celso; Baptista, Murilo S.

    2015-01-01

    Abrupt changes of behaviour in complex networks can be triggered by a single node. This work describes the dynamical fundamentals of how the behaviour of one node affects the whole network formed by coupled phase-oscillators with heterogeneous coupling strengths. The synchronisation of phase-oscillators is independent of the distribution of the natural frequencies, weakly depends on the network size, but highly depends on only one key oscillator whose ratio between its natural frequency in a rotating frame and its coupling strength is maximum. This result is based on a novel method to calculate the critical coupling strength with which the phase-oscillators emerge into frequency synchronisation. In addition, we put forward an analytical method to approximately calculate the phase-angles for the synchronous oscillators. PMID:26656718

  18. Direct message passing for hybrid Bayesian networks and performance analysis

    NASA Astrophysics Data System (ADS)

    Sun, Wei; Chang, K. C.

    2010-04-01

    Probabilistic inference for hybrid Bayesian networks, which involves both discrete and continuous variables, has been an important research topic over the recent years. This is not only because a number of efficient inference algorithms have been developed and used maturely for simple types of networks such as pure discrete model, but also for the practical needs that continuous variables are inevitable in modeling complex systems. Pearl's message passing algorithm provides a simple framework to compute posterior distribution by propagating messages between nodes and can provides exact answer for polytree models with pure discrete or continuous variables. In addition, applying Pearl's message passing to network with loops usually converges and results in good approximation. However, for hybrid model, there is a need of a general message passing algorithm between different types of variables. In this paper, we develop a method called Direct Message Passing (DMP) for exchanging messages between discrete and continuous variables. Based on Pearl's algorithm, we derive formulae to compute messages for variables in various dependence relationships encoded in conditional probability distributions. Mixture of Gaussian is used to represent continuous messages, with the number of mixture components up to the size of the joint state space of all discrete parents. For polytree Conditional Linear Gaussian (CLG) Bayesian network, DMP has the same computational requirements and can provide exact solution as the one obtained by the Junction Tree (JT) algorithm. However, while JT can only work for the CLG model, DMP can be applied for general nonlinear, non-Gaussian hybrid model to produce approximate solution using unscented transformation and loopy propagation. Furthermore, we can scale the algorithm by restricting the number of mixture components in the messages. Empirically, we found that the approximation errors are relatively small especially for nodes that are far away from

  19. Postlumpectomy Focal Brachytherapy for Simultaneous Treatment of Surgical Cavity and Draining Lymph Nodes

    SciTech Connect

    Hrycushko, Brian A.; Li Shihong; Shi Chengyu; Goins, Beth; Liu Yaxi; Phillips, William T.; Otto, Pamela M.; Bao, Ande

    2011-03-01

    Purpose: The primary objective was to investigate a novel focal brachytherapy technique using lipid nanoparticle (liposome)-carried {beta}-emitting radionuclides (rhenium-186 [{sup 186}Re]/rhenium-188 [{sup 188}Re]) to simultaneously treat the postlumpectomy surgical cavity and draining lymph nodes. Methods and Materials: Cumulative activity distributions in the lumpectomy cavity and lymph nodes were extrapolated from small animal imaging and human lymphoscintigraphy data. Absorbed dose calculations were performed for lumpectomy cavities with spherical and ellipsoidal shapes and lymph nodes within human subjects by use of the dose point kernel convolution method. Results: Dose calculations showed that therapeutic dose levels within the lumpectomy cavity wall can cover 2- and 5-mm depths for {sup 186}Re and {sup 188}Re liposomes, respectively. The absorbed doses at 1 cm sharply decreased to only 1.3% to 3.7% of the doses at 2 mm for {sup 186}Re liposomes and 5 mm for {sup 188}Re liposomes. Concurrently, the draining sentinel lymph nodes would receive a high focal therapeutic absorbed dose, whereas the average dose to 1 cm of surrounding tissue received less than 1% of that within the nodes. Conclusions: Focal brachytherapy by use of {sup 186}Re/{sup 188}Re liposomes was theoretically shown to be capable of simultaneously treating the lumpectomy cavity wall and draining sentinel lymph nodes with high absorbed doses while significantly lowering dose to surrounding healthy tissue. In turn, this allows for dose escalation to regions of higher probability of containing residual tumor cells after lumpectomy while reducing normal tissue complications.

  20. The use of mammals as sentinels for human exposure to toxic contaminants in the environment.

    PubMed Central

    O'Brien, D J; Kaneene, J B; Poppenga, R H

    1993-01-01

    The use of sentinel species shows the potential to bridge the gap between animal-based and human-based environmental health research. With regard to the assessment of environmental contamination, the use of the terms "indicator," "monitor," and "sentinel" has often been confusing and ambiguous. A set of definitions is proposed as a standard to rectify this situation. The advantages of the use of sentinel species are provided, as well as criteria for sentinel selection, based on species characteristics. The recent use of mammals as sentinels for human exposure to toxic environmental contaminants is reviewed. A tabulated review of mammals proposed as indicators or monitors is included, as these may act as a database for the selection of sentinel species for future research efforts. The complexity and subtlety of factors interacting between an organism and its environment make it imperative that one provide a focused definition of what one wants the sentinel to assess and for what particular aspect of human health. Some examples of how sentinels might be selected for particular research questions are provided. While the potential for sentinel use in the field of environmental health is enormous, future investigators need to choose sentinels carefully, based on well-defined research questions, and confine conclusions drawn to the particular problem the sentinel was chosen to assess. PMID:8319652

  1. Sentinel-5 Precursor: Global Monitoring of Atmospheric Trace Gases & Aerosols

    NASA Astrophysics Data System (ADS)

    Nett, Herbert; McMullan, Kevin; Ingmann, Paul

    2013-04-01

    ESA's Sentinel 5 Precursor (S5P) Mission will form part of the Space Component under the Global Monitoring for Environment and Security (GMES) initiative. It represents a preparatory project for the GMES atmospheric missions that comprise both a geo-stationary (Sentinel-4 / part of MTG-S payload) and a polar orbiting (Sentinel-5 / MetOp Second Generation) component. In view of the planned launch date of around 2020 for the first S-4 MTG-S and MetOp-SG spacecrafts, respectively, S5P (launch: mid 2015) shall minimize gaps in the availability of global atmospheric data products as provided by its predecessor missions SCIAMACHY (Envisat) and OMI (AURA). The satellite's single payload instrument, TROPOMI (TROPOspheric Monitoring Instrument), is jointly developed by The Netherlands and ESA. Covering spectral channels located in the UV, visible, near- and short-wave infrared it will measure various key species including stratospheric ozone, as well as NO2, SO2, CO, CH4, CH2O and aerosols, specifically in the lower Troposphere. The envisaged formation flying with NASA's Suomi NPP satellite will allow use of high spatial resolution imager data for enhanced cloud clearing of the observational data specifically in the short-wave infrared range. An outline of the Sentinel-5P mission objectives will be given. The status of development activities, covering Spacecraft and the Ground Segment will be presented.

  2. Red Fox as Sentinel for Blastomyces dermatitidis, Ontario, Canada

    PubMed Central

    Campbell, G. Douglas; Oesterle, Paul T.; Shirose, Lenny; McEwen, Beverly; Jardine, Claire M.

    2016-01-01

    Blastomyces dermatitidis, a fungus that can cause fatal infection in humans and other mammals, is not readily recoverable from soil, its environmental reservoir. Because of the red fox’s widespread distribution, susceptibility to B. dermatitidis, close association with soil, and well-defined home ranges, this animal has potential utility as a sentinel for this fungus. PMID:27314650

  3. Sentinel-3 Surface Topography Mission (STM) User Data Products

    NASA Astrophysics Data System (ADS)

    Nogueira Loddo, Carolina; Scharroo, Remko; Wilson, Hilary; Bonekamp, Hans

    2015-04-01

    The Sentinel-3 Surface Topography Mission (STM) is a key component of the Copernicus Sentinel-3 mission, set to revolutionise operational oceanography with a suite of advanced surface topography data products over ocean and sea sea-ice. In addition the STM will collect data over all earth surfaces providing improved monitoring of River and Lake stage heights and inputs to the development of Digital Elevation Models. Sentinel-3 will be the first Earth Observation mission to provide 100% SAR altimetry coverage and LRM will be maintained as a backup operating mode. In order to fully exploit the SAR capability, and validating the algorithms evolution, lower level data products (L1A, L1B and L1B-S) will be made available to the users, in addition to the level 2 products. This poster provides an overview of the S-3 STM data products that will be generated operationally within the Sentinel-3 Payload Data Ground Segment by the Instrument Processing Facilities (IPFs), and disseminated to the users.

  4. Red Fox as Sentinel for Blastomyces dermatitidis, Ontario, Canada.

    PubMed

    Nemeth, Nicole M; Campbell, G Douglas; Oesterle, Paul T; Shirose, Lenny; McEwen, Beverly; Jardine, Claire M

    2016-07-01

    Blastomyces dermatitidis, a fungus that can cause fatal infection in humans and other mammals, is not readily recoverable from soil, its environmental reservoir. Because of the red fox's widespread distribution, susceptibility to B. dermatitidis, close association with soil, and well-defined home ranges, this animal has potential utility as a sentinel for this fungus. PMID:27314650

  5. Solar Sentinels: Report of the Science and Technology Definition Team

    NASA Technical Reports Server (NTRS)

    2006-01-01

    The goal of NASA s Living With a Star (LWS) program is to develop the scientific understanding necessary to effectively address those aspects of the connected Sun Earth system that directly affect life and society. Along with the other elements of LWS, Solar Sentinels aims to discover, understand, and model the heliospheric initiation, propagation, and solar connection of those energetic phenomena that adversely affect space exploration and life and society here on Earth. The Solar Sentinels mission will address the following questions: (1) How, where, and under what circumstances are solar energetic particles (SEPs) accelerated to high energies and how do they propagate through the heliosphere? And (2) How are solar wind structures associated with these SEPs, like CMEs, shocks, and high-speed streams, initiated, propagate, evolve, and interact in the inner heliosphere? The Sentinels STDT recommends implementing this mission in two portions, one optimized for inner heliospheric in-situ measurements and the other for solar remote observations. Sentinels will greatly enhance the overall LWS science return.

  6. The Living With a Star (LWS) Sentinels Mission

    NASA Technical Reports Server (NTRS)

    Szabo, A.

    2005-01-01

    The Sentinels Mission, the heliospheric element of the NASA Living With a Star (LWS) program, is still rapidly evolving, especially as the Sentinels Science and Technology Definition Team is progressing with its work. With the Solar Dynamics Observatory, the solar component, and the Geospace elements taking a more finalized form, it becomes clearer what scientific and measurement objectives will be necessary to establish the solar-geospace connection in order to achieve the goals of the LWS program. Possible, early formulation designs of the Sentinels mission will be presented that includes the Inner Heliospheric Mappers, a four spacecraft mission to observe the inner heliosphere between 0.25 and 1.0 AUs along with a Far Side Sentinel that will perform remote solar observations from nearly the opposite side of the Sun. Moreover, the complementarity of the various planned international missions (e.g., ESA Solar Orbiter, and Beppi Colombo) along with NASA planetary projects (e.g., Mars program and MESSENGER) will be discussed and how they can form a coherent system. Finally, the importance of already available heliospheric data will be emphasized.

  7. ANIMALS AS SENTINELS OF HUMAN HEALTH HAZARDS OF ENVIRONMENTAL CHEMICALS

    EPA Science Inventory

    A workshop titled "Using Sentinel Species Data to Address the Potential Human Health Effects of Chemicals in the Environmnet," sponsored by the U.S. Army Center for Environmental Health Research, the National Center for Environmental Assessment of the EPA, and the Agency for Toxi...

  8. SENTINEL: A Multiple Engine Information Retrieval and Visualization System.

    ERIC Educational Resources Information Center

    Fox, Kevin L.; Frieder, Ophir; Knepper, Margaret M.; Snowberg, Eric J.

    1999-01-01

    Describes SENTINEL, a prototype information-retrieval system that is a fusion of multiple information-retrieval technologies, integrating n-grams, a vector space model, and a neural network training rule. Discusses three-dimensional visualization capability, precision and recall, mathematical representation of a document, query building, and…

  9. Formal Analysis of Message Passing

    NASA Astrophysics Data System (ADS)

    Siegel, Stephen F.; Gopalakrishnan, Ganesh

    The message passing paradigm underlies many important families of programs - for instance programs in the area of high performance computing that support science and engineering research. Unfortunately, very few formal methods researchers are involved in developing formal analysis tools and techniques for message passing programs. This paper summarizes research being done in our groups in support of this area, specifically with respect to the Message Passing Interface. We emphasize the need for specialized varieties of many familiar notions such as deadlock detection, race analysis, symmetry analysis, partial order reduction, static analysis and symbolic reasoning support. Since these issues are harbingers of those being faced in multicore programming, the time is ripe to build a critical mass of researchers working in this area.

  10. The Sentinel-4 Mission: Instrument Description and Atmospheric Composition Products

    NASA Astrophysics Data System (ADS)

    Veihelmann, Ben; Meijer, Yasjka; Ingmann, Paul; Koopman, Rob; Bazalgette Courrèges-Lacoste, Grégory; Stark, Hendrik

    2013-04-01

    The Sentinel-4 mission, together with Sentinel-5 and the Sentinel-5 Precursor missions, is part of the Global Monitoring for Environment and Security (GMES) space component covering the Earth's atmosphere. The primary objective of the Sentinel-4 mission is the observation of the diurnal cycle of tropospheric species in support of the air quality applications of GMES Atmosphere Services. The presentation focuses on the Sentinel-4/UVN instrument and its related Level-2 atmospheric composition products. The Sentinel-4 instrument is an Ultra-violet Visible Near infrared spectrometer (S4/UVN) which is embarked on the geostationary Meteosat Third Generation-Sounder (MTG-S) platforms. Key features of the S4/UVN instrument are the spectral range from 305 nm to 500 nm with a spectral resolution of 0.5 nm, and from 750 nm to 775 nm with a spectral resolution of 0.12 nm, in combination with a low polarization sensitivity and a high radiometric accuracy. The instrument shall observe Europe with a revisit time of one hour. The spatial sampling distance varies across the geographic coverage area and takes a value of 8 km at a reference location at 45˚ N. The expected launch date of the first MTG-S platform is 2019, and the expected lifetime is 15 years (two S4/UVN instruments in sequence on two MTG-S platforms). ESA will develop products based on the S4/UVN measurements for the key target species, which are NO2, O3, HCHO, SO2, aerosols, and CHOCHO, and for cloud and surface properties (mainly intermediate products). Also a synergetic O3 vertical profile product is foreseen based on observations from the S4/UVN and the MTG InfraRed Sounder (IRS) on-board the same platform. Synergetic aerosol and cloud products are foreseen based on observations from the S4/UVN and from the MTG Flexible Combined Imager (FCI) on-board the MTG-Imager (MTG-I) platform. Current pre-development studies are dedicated to a daily surface reflectance map product that treats the surface directionality as

  11. Management of Early Node-Positive Breast Cancer in Australia: A Multicentre Study.

    PubMed

    Gannan, Emma; Khoo, Jeremy; Nightingale, Sophie; Suhardja, Thomas Surya; Lippey, Jocelyn; Keane, Holly; Tan, Kian Jin; Clouston, David; Gorelik, Alexandra; Mann, Gregory Bruce

    2016-07-01

    To examine practice patterns for breast cancer patients with limited sentinel node (SN) disease in light of the ACOSOG Z0011 results. Retrospective analysis of patients with T1-2 breast cancer and positive sentinel lymph node biopsy (SLNB) admitted between January 2009 and December 2012. Patient demographics, tumor characteristics, and treatments were recorded. Eight hundred positive SLNBs were identified. A total of 452 (56.5%) proceeded to completion axillary lymph node dissection (cALND). cALND rate decreased from 65.1% to 49.7% from 2009-2010 to 2011-2012. cALND was performed for micrometastasis or isolated tumor cells in 39.3% in 2009-2010 and 22.2% in 2011-2012, whereas for macrometastases the rates were 83.1% and 68.6%, respectively. cALND rates diminished for both Z0011-eligible and -ineligible patients. The ACOSOG Z0011 trial presentation and publication coincided with a reduction in cALND for breast cancer with limited nodal disease. There appears equipoise regarding management of macrometastatic SN disease. PMID:27095381

  12. Management of the regional lymph nodes following breast-conservation therapy for early-stage breast cancer: an evolving paradigm.

    PubMed

    Warren, Laura E G; Punglia, Rinaa S; Wong, Julia S; Bellon, Jennifer R

    2014-11-15

    Radiation therapy to the breast following breast conservation surgery has been the standard of care since randomized trials demonstrated equivalent survival compared to mastectomy and improved local control and survival compared to breast conservation surgery alone. Recent controversies regarding adjuvant radiation therapy have included the potential role of additional radiation to the regional lymph nodes. This review summarizes the evolution of regional nodal management focusing on 2 topics: first, the changing paradigm with regard to surgical evaluation of the axilla; second, the role for regional lymph node irradiation and optimal design of treatment fields. Contemporary data reaffirm prior studies showing that complete axillary dissection may not provide additional benefit relative to sentinel lymph node biopsy in select patient populations. Preliminary data also suggest that directed nodal radiation therapy to the supraclavicular and internal mammary lymph nodes may prove beneficial; publication of several studies are awaited to confirm these results and to help define subgroups with the greatest likelihood of benefit. PMID:25585780

  13. Management of the Regional Lymph Nodes Following Breast-Conservation Therapy for Early-Stage Breast Cancer: An Evolving Paradigm

    SciTech Connect

    Warren, Laura E.G.; Punglia, Rinaa S.; Wong, Julia S.; Bellon, Jennifer R.

    2014-11-15

    Radiation therapy to the breast following breast conservation surgery has been the standard of care since randomized trials demonstrated equivalent survival compared to mastectomy and improved local control and survival compared to breast conservation surgery alone. Recent controversies regarding adjuvant radiation therapy have included the potential role of additional radiation to the regional lymph nodes. This review summarizes the evolution of regional nodal management focusing on 2 topics: first, the changing paradigm with regard to surgical evaluation of the axilla; second, the role for regional lymph node irradiation and optimal design of treatment fields. Contemporary data reaffirm prior studies showing that complete axillary dissection may not provide additional benefit relative to sentinel lymph node biopsy in select patient populations. Preliminary data also suggest that directed nodal radiation therapy to the supraclavicular and internal mammary lymph nodes may prove beneficial; publication of several studies are awaited to confirm these results and to help define subgroups with the greatest likelihood of benefit.

  14. Copernicus Sentinel-2 mission: products, algorithms and Cal/Val

    NASA Astrophysics Data System (ADS)

    Gascon, F.; Cadau, E.; Colin, O.; Hoersch, B.; Isola, C.; López Fernández, B.; Martimort, P.

    2014-09-01

    The Copernicus programme is a European initiative for the implementation of information services dealing with environment and security, based on observation data received from Earth Observation (EO) satellites and ground based information. Within this context, ESA is responsible in particular, for the implementation of the Copernicus Sentinel missions, feeding the Copernicus services with operational EO data. The Sentinel-2 optical high-resolution imaging mission will be devoted to the operational and systematic monitoring of land and coastal areas. To maximize the products suitability and readiness to downstream usage for the majority of applications, the Sentinel-2 Payload Data Ground Segment (PDGS) will systematically generate, archive and distribute Level-1C products, which will provide Top-of-Atmosphere (TOA) reflectance images, orthorectified using a global Digital Elevation Model (DEM) and projected on Universal Transverse Mercator (UTM) coordinate system. A Level-1B product will also be available for expert users, providing radiance images in sensor geometry together with an appended geometric model. Additionally, a complementary atmospheric correction and enhanced cloud screening algorithm is being prototyped. This processor will allow converting the Level-1C TOA reflectance image into Bottom-of-Atmosphere (BOA) reflectance. The processor will be provided as plug-in software of the Sentinel-2 Toolbox that will run on user side. During the operational phase, the Sentinel-2 Mission Performance Centre (MPC), as integrating part of the mission ground segment, will be in charge of ensuring that mission performances are met in terms of data quality through the calibration and validation activities.

  15. Sentinel-2: presentation of the CAL/VAL commissioning phase

    NASA Astrophysics Data System (ADS)

    Trémas, Thierry L.; Déchoz, Cécile; Lacherade, Sophie; Nosavan, Julien; Petrucci, Beatrice

    2015-10-01

    In partnership with the European Commission and in the frame of the Copernicus program, the European Space Agency (ESA) has developed the Sentinel-2 optical imaging mission devoted to the operational monitoring of land and coastal areas. The Sentinel-2 mission is based on a satellites constellation deployed in polar sun-synchronous orbits. Sentinel-2 will offer a unique combination of global coverage with a wide field of view (290km), a high revisit (5 days with two satellites), a high resolution (10m, 20m and 60m) and multi-spectral imagery (13 spectral bands in visible and shortwave infra-red domains). The first sentinel 2A has been launched on June 22nd, 2015, from Kourou, French Guyana. In this context, the Centre National d'Etudes Spatiales (CNES) supports ESA to insure the cal/val commissioning phase, for Image Quality aspects. This paper provides first, an overview of the Sentinel-2 system after the launch. Then the articles focuses on the means implemented and activated in CNES to perform the In Orbit Commissioning, the availability and performances of the different devices involved in the ground segment : the GPP in charge of producing the level 1 files, the "radiometric unit" that processes sensitivity parameters, the "geometric unit" in charge of fitting the images on a reference map, MACCS that will produce Level 2A files (computing reflectances at the Bottom of Atmosphere) and the TEC-S2 that will coordinate all the previous software and drive a database in which will be gather the incoming Level 0 files and the processed Level 1 files.

  16. Sentinel-1 InSAR processing: challenges and opportunities

    NASA Astrophysics Data System (ADS)

    Gonzalez, P. J.; Wright, T. J.; Hooper, A. J.; Walters, R. J.

    2015-12-01

    Radar interferometry has been successfully applied to measure ground deformation for over two decades. However, until now the data have been acquired on an ad-hoc basis. The recently-launched Sentinel-1 mission is the first to acquire global data systematically. Moreover, the default mode of radar acquisition for Sentinel-1 is the Terrain Observation by Progressive Scans (TOPS). In this new acquisition mode the steering of the radar antenna in the along-track direction induces that certain areas of the image are illuminated more than once and any surface deformation projects with a different line-of-sight unit vector across the scene. The consequence is that the scanning feature of Sentinel-1 TOPS mode make interpretation and analysis of differential interferograms more complex to process and interpret than the traditionally use of radar interferometry. However, at the same time, it also presents a number of opportunities such as redundant data, and increased sensitivity to along track displacement. Here, we present in detail the basic processing steps which differ from the traditional stripmap mode interferometry, and we illustrate some of the special features with actual results of significant deformation events: the 2014-2015 eruption of Pico do Fogo volcano and The 2015 Gorkha (Nepal) earthquake. Here, we show that the new Sentinel-1 TOPS-mode interferometry can be used to estimate relevant geophysical parameters, and most applications should not be affected by the new mode. The planned 20 year Sentinel-1 mission, provides access to a wealth of open and free high-quality radar data that should greatly improve our understanding of deformation phenomena in the future.

  17. Sentinel hospital surveillance of HIV infection in Quebec. Quebec Sentinel Hospital HIV-Seroprevalence Study Group.

    PubMed Central

    Alary, M; Joly, J R; Parent, R; Fauvel, M; Dionne, M

    1994-01-01

    OBJECTIVE: To measure the HIV seroprevalence rate in a surrogate sample of the general population in the province of Quebec, using a network of sentinel hospitals. DESIGN: Anonymous unlinked sentinel surveillance study. SETTING: Outpatient surgery units in 19 acute care hospitals throughout Quebec. PARTICIPANTS: All patients attending the outpatient surgery units from November 1990 to October 1992. A total of 61,547 plasma samples were obtained from leftover blood samples collected for cell counts. Fifty samples were excluded because of an insufficient amount of plasma and one because of an indeterminate result. INTERVENTION: HIV antibody testing with enzyme-linked immunosorbent assay; positive results confirmed with radioimmunoprecipitation assay. OUTCOME MEASURES: HIV antibody status, sex, year of birth and area of residence. RESULTS: The crude seroprevalence rate among the subjects aged 15 years or more was 0.4 per 1000 population (95% confidence interval [CI] 0.2 to 0.7) among the women and 3.6 per 1000 population (95% CI 2.8 to 4.4) among the men (p < 0.001). The rate after adjustment for age, sex and geographic distribution of the study population was 2.3 per 1000 population (95% CI 1.9 to 2.7). The seroprevalence rate among the male patients in the City of Montreal was much higher than the rates elsewhere in the province. It increased progressively during each of the four 6-month intervals of the study: 8.1, 8.7, 13.9 and 18.3 per 1000 respectively (chi 2 linear trend = 4.76; p = 0.029). No similar trends were observed outside Montreal for the male patients. There were too few seropositive female patients to draw any solid conclusion. CONCLUSIONS: Despite the possible drawbacks of a nonrandomized sampling scheme, this study suggests that in the male population the HIV seroprevalence rate is increasing in Montreal and is stable in all other areas of the province. The continued surveillance of HIV infection through anonymous unlinked studies is useful to

  18. Multi-pass light amplifier

    NASA Technical Reports Server (NTRS)

    Plaessmann, Henry (Inventor); Grossman, William M. (Inventor)

    1997-01-01

    A multiple-pass laser amplifier that uses optical focusing between subsequent passes through a single gain medium so that a reproducibly stable beam size is achieved within the gain region. A confocal resonator or White Cell resonator is provided, including two or three curvilinearly shaped mirrors facing each other along a resonator axis and an optical gain medium positioned on the resonator axis between the mirrors (confocal resonator) or adjacent to one of the mirrors (White Cell). In a first embodiment, two mirrors, which may include adjacent lenses, are configured so that a light beam passing through the gain medium and incident on the first mirror is reflected by that mirror toward the second mirror in a direction approximately parallel to the resonator axis. A light beam translator, such as an optical flat of transparent material, is positioned to translate this light beam by a controllable amount toward or away from the resonator axis for each pass of the light beam through the translator. The optical gain medium may be solid-state, liquid or gaseous medium and may be pumped longitudinally or transversely. In a second embodiment, first and second mirrors face a third mirror in a White Cell configuration, and the optical gain medium is positioned at or adjacent to one of the mirrors. Defocusing means and optical gain medium cooling means are optionally provided with either embodiment, to controllably defocus the light beam, to cool the optical gain medium and to suppress thermal lensing in the gain medium.

  19. Statistics of Epidemics in Networks by Passing Messages

    NASA Astrophysics Data System (ADS)

    Shrestha, Munik Kumar

    Epidemic processes are common out-of-equilibrium phenomena of broad interdisciplinary interest. In this thesis, we show how message-passing approach can be a helpful tool for simulating epidemic models in disordered medium like networks, and in particular for estimating the probability that a given node will become infectious at a particular time. The sort of dynamics we consider are stochastic, where randomness can arise from the stochastic events or from the randomness of network structures. As in belief propagation, variables or messages in message-passing approach are defined on the directed edges of a network. However, unlike belief propagation, where the posterior distributions are updated according to Bayes' rule, in message-passing approach we write differential equations for the messages over time. It takes correlations between neighboring nodes into account while preventing causal signals from backtracking to their immediate source, and thus avoids "echo chamber effects" where a pair of adjacent nodes each amplify the probability that the other is infectious. In our first results, we develop a message-passing approach to threshold models of behavior popular in sociology. These are models, first proposed by Granovetter, where individuals have to hear about a trend or behavior from some number of neighbors before adopting it themselves. In thermodynamic limit of large random networks, we provide an exact analytic scheme while calculating the time dependence of the probabilities and thus learning about the whole dynamics of bootstrap percolation, which is a simple model known in statistical physics for exhibiting discontinuous phase transition. As an application, we apply a similar model to financial networks, studying when bankruptcies spread due to the sudden devaluation of shared assets in overlapping portfolios. We predict that although diversification may be good for individual institutions, it can create dangerous systemic effects, and as a result

  20. LCP nanoparticle for tumor and lymph node metastasis imaging

    NASA Astrophysics Data System (ADS)

    Tseng, Yu-Cheng

    A lipid/calcium/phosphate (LCP) nanoparticle formulation (particle diameter ˜25 nm) has previously been developed to delivery siRNA with superior efficiency. In this work, 111In was formulated into LCP nanoparticles to form 111In-LCP for SPECT/CT imaging. With necessary modifications and improvements of the LCP core-washing and surface-coating methods, 111In-LCP grafted with polyethylene glycol exhibited reduced uptake by the mononuclear phagocytic system. SPECT/CT imaging supported performed biodistribution studies, showing clear tumor images with accumulation of 8% or higher injected dose per gram tissue (ID/g) in subcutaneous, human-H460, lung-cancer xenograft and mouse-4T1, breast cancer metastasis models. Both the liver and the spleen accumulated ˜20% ID/g. Accumulation in the tumor was limited by the enhanced permeation and retention effect and was independent of the presence of a targeting ligand. A surprisingly high accumulation in the lymph nodes (˜70% ID/g) was observed. In the 4T1 lymph node metastasis model, the capability of intravenously injected 111In-LCP to visualize the size-enlarged and tumor-loaded sentinel lymph node was demonstrated. By analyzing the SPECT/CT images taken at different time points, the PK profiles of 111In-LCP in the blood and major organs were determined. The results indicated that the decrement of 111In-LCP blood concentration was not due to excretion, but to tissue penetration, leading to lymphatic accumulation. Larger LCP (diameter ˜65 nm) nanoparticles were also prepared for the purpose of comparison. Results indicated that larger LCP achieved slightly lower accumulation in the tumor and lymph nodes, but much higher accumulation in the liver and spleen; thus, larger nanoparticles might not be favorable for imaging purposes. We also demonstrated that LCP with a diameter of ˜25 nm were better able to penetrate into tissues, travel in the lymphatic system and preferentially accumulate in the lymph nodes due to 1) small

  1. Imaging of Lymph Node Micrometastases Using an Oncolytic Herpes Virus and [18F]FEAU PET

    PubMed Central

    Brader, Peter; Kelly, Kaitlyn; Gang, Sheng; Shah, Jatin P.; Wong, Richard J.; Hricak, Hedvig; Blasberg, Ronald G.; Fong, Yuman; Gil, Ziv

    2009-01-01

    Background In patients with melanoma, knowledge of regional lymph node status provides important information on outlook. Since lymph node status can influence treatment, surgery for sentinel lymph node (SLN) biopsy became a standard staging procedure for these patients. Current imaging modalities have a limited sensitivity for detection of micrometastases in lymph nodes and, therefore, there is a need for a better technique that can accurately identify occult SLN metastases. Methodology/Principal Findings B16-F10 murine melanoma cells were infected with replication-competent herpes simplex virus (HSV) NV1023. The presence of tumor-targeting and reporter-expressing virus was assessed by [18F]-2′-fluoro-2′-deoxy-1-β-D-β-arabinofuranosyl-5-ethyluracil ([18F]FEAU) positron emission tomography (PET) and confirmed by histochemical assays. An animal foot pad model of melanoma lymph node metastasis was established. Mice received intratumoral injections of NV1023, and 48 hours later were imaged after i.v. injection of [18F]FEAU. NV1023 successfully infected and provided high levels of lacZ transgene expression in melanoma cells. Intratumoral injection of NV1023 resulted in viral trafficking to melanoma cells that had metastasized to popliteal and inguinal lymph nodes. Presence of virus-infected tumor cells was successfully imaged with [18F]FEAU-PET, that identified 8 out of 8 tumor-positive nodes. There was no overlap between radioactivity levels (lymph node to surrounding tissue ratio) of tumor-positive and tumor-negative lymph nodes. Conclusion/Significance A new approach for imaging SLN metastases using NV1023 and [18F]FEAU-PET was successful in a murine model. Similar studies could be translated to the clinic and improve the staging and management of patients with melanoma. PMID:19274083

  2. Copernicus Sentinel-1 Satellite And C-SAR Instrument

    NASA Astrophysics Data System (ADS)

    Panetti, Aniceto; Rostan, Friedhelm; L'Abbate, Michelangelo; Bruno, Claudio; Bauleo, Antonio; Catalano, Toni; Cotogni, Marco; Galvagni, Luigi; Pietropaolo, Andrea; Taini, Giacomo; Venditti, Paolo; Huchler, Markus; Torres, Ramon; Lokaas, Svein; Bibby, David

    2013-12-01

    The Copernicus Sentinel-1 Earth Radar Observatory, a mission funded by the European Union and developed by ESA, is a constellation of two C-band radar satellites. The satellites have been conceived to be a continuous and reliable source of C-band SAR imagery for operational applications such as mapping of global landmasses, coastal zones and monitoring of shipping routes. The Sentinel-1 satellites are built by an industrial consortium led by Thales Alenia Space Italia as Prime Contractor and with Astrium GmbH as SAR Instrument Contractor. The paper describes the general satellite architecture, the spacecraft subsystems, AIT flow and the satellite key performances. It provides also an overview on the C-SAR Instrument, its development status and pre- launch SAR performance prediction.

  3. New Sentinel-2 radiometric validation approaches (SEOM program)

    NASA Astrophysics Data System (ADS)

    Bruniquel, Véronique; Lamquin, Nicolas; Ferron, Stéphane; Govaerts, Yves; Woolliams, Emma; Dilo, Arta; Gascon, Ferran

    2016-04-01

    SEOM is an ESA program element whose one of the objectives aims at launching state-of-the-art studies for the scientific exploitation of operational missions. In the frame of this program, ESA awarded ACRI-ST and its partners Rayference and National Physical Laboratory (NPL) early 2016 for a R&D study on the development and intercomparison of algorithms for validating the Sentinel-2 radiometric L1 data products beyond the baseline algorithms used operationally in the frame of the S2 Mission Performance Centre. In this context, several algorithms have been proposed and are currently in development: The first one is based on the exploitation of Deep Convective Cloud (DCC) observations over ocean. This method allows an inter-band radiometry validation from the blue to the NIR (typically from B1 to B8a) from a reference band already validated for example with the well-known Rayleigh method. Due to their physical properties, DCCs appear from the remote sensing point of view to have bright and cold tops and they can be used as invariant targets to monitor the radiometric response degradation of reflective solar bands. The DCC approach is statistical i.e. the method shall be applied on a large number of measurements to derive reliable statistics and decrease the impact of the perturbing contributors. The second radiometric validation method is based on the exploitation of matchups combining both concomitant in-situ measurements and Sentinel-2 observations. The in-situ measurements which are used here correspond to measurements acquired in the frame of the RadCalNet networks. The validation is performed for the Sentinel-2 bands similar to the bands of the instruments equipping the validation site. The measurements from the Cimel CE 318 12-filters BRDF Sun Photometer installed recently in the Gobabeb site near the Namib desert are used for this method. A comprehensive verification of the calibration requires an analysis of MSI radiances over the full dynamic range

  4. Chronic toxicity of environmental contaminants: sentinels and biomarkers.

    PubMed Central

    LeBlanc, G A; Bain, L J

    1997-01-01

    Due to the use of a limited number of species and subchronic exposures, current ecological hazard assessment processes can underestimate the chronic toxicity of environmental contaminants resulting in adverse responses of sentinel species. Several incidences where sentinel species have responded to the effects of chronic exposure to ambient levels of environmental contaminants are discussed, including the development of neoplasia in fish, immunosuppression in marine mammals, pseudohermaphrodism in invertebrates, teratogenicity in amphibians, and aberrations in the sexual development of fish and reptiles. Biomarkers of chronic toxicity, including DNA mutations, alterations in specific protein and mRNA levels, and perturbations in metabolism, are presented. The incorporation of appropriate surrogate species and biomarkers of chronic toxicity into standard toxicity characterizations is proposed as a means of significantly refining the ecological hazard assessment process. PMID:9114278

  5. DInSAR time series generation within a cloud computing environment: from ERS to Sentinel-1 scenario

    NASA Astrophysics Data System (ADS)

    Casu, Francesco; Elefante, Stefano; Imperatore, Pasquale; Lanari, Riccardo; Manunta, Michele; Zinno, Ivana; Mathot, Emmanuel; Brito, Fabrice; Farres, Jordi; Lengert, Wolfgang

    2013-04-01

    requests of processing resources linked to disaster events. This work aims at presenting a parallel computational model for the widely used DInSAR algorithm named as Small BAseline Subset (SBAS), which has been implemented within the cloud computing environment provided by the ESA-CIOP platform. This activity has resulted in developing a scalable, unsupervised, portable, and widely accessible (through a web portal) parallel DInSAR computational tool. The activity has rewritten and developed the SBAS application algorithm within a parallel system environment, i.e., in a form that allows us to benefit from multiple processing units. This requires the devising a parallel version of the SBAS algorithm and its subsequent implementation, implying additional complexity in algorithm designing and an efficient multi processor programming, with the final aim of a parallel performance optimization. Although the presented algorithm has been designed to work with Sentinel-1 data, it can also process other satellite SAR data (ERS, ENVISAT, CSK, TSX, ALOS). Indeed, the performance analysis of the implemented SBAS parallel version has been tested on the full ASAR archive (64 acquisitions) acquired over the Napoli Bay, a volcanic and densely urbanized area in Southern Italy. The full processing - from the raw data download to the generation of DInSAR time series - has been carried out by engaging 4 nodes, each one with 2 cores and 16 GB of RAM, and has taken about 36 hours, with respect to about 135 hours of the sequential version. Extensive analysis on other test areas significant from DInSAR and geophysical viewpoint will be presented. Finally, preliminary performance evaluation of the presented approach within the Sentinel-1 scenario will be provided.

  6. Right paraesophageal lymph node metastasis

    PubMed Central

    Shaha, Ashok R.

    2016-01-01

    Zhang1 and colleagues at Peking Union Medical College in Beijing have described their experience of dissecting the right paraesophageal lymph node metastasis and correlated the overall incidence to important prognostic factors of the primary tumor and lateral nodal metastasis. Zhang et al., reviewed their experience of 246 patients who underwent surgery for papillary thyroid carcinoma. They noted right paraesophageal lymph node metastasis (RPELN) in 33 patients (13.4%). Their multivariate analysis showed higher incidence of RPELN metastasis in patients with right sided tumor, 3 of more lateral positive lymph nodes and positive right central compartment nodes. The prevalence of RPELN metastasis was significantly higher (26%) in recurrent cases. PMID:26610750

  7. GlobCurrent: Sentinel-3 Synergy in Action

    NASA Astrophysics Data System (ADS)

    Johannessen, J. A.; Chapron, B.; Collard, F.; Rio, M.-H.; Piolle, J.-F.; Quartly, G.; Shutler, J.; Escola, R.; Donlon, C.; Danielson, R.; Korosov, A.; Raj, R. P.; Kudryavtsev, V.; Roca, M.; Tournadre, J.; Larnicol, G.; Labroue, S.; Miller, P.; Nencioli, F.; Warren, M.; Hansen, M.

    2015-12-01

    The ESA Data User Element (DUE) funded GlobCurrent project (http://www.globcurrent.org) aims to: (i) advance the quantitative estimation of ocean surface currents from satellite sensor synergy; and (ii) demonstrate impact in user-led scientific, operational and commercial applications that, in turn, will improve and strengthen the uptake of satellite measurements. Today, a synergetic approach for quantitative analysis can build on high-resolution imaging radar and spectrometer data, infrared radiometer data and radar altimeter measurements. It will further integrate Sentinel-3 in combination with Sentinel-1 SAR data. From existing and past missions, it is often demonstrated that sharp gradients in the sea surface temperature (SST) field and the ocean surface chlorophyll-a distribution are spatially correlated with the sea surface roughness anomaly fields at small spatial scales, in the sub-mesocale (1-10 km) to the mesoscale (30-80 km). At the larger mesoscale range (>50 km), information derived from radar altimeters often depict the presence of coherent structures and eddies. The variability often appears largest in regions where the intense surface current regimes (>100 - 200 km) are found. These 2-dimensional structures manifested in the satellite observations represent evidence of the upper ocean (~100-200 m) dynamics. Whereas the quasi geostrophic assumption is valid for the upper ocean dynamics at the larger scale (>100 km), possible triggering mechanisms for the expressions at the mesoscale-to-sub-mesoscale may include spiraling tracers of inertial motion and the interaction of the wind-driven Ekman layer with the quasi-geostrophic current field. This latter, in turn, produces bands of downwelling (convergence) and upwelling (divergence) near fronts. A regular utilization of the sensor synergy approach with the combination of Sentinel-3 and Sentinel-1 will provide a highly valuable data set for further research and development to better relate the 2

  8. Sentinel-2 geometric image quality commissioning: first results

    NASA Astrophysics Data System (ADS)

    Languille, F.; Déchoz, C.; Gaudel, A.; Greslou, D.; de Lussy, F.; Trémas, T.; Poulain, V.

    2015-10-01

    In the frame of the Copernicus program of the European Comission, Sentinel-2 will offer multispectral highspatial- resolution optical images over global terrestrial surfaces. In cooperation with ESA, the Centre National d'Etudes Spatiales (CNES) is in charge of the image quality of the project, and will so ensure the CAL/VAL commissioning phase during the months following the launch. Sentinel-2 is a constellation of 2 satellites on a polar sun-synchronous orbit with a revisit time of 5 days (with both satellites), a high field of view - 290km, 13 spectral bands in visible and shortwave infrared, and high spatial resolution - 10m, 20m and 60m. The Sentinel-2 mission offers a global coverage over terrestrial surfaces. The satellites acquire systematically terrestrial surfaces under the same viewing conditions in order to have temporal images stacks. The first satellite has been launched in June 2015. Following the launch, the CAL/VAL commissioning phase will then last during 6 months for geometrical calibration. This paper first provides explanations about Sentinel-2 products delivered with geometric corrections. Then this paper details calibration sites, and the methods used for geometrical parameters calibration and presents the first linked results. The following topics are presented: viewing frames orientation assessment, focal plane mapping for all spectral bands, first results on geolocation assessment, and multispectral registration. There is a systematic images recalibration over a same reference which will be a set of S2 images produced during the 6 months of CAL/VAL. As it takes time to have all needed images, the geolocation performance with ground control points and the multitemporal performance are only first results and will be improved during the last phase of the CAL/VAL. So this paper mainly shows the system performances, the preliminary product performances and the way to perform them.

  9. SENTINEL-2 image quality and level 1 processing

    NASA Astrophysics Data System (ADS)

    Meygret, Aimé; Baillarin, Simon; Gascon, Ferran; Hillairet, Emmanuel; Dechoz, Cécile; Lacherade, Sophie; Martimort, Philippe; Spoto, François; Henry, Patrice; Duca, Riccardo

    2009-08-01

    In the framework of the Global Monitoring for Environment and Security (GMES) programme, the European Space Agency (ESA) in partnership with the European Commission (EC) is developing the SENTINEL-2 optical imaging mission devoted to the operational monitoring of land and coastal areas. The Sentinel-2 mission is based on a twin satellites configuration deployed in polar sun-synchronous orbit and is designed to offer a unique combination of systematic global coverage with a wide field of view (290km), a high revisit (5 days at equator with two satellites), a high spatial resolution (10m, 20m and 60 m) and multi-spectral imagery (13 bands in the visible and the short wave infrared spectrum). SENTINEL-2 will ensure data continuity of SPOT and LANDSAT multispectral sensors while accounting for future service evolution. This paper presents the main geometric and radiometric image quality requirements for the mission. The strong multi-spectral and multi-temporal registration requirements constrain the stability of the platform and the ground processing which will automatically refine the geometric physical model through correlation technics. The geolocation of the images will take benefits from a worldwide reference data set made of SENTINEL-2 data strips geolocated through a global space-triangulation. These processing are detailed through the description of the level 1C production which will provide users with ortho-images of Top of Atmosphere reflectances. The huge amount of data (1.4 Tbits per orbit) is also a challenge for the ground processing which will produce at level 1C all the acquired data. Finally we discuss the different geometric (line of sight, focal plane cartography, ...) and radiometric (relative and absolute camera sensitivity) in-flight calibration methods that will take advantage of the on-board sun diffuser and ground targets to answer the severe mission requirements.

  10. Compression in wearable sensor nodes: impacts of node topology.

    PubMed

    Imtiaz, Syed Anas; Casson, Alexander J; Rodriguez-Villegas, Esther

    2014-04-01

    Wearable sensor nodes monitoring the human body must operate autonomously for very long periods of time. Online and low-power data compression embedded within the sensor node is therefore essential to minimize data storage/transmission overheads. This paper presents a low-power MSP430 compressive sensing implementation for providing such compression, focusing particularly on the impact of the sensor node architecture on the compression performance. Compression power performance is compared for four different sensor nodes incorporating different strategies for wireless transmission/on-sensor-node local storage of data. The results demonstrate that the compressive sensing used must be designed differently depending on the underlying node topology, and that the compression strategy should not be guided only by signal processing considerations. We also provide a practical overview of state-of-the-art sensor node topologies. Wireless transmission of data is often preferred as it offers increased flexibility during use, but in general at the cost of increased power consumption. We demonstrate that wireless sensor nodes can highly benefit from the use of compressive sensing and now can achieve power consumptions comparable to, or better than, the use of local memory. PMID:24658233

  11. Sentinel species for in-situ genotoxic environmental monitoring

    SciTech Connect

    Lower, W.R.; Yanders, A.F. ); Sandhu, S.S. )

    1988-09-01

    A sentinel species has been defined in a draft report of the Society of Environmental Toxicology and Chemistry on Research Priorities in Environmental Risk as --- a plant, animal or microbe that can be used as an indicator of exposure or toxicity of a xenobiotic owing to its sensitivity, initial position in the community, likelihood of exposure, or abundance sufficient to allow statistical interpretation. Three organisms are presented here as candidates for sentinel species: the monocot Tradescantia (family Commelinacea, spiderwort), of which there are four strains or species used: Ictalurus nebulosus (family Ictaluraidae, the brown bullhead catfish); Peromyscus maniculatus, peromyscus leucopus (family Cricetidae, deer mouse, white-footed mouse) which occur over 85% of the continental US including Alaska, and with the two species sympatric over 60% of their geographic ranges. Candidates for consideration for sentinel bioassays presented here are the electron transport system of photosynthesis, sister chromatid exchange, micronuclei formation in animal cells, micronuclei formation in pollen mother cells, tumor formation, hemoglobin synthesis, nucleic acid and protein adduct formation and cytochrome P-450 dependent monoxygenase induction.

  12. Towards Insar Everywhere, all the Time, with SENTINEL-1

    NASA Astrophysics Data System (ADS)

    Li, Zhenhong; Wright, Tim; Hooper, Andrew; Crippa, Paola; Gonzalez, Pablo; Walters, Richard; Elliott, John; Ebmeier, Susanna; Hatton, Emma; Parsons, Barry

    2016-06-01

    Sentinel-1A was launched in April 2014, and has been collecting data routinely over more than one year. Sentinel-1B is set for launch on 22 April 2016. The Sentinel-1 constellation has several advantages over previous radar missions for InSAR applications: (1) Data are being acquired systematically for tectonic and volcanic areas, (2) Images cover a wide footprint, 250 km from near to far range in Interferometric Wide Swath (TOPS) mode, (3) Small perpendicular and temporal baselines greatly improve interferometric coherence at C-band, (4) Data are freely available to all users, (5) The mission is planned to be operational for 20 years, with 1C and 1D planned for future launches. These features enable us to map geological processes occurring in any place at anytime using InSAR. We will review progress within COMET towards our ultimate goal of building a fully-automated processing system that provides deformation results and derived products to the wide InSAR and Geophysics communities. In addition to high-resolution-ECMWFbased atmospheric correction model, we will show results of a systematic analysis of interferometric coherence in tectonic and volcanic areas, and discuss the future goals and timeline for the COMET InSAR automated processing system.

  13. Land Cover Mapping Using SENTINEL-1 SAR Data

    NASA Astrophysics Data System (ADS)

    Abdikan, S.; Sanli, F. B.; Ustuner, M.; Calò, F.

    2016-06-01

    In this paper, the potential of using free-of-charge Sentinel-1 Synthetic Aperture Radar (SAR) imagery for land cover mapping in urban areas is investigated. To this aim, we use dual-pol (VV+VH) Interferometric Wide swath mode (IW) data collected on September 16th 2015 along descending orbit over Istanbul megacity, Turkey. Data have been calibrated, terrain corrected, and filtered by a 5x5 kernel using gamma map approach. During terrain correction by using a 25m resolution SRTM DEM, SAR data has been resampled resulting into a pixel spacing of 20m. Support Vector Machines (SVM) method has been implemented as a supervised pixel based image classification to classify the dataset. During the classification, different scenarios have been applied to find out the performance of Sentinel-1 data. The training and test data have been collected from high resolution image of Google Earth. Different combinations of VV and VH polarizations have been analysed and the resulting classified images have been assessed using overall classification accuracy and Kappa coefficient. Results demonstrate that, combining opportunely dual polarization data, the overall accuracy increases up to 93.28% against 73.85% and 70.74% of using individual polarization VV and VH, respectively. Our preliminary analysis points out that dual polarimetric Sentinel-1SAR data can be effectively exploited for producing accurate land cover maps, with relevant advantages for urban planning and management of large cities.

  14. Sentinel surveillance for travellers' diarrhoea in primary care

    PubMed Central

    Northey, Gemma; Evans, Meirion R; Sarvotham, Tinnu S; Thomas, Daniel R; Howard, Tony J

    2007-01-01

    Background Travellers' diarrhoea is the most common health problem among international travellers and much of the burden falls on general practitioners. We assessed whether sentinel surveillance based in primary care could be used to monitor changes in the epidemiology of travellers' diarrhoea. Methods A sentinel surveillance scheme of 30 volunteer general practices distributed throughout Wales provides weekly reports of consultations for eight infectious diseases to the national Communicable Disease Surveillance Centre. Travellers' diarrhoea was introduced as a new reportable infection in July 2002. Results Between 1 July 2002 and 31 March 2005 there were 90 reports of travellers' diarrhoea. The mean annual consultation rate was 15.2 per 100,000 population (95% confidence interval: 12.2–18.7), with the highest rates in summer, in people aged 15–24 years, and in travellers to Southern Europe. A higher proportion of travellers than expected had visited destinations outside Europe and North America when compared to the proportion of all United Kingdom travellers visiting these destinations (38% vs. 11%; Chi2 = 53.3, p < 0.0001). Conclusion Sentinel surveillance has the potential to monitor secular trends in travellers' diarrhoea and to help characterise population groups or travel destinations associated with higher risk. PMID:17986342

  15. Multi-pass light amplifier

    NASA Technical Reports Server (NTRS)

    Plaessmann, Henry (Inventor); Grossman, William M. (Inventor); Olson, Todd E. (Inventor)

    1996-01-01

    A multiple-pass laser amplifier that uses optical focusing between subsequent passes through a single gain medium so that a reproducibly stable beam size is achieved within the gain region. A resonator or a White Cell cavity is provided, including two or more mirrors (planar or curvilinearly shaped) facing each other along a resonator axis and an optical gain medium positioned on a resonator axis between the mirrors or adjacent to one of the mirrors. In a first embodiment, two curvilinear mirrors, which may include adjacent lenses, are configured so that a light beam passing through the gain medium and incident on the first mirror is reflected by that mirror toward the second mirror in a direction approximately parallel to the resonator axis. A light beam translator, such as an optical flat of transparent material, is positioned to translate this light beam by a controllable amount toward or away from the resonator axis for each pass of the light beam through the translator. A second embodiment uses two curvilinear mirrors and one planar mirror, with a gain medium positioned in the optical path between each curvilinear mirror and the planar mirror. A third embodiment uses two curvilinear mirrors and two planar mirrors, with a gain medium positioned adjacent to a planar mirror. A fourth embodiment uses a curvilinear mirror and three planar mirrors, with a gain medium positioned adjacent to a planar mirror. A fourth embodiment uses four planar mirrors and a focusing lens system, with a gain medium positioned between the four mirrors. A fifth embodiment uses first and second planar mirrors, a focusing lens system and a third mirror that may be planar or curvilinear, with a gain medium positioned adjacent to the third mirror. A sixth embodiment uses two planar mirrors and a curvilinear mirror and a fourth mirror that may be planar or curvilinear, with a gain medium positioned adjacent to the fourth mirror. In a seventh embodiment, first and second mirrors face a third

  16. Ice/water Classification of Sentinel-1 Images

    NASA Astrophysics Data System (ADS)

    Korosov, Anton; Zakhvatkina, Natalia; Muckenhuber, Stefan

    2015-04-01

    Sea Ice monitoring and classification relies heavily on synthetic aperture radar (SAR) imagery. These sensors record data either only at horizontal polarization (RADARSAT-1) or vertically polarized (ERS-1 and ERS-2) or at dual polarization (Radarsat-2, Sentinel-1). Many algorithms have been developed to discriminate sea ice types and open water using single polarization images. Ice type classification, however, is still ambiguous in some cases. Sea ice classification in single polarization SAR images has been attempted using various methods since the beginning of the ERS programme. The robust classification using only SAR images that can provide useful results under varying sea ice types and open water tend to be not generally applicable in operational regime. The new generation SAR satellites have capability to deliver images in several polarizations. This gives improved possibility to develop sea ice classification algorithms. In this study we use data from Sentinel-1 at dual-polarization, i.e. HH (horizontally transmitted and horizontally received) and HV (horizontally transmitted, vertically received). This mode assembles wide SAR image from several narrower SAR beams, resulting to an image of 500 x 500 km with 50 m resolution. A non-linear scheme for classification of Sentinel-1 data has been developed. The processing allows to identify three classes: ice, calm water and rough water at 1 km spatial resolution. The raw sigma0 data in HH and HV polarization are first corrected for thermal and random noise by extracting the background thermal noise level and smoothing the image with several filters. At the next step texture characteristics are computed in a moving window using a Gray Level Co-occurence Matrix (GLCM). A neural network is applied at the last step for processing array of the most informative texture characteristics and ice/water classification. The main results are: * the most informative texture characteristics to be used for sea ice classification

  17. Sentinel surveillance system for early outbreak detection in Madagascar

    PubMed Central

    2010-01-01

    Background Following the outbreak of chikungunya in the Indian Ocean, the Ministry of Health directed the necessary development of an early outbreak detection system. A disease surveillance team including the Institut Pasteur in Madagascar (IPM) was organized to establish a sentinel syndromic-based surveillance system. The system, which was set up in March 2007, transmits patient data on a daily basis from the various voluntary general practitioners throughout the six provinces of the country to the IPM. We describe the challenges and steps involved in developing a sentinel surveillance system and the well-timed information it provides for improving public health decision-making. Methods Surveillance was based on data collected from sentinel general practitioners (SGP). The SGPs report the sex, age, visit date and time, and symptoms of each new patient weekly, using forms addressed to the management team. However, the system is original in that SGPs also report data at least once a day, from Monday to Friday (number of fever cases, rapid test confirmed malaria, influenza, arboviral syndromes or diarrhoeal disease), by cellular telephone (encrypted message SMS). Information can also be validated by the management team, by mobile phone. This data transmission costs 120 ariary per day, less than US$1 per month. Results In 2008, the sentinel surveillance system included 13 health centers, and identified 5 outbreaks. Of the 218,849 visits to SGPs, 12.2% were related to fever syndromes. Of these 26,669 fever cases, 12.3% were related to Dengue-like fever, 11.1% to Influenza-like illness and 9.7% to malaria cases confirmed by a specific rapid diagnostic test. Conclusion The sentinel surveillance system represents the first nationwide real-time-like surveillance system ever established in Madagascar. Our findings should encourage other African countries to develop their own syndromic surveillance systems. Prompt detection of an outbreak of infectious disease may lead to

  18. Regional CalVal of Altimeter Range at Non-Dedicated Sites in Preparation f Sentinel-3

    NASA Astrophysics Data System (ADS)

    Cancet, M.; Watson, C.; Haines, B.; Bonnefond, P.; Lyard, F.; Femenias, P.; Guinle, T.

    2015-12-01

    In situ calibration ensures regular and long-term control of the altimeter sea surface height (SSH) time series through comparisons with independent records. Usually, in situ calibration and validation of altimeter SSH is undertaken at specific CALVAL sites through the direct comparison of the altimeter data with in situ data [1]. However, NOVELTIS has developed a regional CALVAL technique, which aims at increasing the number and the repeatability of the altimeter bias assessments by determining the altimeter bias both on overflying passes and on satellite passes located far away from the calibration site. In principle this extends the single site approach to a wider regional scale, thus reinforcing the link between the local and the global CALVAL analyses. It also provides a means to maintain a calibration time series through periods of data-outage at a specific dedicated calibration site. The regional method was initially developed at the Corsican calibration sites of Senetosa and Ajaccio. The method was used to compute the biases of Jason-1, Jason-2 and Envisat (before and after the orbit change in 2010) at both sites, and proved its stability and generality through this cross-calibration exercise [2]. These last years, the regional method was successfully implemented at the Californian site of Harvest and at the Australian site of Bass Strait, in close collaboration with JPL and the University of Tasmania, respectively. These recent studies gave the first Envisat absolute bias estimates at non-dedicated sites using the same method, and showed high consistency with the analyses of the global CALVAL teams and the work of the in situ CALVAL teams. These results highlight the numerous advantages of this technique for monitoring missions on any orbits such as the future Sentinel-3 and Jason-CS/Sentinel-6 missions.

  19. [Lymph node metastasis of osteosarcomas].

    PubMed

    Vasil'ev, N V

    2016-01-01

    Lymph node metastasis of osteosarcomas is a rather rare phenomenon; according to different authors, the incidence of lymph node metastasis is 4 to 11%. The detection of lymph node metastases in osteosarcoma is associated with a significant reduction in the 5-year survival of patients and allows its classification as clinical stage IV tumor. The risk factors for lymph node metastases in patients with bone sarcomas are age (≥64 years), gender (female), nosological entity (undifferentiated pleomorphic sarcoma, osteosarcoma, chondrosarcoma), tumor depth (muscle, bone), and the size of primary tumor (>5 сm). The mechanism of lymph node metastasis of osteosarcomas seems to be related to mesenchymal-to-epithelial transition. PMID:27600784

  20. Activation of latent metastases in the lung after resection of a metastatic lymph node in a lymph node metastasis mouse model.

    PubMed

    Shao, Lenan; Ouchi, Tomoki; Sakamoto, Maya; Mori, Shiro; Kodama, Tetsuya

    2015-05-01

    Iatrogenic induction of regional and distant cancer metastases is a risk associated with clinical resection of tumor-positive sentinel lymph nodes. However, there have been no studies of this risk in a mouse model of cancer metastasis. Here, we report that resection of a tumor-bearing subiliac lymph node (SiLN) enhanced lung metastasis in a mouse model of lymph node metastasis. Bioluminescence imaging revealed that metastatic tumor cells in the secondary lymph node continued to grow after resection of the SiLN, and that the probability of metastasis to the lungs was increased when the interval between SiLN inoculation and resection was reduced. Futhermore, histological analysis demonstrated that latents in the lung were stimulated to grow after resection of the SiLN. Fluorescence imaging indicated that the route of tumor cell dissemination from SiLN to the lung was the venous system located over the SiLN. We speculate that our mouse model will be useful for studying the mechanisms of tumor cell latency, with a view to improving the detection and treatment of latent metastases. PMID:25824032

  1. Concurrent hypercube system with improved message passing

    NASA Technical Reports Server (NTRS)

    Peterson, John C. (Inventor); Tuazon, Jesus O. (Inventor); Lieberman, Don (Inventor); Pniel, Moshe (Inventor)

    1989-01-01

    A network of microprocessors, or nodes, are interconnected in an n-dimensional cube having bidirectional communication links along the edges of the n-dimensional cube. Each node's processor network includes an I/O subprocessor dedicated to controlling communication of message packets along a bidirectional communication link with each end thereof terminating at an I/O controlled transceiver. Transmit data lines are directly connected from a local FIFO through each node's communication link transceiver. Status and control signals from the neighboring nodes are delivered over supervisory lines to inform the local node that the neighbor node's FIFO is empty and the bidirectional link between the two nodes is idle for data communication. A clocking line between neighbors, clocks a message into an empty FIFO at a neighbor's node and vica versa. Either neighbor may acquire control over the bidirectional communication link at any time, and thus each node has circuitry for checking whether or not the communication link is busy or idle, and whether or not the receive FIFO is empty. Likewise, each node can empty its own FIFO and in turn deliver a status signal to a neighboring node indicating that the local FIFO is empty. The system includes features of automatic message rerouting, block message transfer and automatic parity checking and generation.

  2. A single pass electron accelerator

    NASA Astrophysics Data System (ADS)

    Schuetz, Marlin N.; Vroom, David A.

    1995-02-01

    Higher volumes, increasing competition and the need to improve quality have led us to re-examine the process for irradiation of tubing and wire. Traditionallyin Raychem, product irradiation has involved the use of large multi-purpose facilities that were designed to handle relatively small volumes of a large variety of products as a separate process. Today, with larger volumes of certain products, there is an interest in combining processes to improve quality and reduce cost. We have recently designed and constructed a small, low voltage accelerator system that can be placed in-line with another manufacturing process and can uniformly irradiate a tube or wire product in a single pass. The system is comprised of two conventional accelerator systems having elongated filaments and placed on opposite sides of a linear product path. The ribbon shaped electron beams from these two accelerators are scanned, after acceleration toward the product path, in a conventional manner and 180 degrees out of phase from each other. The two accelerated electron beams then enter a third magnetic field that is synchronous with the scanning magnets and whose oscillating polarity is such that the ribbon beams are converged onto a tubular shaped window close to and around a segment of the product path. Trials with a prototype system have produced tubing having a dose concentricity of better than ± 10 percent on a single pass through the system.

  3. Fluorescence guided lymph node biopsy in large animals using direct image projection device

    NASA Astrophysics Data System (ADS)

    Ringhausen, Elizabeth; Wang, Tylon; Pitts, Jonathan; Akers, Walter J.

    2016-03-01

    The use of fluorescence imaging for aiding oncologic surgery is a fast growing field in biomedical imaging, revolutionizing open and minimally invasive surgery practices. We have designed, constructed, and tested a system for fluorescence image acquisition and direct display on the surgical field for fluorescence guided surgery. The system uses a near-infrared sensitive CMOS camera for image acquisition, a near-infra LED light source for excitation, and DLP digital projector for projection of fluorescence image data onto the operating field in real time. Instrument control was implemented in Matlab for image capture, processing of acquired data and alignment of image parameters with the projected pattern. Accuracy of alignment was evaluated statistically to demonstrate sensitivity to small objects and alignment throughout the imaging field. After verification of accurate alignment, feasibility for clinical application was demonstrated in large animal models of sentinel lymph node biopsy. Indocyanine green was injected subcutaneously in Yorkshire pigs at various locations to model sentinel lymph node biopsy in gynecologic cancers, head and neck cancer, and melanoma. Fluorescence was detected by the camera system during operations and projected onto the imaging field, accurately identifying tissues containing the fluorescent tracer at up to 15 frames per second. Fluorescence information was projected as binary green regions after thresholding and denoising raw intensity data. Promising results with this initial clinical scale prototype provided encouraging results for the feasibility of optical projection of acquired luminescence during open oncologic surgeries.

  4. Connecting node and method for constructing a connecting node

    NASA Technical Reports Server (NTRS)

    Johnson, Christopher J. (Inventor); Raboin, Jasen L. (Inventor); Spexarth, Gary R. (Inventor)

    2011-01-01

    A connecting node comprises a polyhedral structure comprising a plurality of panels joined together at its side edges to form a spherical approximation, wherein at least one of the plurality of panels comprises a faceted surface being constructed with a passage for integrating with one of a plurality of elements comprising a docking port, a hatch, and a window that is attached to the connecting node. A method for manufacturing a connecting node comprises the steps of providing a plurality of panels, connecting the plurality of panels to form a spherical approximation, wherein each edge of each panel of the plurality is joined to another edge of another panel, and constructing at least one of the plurality of panels to include a passage for integrating at least one of a plurality of elements that may be attached to the connecting node.

  5. Senate passes clean air bill

    NASA Astrophysics Data System (ADS)

    In an 89 to 11 vote the Senate passed a clean air bill aimed at reducing pollution by the turn of the century by imposing tougher controls on American industry. The bill is the first revision of the Clean Air Act of 1970 in 13 years and calls for new limits on auto pollution to clean up smog in most U.S. cities, decreasing by half emissions by power plants that cause acid rain to protect the ecology, and increasing technological controls on factories to protect against cancer-causing and toxic substances. The bill will add about $20 billion per year to the estimated $33 billion cost of complying with current pollution laws.

  6. Management of the lymph nodes in penile cancer.

    PubMed

    Heyns, Chris F; Fleshner, Neil; Sangar, Vijay; Schlenker, Boris; Yuvaraja, Thyavihally B; van Poppel, Hendrik

    2010-08-01

    A comprehensive literature study was conducted to evaluate the levels of evidence (LEs) in publications on the diagnosis and staging of penile cancer. Recommendations from the available evidence were formulated and discussed by the full panel of the International Consultation on Penile Cancer in November 2008. The final grades of recommendation (GRs) were assigned according to the LE of the relevant publications. The following consensus recommendations were accepted. Fine needle aspiration cytology should be performed in all patients (with ultrasound guidance in those with nonpalpable nodes). If the findings are positive, therapeutic, rather than diagnostic, inguinal lymph node dissection (ILND) can be performed (GR B). Antibiotic treatment for 3-6 weeks before ILND in patients with palpable inguinal nodes is not recommended (GR B). Abdominopelvic computed tomography (CT) and magnetic resonance imaging (MRI) are not useful in patients with nonpalpable nodes. However, they can be used in those with large, palpable inguinal nodes (GR B). The statistical probability of inguinal micrometastases can be estimated using risk group stratification or a risk calculation nomogram (GR B). Surveillance is recommended if the nomogram probability of positive nodes is <0.1 (10%). Surveillance is also recommended if the primary lesion is grade 1, pTis, pTa (verrucous carcinoma), or pT1, with no lymphovascular invasion, and clinically nonpalpable inguinal nodes, but only provided the patient is willing to comply with regular follow-up (GR B). In the presence of factors that impede reliable surveillance (obesity, previous inguinal surgery, or radiotherapy) prophylactic ILND might be a preferable option (GR C). In the intermediate-risk group (nomogram probability .1-.5 [10%-50%] or primary tumor grade 1-2, T1-T2, cN0, no lymphovascular invasion), surveillance is acceptable, provided the patient is informed of the risks and is willing and able to comply. If not, sentinel node biopsy

  7. The use of the Sentinel missions for science

    NASA Astrophysics Data System (ADS)

    Berger, M.

    2009-04-01

    ESA is currently implementing, in coordination with the European Union, a set of operational Earth observations missions. The five Sentinel families under development will feature radar, super-spectral imaging and ocean and atmospheric monitoring capacities. They are primarly designed to provide routine observations for operational GMES services. However, the manifold instrumentations with different spectral and spatial resolutions, the global coverage with high revisit times, and the long-term operational commitments of the Sentinel missions are also very relevant for studying and monitoring of Earth system processes with time-scales up to several years. Understanding and modeling the dynamic behaviour of the Earth System with all its' components and their interaction is the ‘grand challenge' for the geoscience community. It is motivated by our limited knowledge about the consequences on the different Earth System components introduced by human activities, such as fossil fuel combustion, and the fragmentation of terrestrial vegetation cover and the related loss of biodiversity. The development of such an Earth System model requires the involvement of all relevant science disciplines whereas Earth observation, as the tool which allows a synoptic view on the globe with spatially and temporally relevant observations, plays an important role. ESA is supporting this scientific undertaking with dedicated Earth Explorer missions, each tailored to specific scientific questions. In addition, the series of Sentinel missions, though not tailored towards the scientific challences, are very relevant for addressing the grand challences of the Earth science disciplines. This is based on data continuity of data already widely used within the science communities including the long-term operational commitment, essential for the parameterisation of long-trend forecasting. Furthermore, the high temporal frequencies, well-matched for capturing rapid changes, are supporting model

  8. SENTINEL-2 Level 1 Products and Image Processing Performances

    NASA Astrophysics Data System (ADS)

    Baillarin, S. J.; Meygret, A.; Dechoz, C.; Petrucci, B.; Lacherade, S.; Tremas, T.; Isola, C.; Martimort, P.; Spoto, F.

    2012-07-01

    In partnership with the European Commission and in the frame of the Global Monitoring for Environment and Security (GMES) program, the European Space Agency (ESA) is developing the Sentinel-2 optical imaging mission devoted to the operational monitoring of land and coastal areas. The Sentinel-2 mission is based on a satellites constellation deployed in polar sun-synchronous orbit. While ensuring data continuity of former SPOT and LANDSAT multi-spectral missions, Sentinel-2 will also offer wide improvements such as a unique combination of global coverage with a wide field of view (290 km), a high revisit (5 days with two satellites), a high resolution (10 m, 20 m and 60 m) and multi-spectral imagery (13 spectral bands in visible and shortwave infra-red domains). In this context, the Centre National d'Etudes Spatiales (CNES) supports ESA to define the system image products and to prototype the relevant image processing techniques. This paper offers, first, an overview of the Sentinel-2 system and then, introduces the image products delivered by the ground processing: the Level-0 and Level-1A are system products which correspond to respectively raw compressed and uncompressed data (limited to internal calibration purposes), the Level-1B is the first public product: it comprises radiometric corrections (dark signal, pixels response non uniformity, crosstalk, defective pixels, restoration, and binning for 60 m bands); and an enhanced physical geometric model appended to the product but not applied, the Level-1C provides ortho-rectified top of atmosphere reflectance with a sub-pixel multi-spectral and multi-date registration; a cloud and land/water mask is associated to the product. Note that the cloud mask also provides an indication about cirrus. The ground sampling distance of Level-1C product will be 10 m, 20 m or 60 m according to the band. The final Level-1C product is tiled following a pre-defined grid of 100x100 km2, based on UTM/WGS84 reference frame. The

  9. Effect of multiple extrusion passes on zein

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Zein was repeatedly processed up to seven times using a single screw extruder at a temperature of 145 °C and at approximately 15 grams per minute to determine the extent of degradation that occurs with multiple extrusion passes. SDS-PAGE shows that with the second pass, and each additional pass, the...

  10. SPICE: Sentinel-3 Performance Improvement for Ice Sheets

    NASA Astrophysics Data System (ADS)

    McMillan, Malcolm; Shepherd, Andrew; Roca, Monica; Escorihuela, Maria Jose; Thibaut, Pierre; Remy, Frederique; Escola, Roger; Benveniste, Jerome; Ambrozio, Americo; Restano, Marco

    2016-04-01

    Since the launch of ERS-1 in 1991, polar-orbiting satellite radar altimeters have provided a near continuous record of ice sheet elevation change, yielding estimates of ice sheet mass imbalance at the scale of individual ice sheet basins. One of the principle challenges associated with radar altimetry comes from the relatively large ground footprint of conventional pulse-limited radars, which limits their capacity to make reliable measurements in areas of complex topographic terrain. In recent years, progress has been made towards improving ground resolution, through the implementation of Synthetic Aperture Radar (SAR), or Delay-Doppler, techniques. In 2010, the launch of CryoSat heralded the start of a new era of SAR altimetry, although full SAR coverage of the polar ice sheets will only be achieved with the launch of the first Sentinel-3 satellite in January 2016. Because of the heritage of SAR altimetry provided by CryoSat, current SAR altimeter processing techniques have to some extent been optimized and evaluated for water and sea ice surfaces. This leaves several outstanding issues related to the development and evaluation of SAR altimetry for ice sheets, including improvements to SAR processing algorithms and SAR altimetry waveform retracking procedures. Here we will outline SPICE (Sentinel-3 Performance Improvement for Ice Sheets), a 2 year project which began in September 2015 and is funded by ESA's SEOM (Scientific Exploitation of Operational Missions) programme. This project aims to contribute to the development and understanding of ice sheet SAR altimetry through the emulation of Sentinel-3 data from dedicated CryoSat SAR acquisitions made at several sites in Antarctica. More specifically, the project aims to (1) evaluate and improve the current Delay-Doppler processing and SAR waveform retracking algorithms, (2) evaluate higher level SAR altimeter data, and (3) investigate radar wave interaction with the snowpack. We will provide a broad overview of

  11. Validation of Hotspots Detected by Satellites in Sentinel Asia

    NASA Astrophysics Data System (ADS)

    Kaku, K.; Kushida, K.; Fukuda, M.

    2008-12-01

    The Sentinel Asia (SA) initiative is a collaboration between space agencies and disaster management agencies, applying remote sensing and Web-GIS technologies to assist disaster management in the Asia- Pacific region. It aims to: "EImprove safety in society by ICT and space technology "EImprove speed and accuracy of disaster preparedness and early warning "EMinimize the number of victims and social/economic losses. SA is a voluntary initiative led by the Asia-Pacific Regional Space Agency Forum (APRSAF) to share disaster information in near-real-time across the Asia-Pacific region. Wildfire is a major and recurring phenomenon that has a serious impact on property and human health, affecting many countries in the Asia region. Compared to other disasters in the area, it does not necessarily cause many immediate fatalities. However, it causes serious impact on property and human health due to smoke. Furthermore, its effects are of great relevance both at a regional and global level, and accordingly bear substantial influence on global warming. Responding to requirements from Asian countries, under Sentinel Asia a dedicated Wildfire Working Group (WG) has been established to apply remote sensing technology to the management of wildfire. Having accurate information on the location and intensity of the fires, and subsequent control of wildfire, are therefore very important and urgent tasks across the region. SA primarily addresses the issue of near-real-time information distribution on wildfires in the region. Concerning hotspot data obtained by satellites, it is essential to validate and improve its accuracy. In the framework of Sentinel Asia Wildfire WG, various approaches to hotspot detection, including MOD14 algorithm for MODIS hotspots, were studied, and their validations were carried out, comparing them with active fires extracted from satellite imagery and ground truth data in Chiengmai, Thailand and in Kalimantan, Indonesia.

  12. Sentinel-3 OLCI Radiometric and Spectral Performance Activities

    NASA Astrophysics Data System (ADS)

    Bourg, L.; Blanot, L.; Lamquin, N.; Bruniquel, V.; Meskini, N.; Nieke, J.; Bouvet, M.; Fougnie, B.

    2015-12-01

    The paper presents the activities to be undertaken by ACRI-ST under ESA/ESTEC coordination for the assessment of OLCI Radiometric and Spectral Performances during the SENTINEL-3 Commissioning Phase. As an introduction, it briefly describes the instrument concept and available on-board calibration hardware, the context and main objective of the work. Insisting on the fact that radiometric calibration of OLCI is based on in-flight measurements, as was for MERIS, it then describes the methodology and tools to be used during Commissioning. Finally, as in-flight based radiometry implies the need for independent validation, it describes the corresponding methods and tools.

  13. Altimeter Products for the Sentinel-6/Jason-CS Mission

    NASA Astrophysics Data System (ADS)

    Scharroo, Remko; Bonekamp, Hans; Ponsard, Christelle; Nogueira Loddo, Carolina

    2015-12-01

    The Sentinel-6 mission will be developed and implemented through a partnership between the EU, ESA, EUMETSAT and NOAA . Its aim is to secure the continuity until 2030+ of critical high precision observations of ocean surface topography beyond Jason-3. The European contribution will be implemented through the combination of the ESA Copernicus Space Component, the EUMETSAT Jason-CS optional programme, and the EU Copernicus programme, for the joint benefits of the meteorological and Copernicus user communities in Europe. NASA and CNES will be supporting partners. The mission will start with the launch of Jason-CS A in 2020, followed by Jason-CS B in 2025.

  14. SPICE: Sentinel-3 Performance Improvement for Ice Sheets

    NASA Astrophysics Data System (ADS)

    Benveniste, Jérôme; Escolà, Roger; Roca, Mònica; Ambrózio, Américo; Restano, Marco; McMillan, Malcolm; Escorihuela, Maria Jose; Shepherd, Andrew; Thibaut, Pierre; Remy, Frederique

    2016-07-01

    Since the launch of ERS-1 in 1991, polar-orbiting satellite radar altimeters have provided a near continuous record of ice sheet elevation change, yielding estimates of ice sheet mass imbalance at the scale of individual ice sheet basins. One of the principle challenges associated with radar altimetry comes from the relatively large ground footprint of conventional pulse-limited radars, which limits their capacity to make reliable measurements in areas of complex topographic terrain. In recent years, progress has been made towards improving ground resolution, through the implementation of Synthetic Aperture Radar (SAR), or Delay-Doppler, techniques. In 2010, the launch of CryoSat-2 by the European Space Agency heralded the start of a new era of SAR altimetry, although full SAR coverage of the polar ice sheets will only be achieved with the launch of the first Sentinel-3 satellite in February 2016. Because of the heritage of SAR altimetry provided by CryoSat-2, current SAR altimeter processing techniques have been optimized and evaluated for water and sea ice surfaces. This leaves several outstanding issues related to the development and evaluation of SAR altimetry for ice sheets, including improvements to SAR processing algorithms and SAR altimetry waveform retracking procedures. Here we will present interim results from SPICE (Sentinel-3 Performance Improvement for Ice Sheets), a 2 year project that focuses on the expected performance of Sentinel-3 SAR altimetry over the Polar ice sheets. The project, which began in September 2015 and is funded by ESA's SEOM (Scientific Exploitation of Operational Missions) programme, aims to contribute to the development and understanding of ice sheet SAR altimetry through the emulation of Sentinel-3 data from dedicated CryoSat SAR acquisitions made at several sites in Antarctica and Greenland. More specifically, the project aims to (1) evaluate and improve the current Delay-Doppler processing and SAR waveform retracking

  15. Addressing a radiation safety sentinel event alert: one state's experience.

    PubMed

    Temme, James B; Lane, Thomas; Rutar, Frank; McGowan, Ann

    2012-01-01

    The Joint Commission issued a Sentinel Event Alert in August 2011 to address the radiation risks related to diagnostic medical imaging. The University of Nebraska Medical Center (UNMC) and Nebraska Coalition for Patient Safety (NCPS) sent a survey to Nebraska hospital radiology departments in May 2012 to solicit responses regarding radiation safety management practices. Survey results demonstrate that Nebraska hospitals perform well in many radiation safety efforts, but lack in others, as well as the need for additional research to track or compare progress. Nebraska's experience can serve as a model for other states to perform similar radiation safety management research. PMID:23270117

  16. Rapid diagnosis of lymph node metastasis in breast cancer using a new fluorescent method with γ-glutamyl hydroxymethyl rhodamine green.

    PubMed

    Shinden, Yoshiaki; Ueo, Hiroki; Tobo, Taro; Gamachi, Ayako; Utou, Mitsuaki; Komatsu, Hisateru; Nambara, Sho; Saito, Tomoko; Ueda, Masami; Hirata, Hidenari; Sakimura, Shotaro; Takano, Yuki; Uchi, Ryutaro; Kurashige, Junji; Akiyoshi, Sayuri; Iguchi, Tomohiro; Eguchi, Hidetoshi; Sugimachi, Keishi; Kubota, Yoko; Kai, Yuichiro; Shibuta, Kenji; Kijima, Yuko; Yoshinaka, Heiji; Natsugoe, Shoji; Mori, Masaki; Maehara, Yoshihiko; Sakabe, Masayo; Kamiya, Mako; Kakareka, John W; Pohida, Thomas J; Choyke, Peter L; Kobayashi, Hisataka; Ueo, Hiroaki; Urano, Yasuteru; Mimori, Koshi

    2016-01-01

    Sentinel lymph node biopsy is performed as a standard procedure in breast cancer surgery, and the development of quick and simple methods to detect metastatic lesions is in high demand. Here, we validated a new fluorescent method using γ-glutamyl hydroxymethyl rhodamine green to diagnose metastatic lymph nodes in breast cancer. One hundred and forty-nine lymph nodes from 38 breast cancer patients were evaluated in this study. Comparison of fluorescent and pathological images showed that this fluorescent method was successful for visualizing breast cancer cells in lymph nodes. This method had a sufficiently high sensitivity (97%), specificity (79%) and negative predictive value (99%) to render it useful for an intraoperative diagnosis of cancer. These preliminary findings suggest that this novel method is useful for distinguishing non-cancerous specimens from those in need of careful examination and could help save time and cost for surgeons and pathologists. PMID:27277343

  17. Rapid diagnosis of lymph node metastasis in breast cancer using a new fluorescent method with γ-glutamyl hydroxymethyl rhodamine green

    PubMed Central

    Shinden, Yoshiaki; Ueo, Hiroki; Tobo, Taro; Gamachi, Ayako; Utou, Mitsuaki; Komatsu, Hisateru; Nambara, Sho; Saito, Tomoko; Ueda, Masami; Hirata, Hidenari; Sakimura, Shotaro; Takano, Yuki; Uchi, Ryutaro; Kurashige, Junji; Akiyoshi, Sayuri; Iguchi, Tomohiro; Eguchi, Hidetoshi; Sugimachi, Keishi; Kubota, Yoko; Kai, Yuichiro; Shibuta, Kenji; Kijima, Yuko; Yoshinaka, Heiji; Natsugoe, Shoji; Mori, Masaki; Maehara, Yoshihiko; Sakabe, Masayo; Kamiya, Mako; Kakareka, John W.; Pohida, Thomas J.; Choyke, Peter L.; Kobayashi, Hisataka; Ueo, Hiroaki; Urano, Yasuteru; Mimori, Koshi

    2016-01-01

    Sentinel lymph node biopsy is performed as a standard procedure in breast cancer surgery, and the development of quick and simple methods to detect metastatic lesions is in high demand. Here, we validated a new fluorescent method using γ-glutamyl hydroxymethyl rhodamine green to diagnose metastatic lymph nodes in breast cancer. One hundred and forty-nine lymph nodes from 38 breast cancer patients were evaluated in this study. Comparison of fluorescent and pathological images showed that this fluorescent method was successful for visualizing breast cancer cells in lymph nodes. This method had a sufficiently high sensitivity (97%), specificity (79%) and negative predictive value (99%) to render it useful for an intraoperative diagnosis of cancer. These preliminary findings suggest that this novel method is useful for distinguishing non-cancerous specimens from those in need of careful examination and could help save time and cost for surgeons and pathologists. PMID:27277343

  18. Sentinel events predicting later unwanted sex among girls: A national survey in Haiti, 2012.

    PubMed

    Sumner, Steven A; Marcelin, Louis H; Cela, Toni; Mercy, James A; Lea, Veronica; Kress, Howard; Hillis, Susan D

    2015-12-01

    Sexual violence against children is a significant global public health problem, yet limited studies exist from low-resource settings. In Haiti we conducted the country's first, nationally representative survey focused on childhood violence to help inform the development of a national action plan for violence against children. The Haiti Violence Against Children Survey was a household-level, multistage, cluster survey among youth age 13-24. In this analysis we sought to determine whether sexual violence sentinel events (unwanted sexual touching or unwanted attempted sex) were predictive of later unwanted, completed, penetrative sex in Haiti. We also sought to explore characteristics of sentinel events and help-seeking behavior among Haitian children. Multivariable logistic regression was used to test associations between sentinel events and later unwanted, completed, penetrative sex. Overall, 1,457 females reported on experiences of sexual violence occurring in childhood (before age 18). A sentinel event occurred in 40.4% of females who experienced subsequent unwanted completed sex. Females experiencing a sentinel event were approximately two and a half times more likely to experience later unwanted completed sex (adjusted odds ratio=2.40, p=.004) compared to individuals who did not experience a sentinel event. The mean lag time from first sentinel event to first unwanted completed sex was 2.3 years. Only half (54.6%) of children experiencing a sentinel event told someone about their experience of sexual violence. Among children, sentinel events occur frequently before later acts of completed unwanted sex and may represent a useful point of intervention. Reporting of sexual violence by children in Haiti is low and can be improved to better act on sentinel events. PMID:26297488

  19. Predicting Node Degree Centrality with the Node Prominence Profile

    NASA Astrophysics Data System (ADS)

    Yang, Yang; Dong, Yuxiao; Chawla, Nitesh V.

    2014-11-01

    Centrality of a node measures its relative importance within a network. There are a number of applications of centrality, including inferring the influence or success of an individual in a social network, and the resulting social network dynamics. While we can compute the centrality of any node in a given network snapshot, a number of applications are also interested in knowing the potential importance of an individual in the future. However, current centrality is not necessarily an effective predictor of future centrality. While there are different measures of centrality, we focus on degree centrality in this paper. We develop a method that reconciles preferential attachment and triadic closure to capture a node's prominence profile. We show that the proposed node prominence profile method is an effective predictor of degree centrality. Notably, our analysis reveals that individuals in the early stage of evolution display a distinctive and robust signature in degree centrality trend, adequately predicted by their prominence profile. We evaluate our work across four real-world social networks. Our findings have important implications for the applications that require prediction of a node's future degree centrality, as well as the study of social network dynamics.

  20. Predicting Node Degree Centrality with the Node Prominence Profile

    PubMed Central

    Yang, Yang; Dong, Yuxiao; Chawla, Nitesh V.

    2014-01-01

    Centrality of a node measures its relative importance within a network. There are a number of applications of centrality, including inferring the influence or success of an individual in a social network, and the resulting social network dynamics. While we can compute the centrality of any node in a given network snapshot, a number of applications are also interested in knowing the potential importance of an individual in the future. However, current centrality is not necessarily an effective predictor of future centrality. While there are different measures of centrality, we focus on degree centrality in this paper. We develop a method that reconciles preferential attachment and triadic closure to capture a node's prominence profile. We show that the proposed node prominence profile method is an effective predictor of degree centrality. Notably, our analysis reveals that individuals in the early stage of evolution display a distinctive and robust signature in degree centrality trend, adequately predicted by their prominence profile. We evaluate our work across four real-world social networks. Our findings have important implications for the applications that require prediction of a node's future degree centrality, as well as the study of social network dynamics. PMID:25429797

  1. Rice Crop Mapping Using SENTINEL-1A Phenological Metrics

    NASA Astrophysics Data System (ADS)

    Chen, C. F.; Son, N. T.; Chen, C. R.; Chang, L. Y.; Chiang, S. H.

    2016-06-01

    Rice is the most important food crop in Vietnam, providing food more than 90 million people and is considered as an essential source of income for majority of rural populations. Monitoring rice-growing areas is thus important to developing successful strategies for food security in the country. This paper aims to develop an approach for crop acreage estimation from multi-temporal Sentinel-1A data. We processed the data for two main cropping seasons (e.g., winter-spring, summer-autumn) in the Mekong River Delta (MRD), Vietnam through three main steps: (1) data pre-processing, (3) rice classification based on crop phenological metrics, and (4) accuracy assessment of the mapping results. The classification results compared with the ground reference data indicated the overall accuracy of 86.2% and Kappa coefficient of 0.72. These results were reaffirmed by close correlation between the government's rice area statistics for such crops (R2 > 0.95). The values of relative error in area obtained for the winter-spring and summer-autumn were -3.6% and 6.7%, respectively. This study demonstrates the potential application of multi-temporal Sentinel-1A data for rice crop mapping using information of crop phenology in the study region.

  2. Ocean Surface reconstruction from the synergy of Sentinel-3 sensors

    NASA Astrophysics Data System (ADS)

    Gonzalez-Haro, C.; Autret, E.; Isern-Fontanet, J.; Tandeo, P.; Le Goff, C.; Garello, R.; Fablet, R.

    2015-12-01

    Along-track altimetric measurements of Sea Surface Heights (SSH) are very well suited to quantify across-track currents. However, the spatial resolution of derived 2D velocities is restricted to scales above 100-150 km and the limited number of altimeters can lead to errors in the location of currents. On the contrary, infrared measurements of Sea Surface Temperature (SST) are well suited to locate flow patterns but it is difficult to extract quantitative estimations of ocean currents. During the last years, some works began to exploit the synergy of SST and altimetry measurements in order to retrieve ocean currents. Nevertheless, all this previous works employed measurements which were near in time but not simultaneous. In that sense, Sentinel-3 is a multi-instrument mission that will circumvent this temporal limitation, providing simultaneous measurements of SST and altimetry with high-end accuracy and reliability. Our approach, based on the spectral properties of simultaneous SST and SSH observations, is tested using ENVISAT (RA, AATSR) data, since its geometry is similar to that of Sentinel-3 (SRAL, SLSTR).

  3. The Portals 3.0 Message Passing Interface Revision 1.0

    SciTech Connect

    BRIGHTWELL,RONALD B.; HUDSON,TRAMMELL B.; RIESEN,ROLF E.; MACCABE,ARTHUR B.

    1999-12-01

    This report presents a specification for the Portals 3.0 message passing interface. Portals 3.0 is intended to allow scalable, high-performance network communication between nodes of a parallel computing system. Specifically, it is designed to support a parallel computing platform composed of clusters of commodity workstations connected by a commodity system area network fabric. In addition, Portals 3.0 is well suited to massively parallel processing and embedded systems. Portals 3.0 represents an adoption of the data movement layer developed for massively parallel processing platforms, such as the 4500-node Intel TeraFLOPS machine.

  4. Comparison of Trapping Performance Between the Original BG-Sentinel® Trap and BG-Sentinel 2® Trap (1).

    PubMed

    Arimoto, Hanayo; Harwood, James F; Nunn, Peter J; Richardson, Alec G; Gordon, Scott; Obenauer, Peter J

    2015-12-01

    Recently, the BG-Sentinel® trap (BGS) trap has been reconfigured for increased durability during harsh field conditions. We evaluated the attractiveness of this redesigned trap, BG-Sentinel 2® (BGS2), and its novel granular lure cartridge system relative to the original trap and lure. Granular lures containing different combinations of lactic acid, ammonia, hexanoic acid, and octenol were also evaluated. Lure cartridges with all components except octenol trapped significantly more Aedes albopictus than lures containing octenol. This new granular lure combination and original BG-Lure® system were paired with BGS and BGS2 traps to compare relative attractiveness of the lures and the traps. All evaluations were conducted under field conditions in a suburban neighborhood in northeastern Florida from July to October 2014. Overall, the average numbers of Ae. albopictus collected by BGS or BGS2 were similar regardless of the lure type (i.e., mesh bag versus granules) (P  =  0.56). The functionality and durability of both trap models are discussed. PMID:26675464

  5. General considerations for a Sentinel-1 constellation InSAR time series processing chain for ground deformation measurements

    NASA Astrophysics Data System (ADS)

    Gonzalez, P. J.; Wright, T. J.; Hooper, A. J.; Walters, R. J.

    2014-12-01

    Sentinel-1A was launched on April 3rd, 2014. It is the first satellite of a European Space Agency (ESA) constellation that promises to revolutionize measurement of deformation of the Earth's surface. The constellation is designed to acquire data globally as frequently as every 6 days on the same orbital pass, and every 3 days in alternating ascending and descending orbits over the same regions. This data acquisition plan is possible due to a much larger swath coverage than previous SAR (Synthetic Aperture Radar) sensors. In addition, all observations from Copernicus, the European Commission Earth Observation program, have a liberal data policy, which will enable full exploitation of the archived Sentinel-1 big data, both for scientific and commercial use.Sentinel-1, and similar future constellations, shape a new landscape in the way that InSAR data have traditionally been processed. We have started to develop a completely new re-engineered and adapted InSAR time series processing approach, which efficiently processes the data from this new type of SAR constellation, with the goal to deliver ground deformation products with the highest possible precision. In summary, the proposed system approach will require the development of an automatic, almost unsupervised, system that integrates methods to obtain time-dependent surface deformation estimates and correction products for atmospheric noise and refined orbits. The ground velocity maps will ideally meet the desired precision of 1 mm/yr / 100 km to measure strain-rates (10 nanostrain/yr) at a comparable level of precision to current existing sparse regional GPS measurement networks.In this communication, we describe the different steps we have adopted to partially solve: 1) coregistration of TOPS (Terrain Observation with Progressive Scans) SAR images to enable interferometry, 2) how to manage the ambiguity between ground motion in azimuth and in line-of-sight for TOPS InSAR, 3) how to process efficiently newly

  6. LEGION: Lightweight Expandable Group of Independently Operating Nodes

    NASA Technical Reports Server (NTRS)

    Burl, Michael C.

    2012-01-01

    LEGION is a lightweight C-language software library that enables distributed asynchronous data processing with a loosely coupled set of compute nodes. Loosely coupled means that a node can offer itself in service to a larger task at any time and can withdraw itself from service at any time, provided it is not actively engaged in an assignment. The main program, i.e., the one attempting to solve the larger task, does not need to know up front which nodes will be available, how many nodes will be available, or at what times the nodes will be available, which is normally the case in a "volunteer computing" framework. The LEGION software accomplishes its goals by providing message-based, inter-process communication similar to MPI (message passing interface), but without the tight coupling requirements. The software is lightweight and easy to install as it is written in standard C with no exotic library dependencies. LEGION has been demonstrated in a challenging planetary science application in which a machine learning system is used in closed-loop fashion to efficiently explore the input parameter space of a complex numerical simulation. The machine learning system decides which jobs to run through the simulator; then, through LEGION calls, the system farms those jobs out to a collection of compute nodes, retrieves the job results as they become available, and updates a predictive model of how the simulator maps inputs to outputs. The machine learning system decides which new set of jobs would be most informative to run given the results so far; this basic loop is repeated until sufficient insight into the physical system modeled by the simulator is obtained.

  7. Pass-transistor very large scale integration

    NASA Technical Reports Server (NTRS)

    Maki, Gary K. (Inventor); Bhatia, Prakash R. (Inventor)

    2004-01-01

    Logic elements are provided that permit reductions in layout size and avoidance of hazards. Such logic elements may be included in libraries of logic cells. A logical function to be implemented by the logic element is decomposed about logical variables to identify factors corresponding to combinations of the logical variables and their complements. A pass transistor network is provided for implementing the pass network function in accordance with this decomposition. The pass transistor network includes ordered arrangements of pass transistors that correspond to the combinations of variables and complements resulting from the logical decomposition. The logic elements may act as selection circuits and be integrated with memory and buffer elements.

  8. Photoacoustic Soot Spectrometer (PASS) Instrument Handbook

    SciTech Connect

    Dubey, M; Springston, S; Koontz, A; Aiken, A

    2013-01-17

    The photoacoustic soot spectrometer (PASS) measures light absorption by aerosol particles. As the particles pass through a laser beam, the absorbed energy heats the particles and in turn the surrounding air, which sets off a pressure wave that can be detected by a microphone. The PASS instruments deployed by ARM can also simultaneously measure the scattered laser light at three wavelengths and therefore provide a direct measure of the single-scattering albedo. The Operator Manual for the PASS-3100 is included here with the permission of Droplet Measurement Technologies, the instrument’s manufacturer.

  9. The Damper Spring Unit of the Sentinel 1 Solar Array

    NASA Technical Reports Server (NTRS)

    Doejaaren, Frans; Ellenbroek, Marcel

    2012-01-01

    The Damper Spring Unit (DSU, see Figure 1) has been designed to provide the damping required to control the deployment speed of the spring driven solar array deployment in an ARA Mk3 or FRED based Solar Array in situations where the standard application of a damper at the root-hinge is not feasible. The unit consists of four major parts: a main bracket, an eddy current damper, a spring unit, an actuation pulley which is coupled via Kevlar cables to a synchro-pulley of a hinge. The damper slows down the deployment speed and prevents deployment shocks at deployment completion. The spring unit includes 4 springs which overcome the resistances of the damper and the specific DSU control cable loop. This means it can be added to any spring driven deployment system without major modifications of that system. Engineering models of the Sentinel 1 solar array wing have been built to identify the deployment behavior, and to help to determine the optimal pulley ratios of the solar array and to finalize the DSU design. During the functional tests, the behavior proved to be very sensitive for the alignment of the DSU. This was therefore monitored carefully during the qualification program, especially prior to the TV cold testing. During TV "Cold" testing the measured retarding torque exceeded the max. required value: 284 N-mm versus the required 247 N-mm. Although this requirement was not met, the torque balance analysis shows that the 284 N-mm can be accepted, because the spring unit can provide 1.5 times more torque than required. Some functional tests of the DSU have been performed without the eddy current damper attached. It provided input data for the ADAMS solar array wing model. Simulation of the Sentinel-1 deployment (including DSU) in ADAMS allowed the actual wing deployment tests to be limited in both complexity and number of tests. The DSU for the Sentinel-1 solar array was successfully qualified and the flight models are in production.

  10. Sentinel-1 EPS Architecture And Power Conversion Trade-Off

    NASA Astrophysics Data System (ADS)

    Catalano, Toni Fabio; Costanitini, Stefano; Daparati, Giorgio

    2011-10-01

    The paper will present the selected EPS (Electrical Power System) Architecture for the Sentinel-1 mission. After a brief survey of Sentinel-1 mission, the EPS design will be illustrated, with particular focus on the architecture adopted for SAW (Solar Array Wing) power conversion and relevant trade-off. In the early phase of the project, various trade-offs have been carried out in order to define the suitable Sentinel- 1 EPS architecture. Mainly the following subjects have been exploited: -BTA (Battery) technology and topology identification; -SAW rotation strategy and relevant mechanism selection; -primary power bus voltage selection; - distribution and protection philosophy; -SAW power conditioning strategy. All those, and many minor ones, have been evaluated singly to assess the best solution for the individual problem and all together to evaluate the consequences of the interactions at subsystem level to be finally reflected in system budget and architecture sizing. As the choice of the most appropriate conditioning architecture is directly influenced by chosen EPS architecture and has direct impact on S/C (Spacecraft) capability to sustain required operational profile, specially considering the long mission lifetime plus mission extension, dedicated analysis and simulations have been carried out. This paper focuses on SAW conditioning trade-off analysis results along with a brief description of the in- house developed simulator used during this study. Basing on project inputs such as mission operational scenarios, system requirement and HW constraints, a direct comparison of the performances achievable with the different accounted conditioning systems, S3R, MPPT buck and MPPT boost, is given. Finally, the outcomes of simulations run lead to a substantial equivalence of the three architecture topologies if no specific BTA configuration is accounted (ideal configuration). When considering different BTA topologies (s-p or p-s) and related possible failures, a

  11. Filtering role of the atrioventricular node in atrial fibrillations.

    PubMed

    Mazgalev, T

    1985-01-01

    Experiments on rabbit heart preparations were carried out with the aim of studying the causal relation between the signals at the input and at the output of the atrioventricular node (AVN) during atrial fibrillations (AF). Electrograms were recorded simultaneously from the posterior and anterior inputs and from the output of AVN, together with cellular action potentials from one or two structures of the node. AVN is shown to play the role of a filtering unit for the excitatory waves passing from the atria to the ventricles during AF. The random and fragmentary character of the atrial excitatory front during AF causes summation of excitatory waves, local and manifested re-entry, and conduction along competitive pathways. These processes accompany both the successful conduction through AVN and the blocking of the excitation at different levels in the node. The filtration process takes place mainly in the AN- and N-zones of the node. In the NH-zone conduction does not differ compared to that in the case of spontaneous rhythm. The results obtained show that conduction through AVN during AF does not take place through triggering of specific mechanisms, but through a complex combination of the mechanisms characterizing the deteriorated conduction under extreme conditions. PMID:4050465

  12. Maritime Products Using Terrasar-X and SENTINEL-1 Imagery

    NASA Astrophysics Data System (ADS)

    Lehner, S.; Tings, B.

    2015-04-01

    High resolution remote sensing Synthetic Aperture Radar (SAR) data from TerraSAR-X/Tandem-X satellites are used to determine and monitor the sea surface in near real time and all weather and illumination conditions. The radar backscatter of the sea surface is determined by the sea surface roughness caused by the wind field and the sea state. These meteo parameters are modelled by the newly developed algorithms XMOD and XWAVE relating the wind field and sea state, depending on incidence angle and directionality to the radar backscatter sigma0. The TerraSAR-X Modes Stripmap, Scan SAR and Scan SAR Wide are used together with Sentinel and RADARSAT data to detect ships, oil spills and icebergs. The detectability depending on the background conditions is discussed. Several examples from near real time campaigns performed together with users are given.

  13. The Basic Radar Altimetry Toolbox for Sentinel 3 Users

    NASA Astrophysics Data System (ADS)

    Lucas, Bruno; Rosmorduc, Vinca; Niemeijer, Sander; Bronner, Emilie; Dinardo, Salvatore; Benveniste, Jérôme

    2013-04-01

    The Basic Radar Altimetry Toolbox (BRAT) is a collection of tools and tutorial documents designed to facilitate the processing of radar altimetry data. This project started in 2006 from the joint efforts of ESA (European Space Agency) and CNES (Centre National d'Etudes Spatiales). The latest version of the software, 3.1, was released on March 2012. The tools enable users to interact with the most common altimetry data formats, being the most used way, the Graphical User Interface (BratGui). This GUI is a front-end for the powerful command line tools that are part of the BRAT suite. BRAT can also be used in conjunction with Matlab/IDL (via reading routines) or in C/C++/Fortran via a programming API, allowing the user to obtain desired data, bypassing the data-formatting hassle. The BratDisplay (graphic visualizer) can be launched from BratGui, or used as a stand-alone tool to visualize netCDF files - it is distributed with another ESA toolbox (GUT) as the visualizer. The most frequent uses of BRAT are teaching remote sensing, altimetry data reading (all missions from ERS-1 to Saral and soon Sentinel-3), quick data visualization/export and simple computation on the data fields. BRAT can be used for importing data and having a quick look at his contents, with several different types of plotting available. One can also use it to translate the data into other formats such as netCDF, ASCII text files, KML (Google Earth) and raster images (JPEG, PNG, etc.). Several kinds of computations can be done within BratGui involving combinations of data fields that the user can save for posterior reuse or using the already embedded formulas that include the standard oceanographic altimetry formulas (MSS, -SSH, MSLA, editing of spurious data, etc.). The documentation collection includes the standard user manual explaining all the ways to interact with the set of software tools but the most important item is the Radar Altimeter Tutorial, that contains a strong introduction to

  14. Containing Epidemic Outbreaks by Message-Passing Techniques

    NASA Astrophysics Data System (ADS)

    Altarelli, F.; Braunstein, A.; Dall'Asta, L.; Wakeling, J. R.; Zecchina, R.

    2014-04-01

    The problem of targeted network immunization can be defined as the one of finding a subset of nodes in a network to immunize or vaccinate in order to minimize a tradeoff between the cost of vaccination and the final (stationary) expected infection under a given epidemic model. Although computing the expected infection is a hard computational problem, simple and efficient mean-field approximations have been put forward in the literature in recent years. The optimization problem can be recast into a constrained one in which the constraints enforce local mean-field equations describing the average stationary state of the epidemic process. For a wide class of epidemic models, including the susceptible-infected-removed and the susceptible-infected-susceptible models, we define a message-passing approach to network immunization that allows us to study the statistical properties of epidemic outbreaks in the presence of immunized nodes as well as to find (nearly) optimal immunization sets for a given choice of parameters and costs. The algorithm scales linearly with the size of the graph, and it can be made efficient even on large networks. We compare its performance with topologically based heuristics, greedy methods, and simulated annealing on both random graphs and real-world networks.

  15. Elective ilioingunial lymph node irradiation

    SciTech Connect

    Henderson, R.H.; Parsons, J.T.; Morgan, L.; Million, R.R.

    1984-06-01

    Most radiologists accept that modest doses of irradiation (4500-5000 rad/4 1/2-5 weeks) can control subclinical regional lymph node metastases from squamous cell carcinomas of the head and neck and adenocarcinomas of the breast. There have been few reports concerning elective irradiation of the ilioinguinal region. Between October 1964 and March 1980, 91 patients whose primary cancers placed the ilioinguinal lymph nodes at risk received elective irradiation at the University of Florida. Included are patients with cancers of the vulva, penis, urethra, anus and lower anal canal, and cervix or vaginal cancers that involved the distal one-third of the vagina. In 81 patients, both inguinal areas were clinically negative; in 10 patients, one inguinal area was positive and the other negative by clinical examination. The single significant complication was a bilateral femoral neck fracture. The inguinal areas of four patients developed mild to moderate fibrosis. One patient with moderate fibrosis had bilateral mild leg edema that was questionably related to irradiation. Complications were dose-related. The advantages and dis-advantages of elective ilioinguinal node irradiation versus elective inguinal lymph node dissection or no elective treatment are discussed.

  16. SensorNet Node Suite

    Energy Science and Technology Software Center (ESTSC)

    2004-09-01

    The software in the SensorNet Node adopts and builds on IEEE 1451 interface principles to read data from and control sensors, stores the data in internal database structures, and transmits it in adapted Web Feature Services protocol packets to the SensorNet database. Failover software ensures that at least one available mode of communication remains alive.

  17. SEOM's Sentinel-3/OLCI' project CAWA: advanced GRASP aerosol retrieval

    NASA Astrophysics Data System (ADS)

    Dubovik, Oleg; litvinov, Pavel; Huang, Xin; Aspetsberger, Michael; Fuertes, David; Brockmann, Carsten; Fischer, Jürgen; Bojkov, Bojan

    2016-04-01

    The CAWA "Advanced Clouds, Aerosols and WAter vapour products for Sentinel-3/OLCI" ESA-SEOM project aims on the development of advanced atmospheric retrieval algorithms for the Sentinel-3/OLCI mission, and is prepared using Envisat/MERIS and Aqua/MODIS datasets. This presentation discusses mainly CAWA aerosol product developments and results. CAWA aerosol retrieval uses recently developed GRASP algorithm (Generalized Retrieval of Aerosol and Surface Properties) algorithm described by Dubovik et al. (2014). GRASP derives extended set of atmospheric parameters using multi-pixel concept - a simultaneous fitting of a large group of pixels under additional a priori constraints limiting the time variability of surface properties and spatial variability of aerosol properties. Over land GRASP simultaneously retrieves properties of both aerosol and underlying surface even over bright surfaces. GRAPS doesn't use traditional look-up-tables and performs retrieval as search in continuous space of solution. All radiative transfer calculations are performed as part of the retrieval. The results of comprehensive sensitivity tests, as well as results obtained from real Envisat/MERIS data will be presented. The tests analyze various aspects of aerosol and surface reflectance retrieval accuracy. In addition, the possibilities of retrieval improvement by means of implementing synergetic inversion of a combination of OLCI data with observations by SLSTR are explored. Both the results of numerical tests, as well as the results of processing several years of Envisat/MERIS data illustrate demonstrate reliable retrieval of AOD (Aerosol Optical Depth) and surface BRDF. Observed retrieval issues and advancements will be discussed. For example, for some situations we illustrate possibilities of retrieving aerosol absorption - property that hardly accessible from satellite observations with no multi-angular and polarimetric capabilities.

  18. Low-Noise Band-Pass Amplifier

    NASA Technical Reports Server (NTRS)

    Kleinberg, L.

    1982-01-01

    Circuit uses standard components to overcome common limitation of JFET amplifiers. Low-noise band-pass amplifier employs JFET and operational amplifier. High gain and band-pass characteristics are achieved with suitable choice of resistances and capacitances. Circuit should find use as low-noise amplifier, for example as first stage instrumentation systems.

  19. PASS--Placement/Advisement for Student Success.

    ERIC Educational Resources Information Center

    Shreve, Chuck; Wildie, Avace

    In 1985-86, Northern Michigan College (NMC) used funds received from the United States Department of Education to develop a system of assessment, advisement, and placement--Placement/Advisement for Student Success (PASS), an integrated system designed to improve student retention. PASS currently consists of three components: summer orientation,…

  20. Multifrequency, single pass free electron laser

    DOEpatents

    Szoke, Abraham; Prosnitz, Donald

    1985-01-01

    A method for simultaneous amplification of laser beams with a sequence of frequencies in a single pass, using a relativistic beam of electrons grouped in a sequence of energies corresponding to the sequence of laser beam frequencies. The method allows electrons to pass from one potential well or "bucket" to another adjacent bucket, thus increasing efficiency of trapping and energy conversion.

  1. Pass transistor implementations of multivalued logic

    NASA Technical Reports Server (NTRS)

    Maki, G.; Whitaker, S.

    1990-01-01

    A simple straight-forward Karnaugh map logic design procedure for realization of multiple-valued logic circuits is presented in this paper. Pass transistor logic gates are used to realize multiple-valued networks. This work is an extension of pass transistor implementations for binary-valued logic.

  2. Jason continuity of services: continuing the Jason altimeter data records as Copernicus Sentinel-6

    NASA Astrophysics Data System (ADS)

    Scharroo, Remko; Bonekamp, Hans; Ponsard, Christelle; Parisot, François; von Engeln, Axel; Tahtadjiev, Milen; de Vriendt, Kristiaan; Montagner, François

    2016-04-01

    The Sentinel-6 mission is proposed as a multi-partner programme to continue the Jason satellite altimeter data services beyond the Jason-2 and Jason-3 missions. The Sentinel-6 mission programme consists of two identical satellites flying in sequence to prolong the climate data record of sea level accumulated by the TOPEX/Poseidon, Jason-1, Jason-2, and Jason-3 missions from 2020 to beyond 2030. The Sentinel-6 mission intends to maintain these services in a fully operational manner. A key feature is the simultaneous pulse-limited and synthetic aperture radar processing allowing direct and continuous comparisons of the sea surface height measurements based on these processing methods and providing backward compatibility. The Sentinel-6 mission will also include radio occultation user services.

  3. Sentinel: An Expert System Decision Aid For A Command, Control And Communications Operator

    NASA Astrophysics Data System (ADS)

    Tobat, Daniel L.; Rogers, Steven K.; Cross, Stephen E.

    1986-03-01

    The growing complexity and quantity of information used in command, control and communications (C3) networks makes it essential to reduce the workload on the operators of these networks. SENTINEL is an expert system which functions as a decision aid for the strategic missile warning officer, using a simulation of a C3 network that involves multiple missile launches and up to 20 countries. In this research, a blackboard model expert system using rule bases and object oriented programming techniques was developed that permits SENTINEL to deal with uncertainty and offer several layers of explanation. SENTINEL deals with uncertainty by using Cohen's endorsement theory and the pattern recognition techniques of feature sets and prototypes. SENTINEL analyzes the causes of reported events into higher level, yet less precise forms to offer an abstract layer of explanation. The results are applicable to further expert system or decision aid development for C3 networks.

  4. Jason continuity of services: continuing the Jason altimeter data records as Copernicus Sentinel-6

    NASA Astrophysics Data System (ADS)

    Scharroo, R.; Bonekamp, H.; Ponsard, C.; Parisot, F.; von Engeln, A.; Tahtadjiev, M.; de Vriendt, K.; Montagner, F.

    2015-12-01

    The Sentinel-6 mission is proposed as a multi-partner programme to continue the Jason satellite altimeter data services beyond the Jason-2 and Jason-3 missions. The Sentinel-6 mission programme consists of two identical satellites flying in sequence to prolong the climate data record of sea level accumulated by the TOPEX/Poseidon, Jason-1, Jason-2, and Jason-3 missions from 2020 to beyond 2030. The Sentinel-6 mission intends to maintain these services in a fully operational manner. A key feature is the simultaneous pulse-limited and synthetic aperture radar processing allowing direct and continuous comparisons of the sea surface height measurements based on these processing methods and providing backward compatibility. The Sentinel-6 mission will also include Radio Occultation user services.

  5. Active messages versus explicit message passing under SUNMOS

    SciTech Connect

    Riesen, R.; Wheat, S.R.; Maccabe, A.B.

    1994-07-01

    In the past few years much effort has been devoted to finding faster and more convenient ways to exchange data between nodes of massively parallel distributed memory machines. One such approach, taken by Thorsten von Eicken et al. is called Active Messages. The idea is to hide message passing latency and continue to compute while data is being sent and delivered. The authors have implemented Active Messages under SUNMOS for the Intel Paragon and performed various experiments to determine their efficiency and utility. In this paper they concentrate on the subset of the Active Message layer that is used by the implementation of the Split-C library. They compare performance to explicit message passing under SUNMOS and explore new ways to support Split-C without Active Messages. They also compare the implementation to the original one on the Thinking Machines CM-5 and try to determine what the effects of low latency and low band-width versus high latency and high bandwidth are on user codes.

  6. Neighbourhood-consensus message passing and its potentials in image processing applications

    NASA Astrophysics Data System (ADS)

    Ružic, Tijana; Pižurica, Aleksandra; Philips, Wilfried

    2011-03-01

    In this paper, a novel algorithm for inference in Markov Random Fields (MRFs) is presented. Its goal is to find approximate maximum a posteriori estimates in a simple manner by combining neighbourhood influence of iterated conditional modes (ICM) and message passing of loopy belief propagation (LBP). We call the proposed method neighbourhood-consensus message passing because a single joint message is sent from the specified neighbourhood to the central node. The message, as a function of beliefs, represents the agreement of all nodes within the neighbourhood regarding the labels of the central node. This way we are able to overcome the disadvantages of reference algorithms, ICM and LBP. On one hand, more information is propagated in comparison with ICM, while on the other hand, the huge amount of pairwise interactions is avoided in comparison with LBP by working with neighbourhoods. The idea is related to the previously developed iterated conditional expectations algorithm. Here we revisit it and redefine it in a message passing framework in a more general form. The results on three different benchmarks demonstrate that the proposed technique can perform well both for binary and multi-label MRFs without any limitations on the model definition. Furthermore, it manifests improved performance over related techniques either in terms of quality and/or speed.

  7. Sentinel-2A: Orbit Modelling Improvements and their Impact on the Orbit Prediction

    NASA Astrophysics Data System (ADS)

    Peter, Heike; Otten, Michiel; Fernández Sánchez, Jaime; Fernández Martín, Carlos; Féménias, Pierre

    2016-07-01

    Sentinel-2A is the second satellite of the European Copernicus Programme. The satellite has been launched on 23rd June 2015 and it is operational since mid October 2015. This optical mission carries a GPS receiver for precise orbit determination. The Copernicus POD (Precise Orbit Determination) Service is in charge of generating precise orbital products and auxiliary files for Sentinel-2A as well as for the Sentinel-1 and -3 missions. The accuracy requirements for the Sentinel-2A orbit products are not very stringent with 3 m in 3D (3 sigma) for the near real-time (NRT) orbit and 10 m in 2D (3 sigma) for the predicted orbit. The fulfilment of the orbit accuracy requirements is normally not an issue. The Copernicus POD Service aims, however, to provide the best possible orbits for all three Sentinel missions. Therefore, a sophisticated box-wing model is generated for the Sentinel-2 satellite as it is done for the other two missions as well. Additionally, the solar wing of the satellite is rewound during eclipse, which has to be modelled accordingly. The quality of the orbit prediction is dependent on the results of the orbit estimation performed before it. The values of the last estimation of each parameter is taken for the orbit propagation, i.e. estimating ten atmospheric drag coefficients per 24h, the value of the last coefficient is used as a fix parameter for the subsequent orbit prediction. The question is whether the prediction might be stabilised by, e.g. using an average value of all ten coefficients. This paper presents the status and the quality of the Sentinel-2 orbit determination in the operational environment of the Copernicus POD Service. The impact of the orbit model improvements on the NRT and predicted orbits is studied in detail. Changes in the orbit parametrization as well as in the settings for the orbit propagation are investigated. In addition, the impact of the quality of the input GPS orbit and clock product on the Sentinel-2A orbit

  8. Lipid-Calcium Phosphate Nanoparticles for Delivery to the Lymphatic System and SPECT/CT Imaging of Lymph Node Metastases

    PubMed Central

    Tseng, Yu-Cheng; Xu, Zhenghong; Guley, Kevin; Yuan, Hong; Huang, Leaf

    2014-01-01

    A lipid/calcium/phosphate (LCP) nanoparticle (NP) formulation (particle diameter ~25 nm) with superior siRNA delivery efficiency was developed and reported previously. Here, we describe the successful formulation of 111In into LCP for SPECT/CT imaging. Imaging and biodistribution studies showed that, polyethylene glycol grafted 111In-LCP preferentially accumulated in the lymph nodes at ~70% ID/g in both C57BL/6 and nude mice when the improved surface coating method was used. Both the liver and spleen accumulated only ~25% ID/g. Larger LCP (diameter ~67 nm) was less lymphotropic. These results indicate that 25 nm LCP was able to penetrate into tissues, enter the lymphatic system, and accumulate in the lymph nodes via lymphatic drainage due to 1) small size, 2) a well-PEGylated lipid surface, and 3) a slightly negative surface charge. The capability of intravenously injected 111In-LCP to visualize an enlarged, tumor-loaded sentinel lymph node was demonstrated using a 4T1 breast cancer lymph node metastasis model. Systemic gene delivery to the lymph nodes after IV injection was demonstrated by the expression of red fluorescent protein cDNA. The potential of using LCP for lymphatic drug delivery is discussed. PMID:24613050

  9. Citrullus lanatus 'sentinel' (watermelon) extract reduces atherosclerosis in LDL receptor-deficient mice.

    PubMed

    Poduri, Aruna; Rateri, Debra L; Saha, Shubin K; Saha, Sibu; Daugherty, Alan

    2013-05-01

    Watermelon (Citrullus lanatus or C. lanatus) has many potentially bioactive compounds including citrulline, which may influence atherosclerosis. In this study, we determined the effects of C. lanatus, provided as an extract of the cultivar 'sentinel,' on hypercholesterolemia-induced atherosclerosis in mice. Male low-density lipoprotein receptor-deficient mice at 8 weeks old were given either C. lanatus 'sentinel' extract (2% vol/vol; n=10) or a mixture of matching carbohydrates (2% vol/vol; n=8) as the control in drinking water while being fed a saturated fat-enriched diet for 12 weeks ad libitum. Mice consuming C. lanatus 'sentinel' extract had significantly increased plasma citrulline concentrations. Systolic blood pressure was comparable between the two groups. Consumption of C. lanatus 'sentinel' extract led to lower body weight and fat mass without influencing lean mass. There were no differences in food and water intake and in urine output between the two groups. C. lanatus 'sentinel' extract administration decreased plasma cholesterol concentrations that were attributed to reductions of intermediate-/low-density lipoprotein cholesterol. Plasma concentrations of monocyte chemoattractant protein-1 and interferon-gamma were decreased and those of interleukin-10 were increased in mice consuming C. lanatus 'sentinel' extract. Intake of C. lanatus 'sentinel' extract resulted in reductions of atherosclerosis in both aortic arch and thoracic regions. In conclusion, consumption of C. lanatus 'sentinel' extract led to reduced body weight gain, decreased plasma cholesterol concentrations, improved homeostasis of pro- and anti-inflammatory cytokines, and attenuated development of atherosclerosis without affecting systolic blood pressure in hypercholesterolemic mice. PMID:22902326

  10. The FDA's sentinel initiative--A comprehensive approach to medical product surveillance.

    PubMed

    Ball, R; Robb, M; Anderson, S A; Dal Pan, G

    2016-03-01

    In May 2008, the Department of Health and Human Services announced the launch of the Sentinel Initiative by the US Food and Drug Administration (FDA) to create the Sentinel System, a national electronic system for medical product safety surveillance. This system complements existing FDA surveillance capabilities that track adverse events reported after the use of FD