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Sample records for sentinel node passing

  1. Sentinel node biopsy (image)

    MedlinePlus

    ... cancer, allows a more accurate staging of the cancer, and leaves unaffected nodes behind to continue the important job of draining fluids. The procedure involves the injection of a dye (sometimes mildly radioactive) to pinpoint the lymph node ...

  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. Sentinel node evaluation in gynecologic cancer.

    PubMed

    Plante, Marie; Renaud, Marie-Claude; Roy, Michel

    2004-01-01

    The sentinel node evaluation has revolutionized the modern surgical management of cutaneous melanoma and breast cancer. In gynecologic oncology, sentinel node mapping has been mainly studied in vulvar and cervical cancer. In vulvar cancer, data from 12 studies including 353 cases indicate that the sentinel node detection rate is 92% and the negative-predictive value is 99%. Three groin recurrences have been documented so far (< 1%). The technique has more recently been studied in cervical cancer. Data from 12 studies including 323 cases indicate a lower sentinel node detection rate of 80% to 86% and a negative-predictive value of 99%. Three false-negative cases have been reported so far (< 1%). Review of the literature suggests that the combined approach with blue dye and lymphoscintigraphy is superior to the blue dye alone for sentinel node detection. It also suggests that the sentinel node mapping technique is feasible in vulvar and cervical cancer and that it may become a valuable alternative to the traditional groin and pelvic lymphadenectomy. However, results have not been duplicated in large multi-institutional trials, and the technique should still be performed in the context of clinical trials. Complications of the sentinel node mapping technique are rare and usually benign but physicians should be aware of the serious risk of anaphylactic reaction to the blue dye (1% to 2%). Before this technique becomes a standard approach in the management of gynecologic malignancies, more data will be needed to clarify some of the related controversies.

  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. 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.

  7. Sentinel Lymph Nodes for Breast Carcinoma A Paradigm Shift

    PubMed Central

    Maguire, Aoife; Brogi, Edi

    2016-01-01

    Context Sentinel lymph node biopsy has been established as the new standard of care for axillary staging in most patients with invasive breast carcinoma. Historically, all patients with a positive sentinel lymph node biopsy result underwent axillary lymph node dissection. Recent trials show that axillary lymph node dissection can be safely omitted in women with clinically node negative, T1 or T2 invasive breast cancer treated with breast-conserving surgery and whole-breast radiotherapy. This change in practice also has implications on the pathologic examination and reporting of sentinel lymph nodes. Objective To review recent clinical and pathologic studies of sentinel lymph nodes and explore how these findings influence the pathologic evaluation of sentinel lymph nodes. Data Sources Sources were published articles from peer-reviewed journals in PubMed (US National Library of Medicine) and published guidelines from the American Joint Committee on Cancer, the Union for International Cancer Control, the American Society of Clinical Oncology, and the National Comprehensive Cancer Network. Conclusions The main goal of sentinel lymph node examination should be to detect all macrometastases (>2 mm). Grossly sectioning sentinel lymph nodes at 2-mm intervals and evaluation of one hematoxylin-eosin–stained section from each block is the preferred method of pathologic evaluation. Axillary lymph node dissection can be safely omitted in clinically node-negative patients with negative sentinel lymph nodes, as well as in a selected group of patients with limited sentinel lymph node involvement. The pathologic features of the primary carcinoma and its sentinel lymph node metastases contribute to estimate the extent of non–sentinel lymph node involvement. This information is important to decide on further axillary treatment. PMID:27472237

  8. Clinical implications of contralateral axillary sentinel lymph nodes.

    PubMed

    Carmon, Moshe; Mintz, Alexander; Hain, Daniel; Olsha, Oded

    2006-04-01

    Extra-axillary sentinel lymph nodes can only be detected if radioactive tracer is used and pre-operative scans are carried out. The presence of metastatic sentinel lymph nodes in most extra-axillary sites will upstage patients if the ipsilateral axillary sentinel lymph node is normal. Paradoxically, the presence of metastatic sentinel lymph nodes in the contralateral axilla has the potential to prevent upstaging to stage IV, but only if detected as a sentinel node at the initial surgery rather than as a systemic recurrence at some later time. We describe a case of bilateral axillary sentinel lymph nodes detected by pre-operative lymphoscintigraphy in a patient with a medial quadrant breast cancer and discuss the possible implications of such a finding. PMID:16005230

  9. Sentinel Lymph Node Biopsy in Colon Cancer

    PubMed Central

    Bembenek, Andreas E.; Rosenberg, Robert; Wagler, Elke; Gretschel, Stephan; Sendler, Andreas; Siewert, Joerg-Ruediger; Nährig, Jörg; Witzigmann, Helmut; Hauss, Johann; Knorr, Christian; Dimmler, Arno; Gröne, Jörn; Buhr, Heinz-Johannes; Haier, Jörg; Herbst, Hermann; Tepel, Juergen; Siphos, Bence; Kleespies, Axel; Koenigsrainer, Alfred; Stoecklein, Nikolas H.; Horstmann, Olaf; Grützmann, Robert; Imdahl, Andreas; Svoboda, Daniel; Wittekind, Christian; Schneider, Wolfgang; Wernecke, Klaus-Dieter; Schlag, Peter M.

    2007-01-01

    Introduction: The clinical impact of sentinel lymph node biopsy (SLNB) in colon cancer is still controversial. The purpose of this prospective multicenter trial was to evaluate its clinical value to predict the nodal status and identify factors that influence these results. Methods: Colon cancer patients without prior colorectal surgery or irradiation were eligible. The sentinel lymph node (SLN) was identified intraoperatively by subserosal blue dye injection around the tumor. The SLN underwent step sections and immunohistochemistry (IHC), if classified free of metastases after routine hematoxylin and eosin examination. Results: At least one SLN (median, n = 2) was identified in 268 of 315 enrolled patients (detection rate, 85%). Center experience, lymphovascular invasion, body mass index (BMI), and learning curve were positively associated with the detection rate. The false-negative rate to identify pN+ patients by SLNB was 46% (38 of 82). BMI showed a significant association to the false-negative rate (P < 0.0001), the number of tumor-involved lymph nodes was inversely associated. If only slim patients (BMI ≤24) were investigated in experienced centers (>22 patients enrolled), the sensitivity increased to 88% (14 of 16). Moreover, 21% (30 of 141) of the patients, classified as pN0 by routine histopathology, revealed micrometastases or isolated tumor cells (MM/ITC) in the SLN. Conclusions: The contribution of SLNB to conventional nodal staging of colon cancer patients is still unspecified. Technical problems have to be resolved before a definite conclusion can be drawn in this regard. However, SLNB identifies about one fourth of stage II patients to reveal MM/ITC in lymph nodes. Further studies must clarify the clinical impact of these findings in terms of prognosis and the indication of adjuvant therapy. PMID:17522509

  10. The history of sentinel node biopsy in head and neck cancer: From visualization of lymphatic vessels to sentinel nodes.

    PubMed

    de Bree, Remco; Nieweg, Omgo E

    2015-09-01

    The aim of this report is to describe the history of sentinel node biopsy in head and neck cancer. Sentinel node biopsy is a minimally invasive technique to select patients for treatment of metastatic lymph nodes in the neck. Although this procedure has only recently been accepted for early oral cancer, the first studies on visualization of the cervical lymphatic vessels were reported in the 1960s. In the 1980s mapping of lymphatic drainage from specific head and neck sites was introduced. Sentinel node biopsy was further developed in the 1990s and after validation in this century the procedure is routinely performed in early oral cancer in several head and neck centers. New techniques may improve the accuracy of sentinel node biopsy further, particularly in difficult subsites like the floor of mouth.

  11. Sentinel node biopsy for ipsilateral breast cancer recurrence: a review.

    PubMed

    Palit, G; Jacquemyn, Y; Tjalma, W

    2008-01-01

    The aim of this study was to review published reports on the feasability, results, and reliability of sentinel node biopsy in cases of ipsilateral recurrent breast cancer. A Medline search on publications from January 1999 to December 2007 and cross-references in published articles were looked for. We identified 16 reports on sentinel node biopsy in recurrent breast cancer, including a total of 287 patients. In 210/287 (73.2%) a sentinel node was identified, 77/210 (37.7%) had had previous axillary lymph node dissection and 131 (62.3%) a previous sentinel node procedure. Aberrant lymphatic drainage, other than the ipsilateral axilla was noted in 68/210 (32.4%). Of these 16/68 (23.6%) were located in the contralateral axilla. Of the removed contralateral axillary sentinel nodes 8/17 (47.1%) were invaded by cancer. We conclude that sentinel node biopsy in cases of recurrent ipsilateral breast cancer is feasible. In about one out of three cases drainage to the contralateral axilla with invasion in almost half the cases takes place. The therapeutical consequences of these findings need further study. PMID:19115679

  12. Sentinel node identification by scintigraphic methods in cutaneous melanoma.

    PubMed

    Dias Moreira, R; Altino de Almeida, S; Maliska Guimarães, C M; Resende, J F; Gutfilen, B; Barbosa da Fonseca, L M

    2005-06-01

    In melanoma patients lymph node metastasis is an important prognostic factor that indicates the need for therapeutic lymph node dissection. Preoperative lymphoscintigraphy mapping associated with radioguided sentinel lymph node biopsy has become a well established procedure for cutaneous melanoma patients without clinically detectable lymph node metastases (stage I, II). This technique is a versatile way of characterizing the lymphatic basin at risk for metastases and identifying involved lymph nodes. The purpose of the present study was to examine the reproducibility of lymphoscintigraphy and sentinel lymph node biopsy in detecting micro metastases in cutaneous melanoma. The study was a single-institution prospective analysis of 74 melanoma patients, with primary tumors having Breslow thickness > 0.7 mm, who underwent lymphoscintigraphies between May 2002 and September 2003. Technetium-99m sulfur colloid was injected intradermally at the primary tumor site and dynamic images were obtained for 40 minutes. Two observers evaluated the images. One to two weeks after the first lymphoscintigraphy, radioguided lymph node biopsy was performed. For the biopsy, technetium-99m sulfer colloid was injected intradermally in the same manner as performed before. Lymph nodes were identified and removed with the aid of a gamma ray detecting probe (GDP), and were submitted to histopathological analysis. The histopathological analysis of the sentinel lymph nodes collected during surgery was performed in a sequential manner. First, frozen sections were analyzed during surgery. The lymph nodes considered negative by frozen section were analyzed by H&E staining. Subsequently, the slides considered negative with H&E were sent for immunohistochemical analysis. Lymphoscintigraphy identified at least one sentinel lymph node in all patients. Sentinel node biopsy detected metastases in 20 patients (27.2%). In all cases the lymph node basins identified during lymphoscintigraphy were found to

  13. 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

  14. [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

  15. 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

  16. The lingual lymph node identified as a sentinel node on CT lymphography in a patient with cN0 squamous cell carcinoma of the tongue

    PubMed Central

    Saito, M; Nishiyama, H; Oda, Y; Shingaki, S; Hayashi, T

    2012-01-01

    We performed CT lymphography on an 81-year-old female patient with a histologically confirmed squamous cell carcinoma of the tongue with no clinical or radiological evidence of cervical lymph node involvement. The lateral lingual lymph node was identified as a sentinel node, which is the first lymph node to receive drainage from a primary tumour. CT lymphography also showed draining lymphatics passing through the sublingual space, the medial side of the submandibular gland and near the hyoid bone and connected with the middle internal jugular node. Although metastasis to the lateral lingual lymph node is known as one of the crucial events in determining survival outcome in cancer of the tongue and floor of the mouth, very few reports are available on the imaging of the lateral lingual lymph node metastasis. This is the first report regarding the lateral lingual lymph node identified as a sentinel node demonstrated on CT lymphography. PMID:22074865

  17. [Sentinel lymph node biopsy in pregnancy-associated breast cancer].

    PubMed

    Mátrai, Zoltán; Bánhidy, Ferenc; Téglás, Melinda; Kovács, Eszter; Sávolt, Akos; Udvarhelyi, Nóra; Bartal, Alexandra; Kásler, Miklós

    2013-12-01

    The incidence of pregnancy-associated breast cancer is rising. Sentinel lymph node biopsy is the method of choice in clinically node negative cases as the indicated minimally invasive regional staging procedure. Some reports have linked radioisotope and blue dye required for lymphatic mapping to teratogenic effects, the idea of which has become a generalized statement and, until recently, contraindication for these agents was considered during pregnancy. Today, there are many published reports of successful interventions with low-dose 99mTc-labeled human albumin nanocolloid, based on dosimetric modeling demonstrating a negligible radiation exposure of the fetus. These results contributed to the seemingly safe and successful use of sentinel lymph node biopsy during pregnancy, though generally it can not replace axillary lymphadenectomy in the absence of high-quality evidence. The possibility of sentinel lymph node biopsy should be offered to pregnancy-associated early breast cancer patients with clinically negative axilla, and patients should be involved in the decision making following extensive counselling. This paper presents the successful use of sentinel lymph node biopsy with low-dose tracer during two pregnancies (in the first and third trimesters) and, for the first time in Hungarian language, it offers a comprehensive literature review on this topic. Orv. Hetil., 154(50), 1991-1997. PMID:24317358

  18. Reoperative sentinel lymph node biopsy in ipsilateral breast cancer relapse.

    PubMed

    Tasevski, R; Gogos, A J; Mann, G B

    2009-10-01

    Sentinel lymph node biopsy (SLNB) is controversial following ipsilateral breast tumour relapse (IBTR) and previous axillary surgery. We retrospectively assessed the feasibility, outcomes and utility of this procedure. Eighteen patients with IBTR who underwent reoperative SLNB were identified. Fifteen women had previously undergone axillary lymph node dissection and three SLNB for breast cancer. Twelve of 16 patients underwent successful lymphoscintigraphy (LSG). Lymphatic drainage patterns varied widely - ipsilateral axilla (5), contralateral axilla (5), and ipsilateral internal mammary (5). Two patients had drainage to more than one nodal basin. Nine of 12 patients demonstrated drainage outside of the ipsilateral axilla. Reoperative SLNB was successful in 12/18 of patients - 4 ipsilateral axilla, 1 ipsilateral internal mammary, 1 ipsilateral intramammary, 4 contralateral axilla. Two patients had sentinel nodes in multiple nodal basins. Positive sentinel node was found in one successful case (contralateral axilla) and isolated tumour cells in two (1 contralateral axilla, 1 ipsilateral internal mammary). In conclusion, reoperative SLNB is feasible. Lymphatic drainage patterns vary widely and preoperative LSG is vital to facilitate identification of sentinel nodes in unusual sites. Its prognostic and therapeutic significance warrants further study. PMID:19819141

  19. Sentinel lymph node biopsy under fluorescent indocyanin green guidance: Initial experience

    PubMed Central

    Aydoğan, Fatih; Arıkan, Akif Enes; Aytaç, Erman; Velidedeoğlu, Mehmet; Yılmaz, Mehmet Halit; Sager, Muhammet Sait; Çelik, Varol; Uras, Cihan

    2016-01-01

    Objective: Sentinel lymph node biopsy can be applied by using either blue dye or radionuclide method or both in breast cancer. Fluorescent imaging with indocyanine green is a new defined method. This study evaluates the applicability of sentinel lymph node biopsy via fluorescent indocyanine green. Material and Methods: IC-VIEW (Pulsion Medical Systems AG, Munich, Germany) infrared visualization system was used for imaging. Two mL of indocyanine green was injected to visualize sentinel lymph nodes. After injection, subcutaneous lymphatics were traced and sentinel lymph nodes were found with simultaneous imaging. Sentinel lymph nodes were excised under fluorescent light guidance, and excised lymph nodes were examined histopathologically. Patients with sentinel lymph node metastases underwent axillary dissection. Results: Four patients with sentinel lymph node biopsy due to breast cancer were included in the study. Sentinel lymph nodes were visualized with indocyanine green in all patients. The median number of excised sentinel lymph node was 2 (2–3). Two patients with lymph node metastasis underwent axillary dissection. No metastasis was detected in lymph nodes other than the sentinel nodes in patients with axillary dissection. There was no complication during and after the operation related to the method. Conclusion: According to our limited experience, sentinel lymph node biopsy under fluorescent indocyanine green guidance, which has an advantage of simultaneous visualization, is technically feasible. PMID:26985159

  20. 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

  1. Advances in sentinel node dissection in prostate cancer from a technical perspective.

    PubMed

    Acar, Cenk; Kleinjan, Gijs H; van den Berg, Nynke S; Wit, Esther Mk; van Leeuwen, Fijs Wb; van der Poel, Henk G

    2015-10-01

    The most important feature of sentinel node biopsy for prostate cancer procedure is that staging can be improved. Sentinel nodes might be found outside the extended pelvic lymph node dissection template what renders the sentinel node additive of extended pelvic lymph node dissection. At the same time, staging within the template can be further refined. We reviewed the literature regarding the sentinel node biopsy procedure for prostate cancer. PubMed and Embase were searched for all English-language publications from January 1999 to September 2014 by using the keywords as "prostate cancer" and "sentinel lymph node" plus "biopsy" "dissection" and/or "procedure." The present review discusses step-by-step sentinel node biopsy for prostate cancer. Topics of discussion are: (i) preoperative sentinel node mapping (tracers and imaging); (ii) intraoperative sentinel node identification (surgical procedure and outcome); and (iii) novelties to improve sentinel node identification (pre- and intraoperative approaches). Conventional sentinel node mapping is carried out after the injection of a (99m) Tc-based tracer and subsequent preoperative imaging; for example, lymphoscintigraphy and single-photon emission computed tomography/computed tomography. This approach allowed the detection of sentinel nodes outside the extended lymph node dissection template in 3.6-36% of men with intermediate- and high-risk prostate cancer. Hereby, an overall false negative rate of sentinel nodes was reported between 0% and 24.4%. To further refine the intraoperative sampling procedure, novel imaging methods such as fluorescence imaging have been introduced. Prospective randomized comparison studies are required to confirm the added benefit of sentinel template directed nodal dissection. A proper and obtainable end-point of such a study could be the number of removed positive nodes for carrying out nodal dissection with or without sentinel template directed dissection. Similarly, the clinical

  2. Pigmentation in the sentinel node correlates with increased sentinel node tumor burden in melanoma patients.

    PubMed

    van Lanschot, Cornelia G F; Koljenović, Senada; Grunhagen, Dirk-Jan; Verhoef, Cornelis; van Akkooi, Alexander C J

    2014-06-01

    The prognosis of sentinel node (SN)-positive melanoma patients is predicted by a number of characteristics such as size and site of the metastases in the SN. The pathway and prognosis of strong pigmentation of melanoma metastases in the SN is unclear. The aim of this study is to evaluate the role of pigmentation and growth pattern of metastases in the SN with respect to survival. A total of 389 patients underwent an SN procedure (1997-2011). Ninety-five patients had a positive SN and material from 75 patients was available for review. The median follow-up time was 75 months (range 6-164). Pigmentation was scored from 0 to 2 using the following scale: 0=absent, 1=slight, and 2=strong. Growth pattern was scored as either eccentric (1) or infiltrative (2). SN tumor burden was measured according to the Rotterdam criteria. The primary melanoma had a median Breslow thickness of 2.90 mm (0.8-12.00 mm). Ulceration was present in 34 patients (45.3%). There was a median SN tumor burden of 0.5 mm (0.05-7.00 mm). In a total of 75 patients, 59 patients (79%) had no pigmentation, 13 patients (17%) had slight pigmentation, and three patients (4%) had strong pigmentation in the SN. Because of the small numbers, the classification was modified to either absent 59 (79%) or present 16 (21%) pigmentation, respectively. The SN tumor burden was significantly higher (P=0.031) for patients with pigmentation. Patients with pigmentation had a 5-year melanoma-specific survival (MSS) of 47% and a 10-year MSS of 33%. Patients without pigmentation had a 5-year MSS of 70% and a 10-year MSS of 59% (P=0.06). There was no difference in MSS for patients with an eccentric or an infiltrative growth pattern, nor did it correlate with other prognostic factors. Multivariate analysis for MSS showed five significant factors associated with worse prognosis: male sex (P=0.036), nodular melanoma (P=0.001), truncal site (P=0.0001), SN tumor burden more than 1.0 mm (P=0.022), and positive completion lymph node

  3. [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.

  4. [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

  5. 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.

  6. 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.

  7. 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

  8. Axillary staging of breast cancer and the sentinel node

    PubMed Central

    Cserni, G

    2000-01-01

    Pathological aspects of axillary nodal staging of breast cancer and in particular sentinel lymph node (SLN) biopsy are reviewed. SLN biopsy seems an almost ideal staging procedure because it has both high accuracy and a low false negative rate. It may also allow a cost effective use of more sensitive methods of metastasis detection. However, the biological relevance of metastases detected only by modern tools remains to be elucidated. This review focuses on standard axillary staging and the histopathological investigation of SLNs, with emphasis on the intraoperative setting. Future trends including ancillary studies, quality control issues, prediction of non-SLN involvement, and suggestions concerning the minimum requirements for the histology of axillary SLNs are also discussed. Key Words: axillary staging • breast cancer • sentinel lymph node PMID:11064665

  9. 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

  10. Failure to remove true sentinel nodes can cause failure of the sentinel node biopsy technique: evidence from antimony concentrations in false-negative sentinel nodes from melanoma patients.

    PubMed

    Scolyer, Richard A; Thompson, John F; Li, Ling-Xi L; Beavis, Alison; Dawson, Michael; Doble, Phillip; Ka, Vivian S K; McKinnon, J Gregory; Soper, Robyne; Uren, Roger F; Shaw, Helen M; Stretch, Jonathan R; McCarthy, Stanley W

    2004-03-01

    We have recently found that antimony (originating from the technetium 99m antimony trisulfide colloid, used for preoperative lymphoscintigraphy) can be measured in tissue sections from archival paraffin blocks of sentinel nodes (SNs) by means of inductively coupled plasma mass spectrometry (ICP-MS) to confirm that removed nodes are true SNs. We performed a retrospective analysis of antimony concentrations in all our false-negative (FN) SNs to determine whether errors in lymphadenectomy (i.e., failure to remove true SNs) may be a cause of FN SN biopsies (SNBs). Among 27 patients with an FN SNB, metastases were found on histopathologic review of the original slides or additional sections in 7 of 23 patients for which they were available; however, antimony concentrations were low in 5 of 20 presumptive SNs. Our results suggest that an FN SNB can occur because of failure to remove the true SN as well as histopathologic misdiagnosis.

  11. 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

  12. Sentinel node biopsy as a surgical staging method for solid cancers.

    PubMed

    Koops, H S; Doting, M H; de Vries, J; Tiebosch, A T; Plukker, J T; Hoekstra, H J; Piers, D A

    1999-04-01

    The sentinel node is the first lymph node that drains a primary tumour. If this lymphatic drainage occurs in a step-wise fashion, this lymph node reflects the pathological status of the remaining lymph node basin. The day before the operation, a total dose of 60 MBq 99mTc nanocolloid is injected around the primary tumour for lymphoscintigraphy. On the day of surgery, 1 ml of blue dye is injected around the primary tumour to facilitate sentinel lymph node detection. After making a small incision over the regional lymph node region, the sentinel node can be detected using a hand-held gamma ray detection probe; the sentinel lymph node and the afferent lymphatic vessels will be stained blue. Sentinel node biopsy has proved useful for malignant melanoma, breast cancer, penile cancer, vulvar cancer, Merkel cell carcinoma and thyroid cancer. New studies are described on breast cancer and malignant melanoma. Gamma-probe-guided localization of radiolabelled lymph nodes can direct the surgeon non-invasively to the exact location of the sentinel node. Once localized with a gamma probe, it is quick and easy to remove the sentinel node through a small incision. Discriminating the node from other tissue can be aided by blue dye which stains the lymph node. It appears that both radioactivity and blue dye are complementary for locating the sentinel node.

  13. 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

  14. 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

  15. Sentinel node biopsy in uro-oncology: a history of the development of a promising concept.

    PubMed

    Jakobsen, Jakob Kristian

    2015-11-01

    Lymph node staging is important in many urologic malignancies. The lack of a sufficiently accurate noninvasive lymph node staging modality has proven to be challenging as most urologic malignancies rely on surgical lymph node removal for regional staging. Penile cancer has been a model disease for the development of the sentinel node concept, which has subsequently been successfully adapted to breast cancer and melanoma studies. Currently, the sentinel node technique is standardized in many centers and under development for new indications. The introduction of near-infrared cameras and fluorescence techniques has paved the way for robot-assisted laparoscopic sentinel node biopsies in prostate cancer, urinary bladder cancer, and renal cancer. Fluorescence techniques have increased visual guidance towards lymph nodes during surgery and have challenged previously established templates for surgical lymph node removal. This review discusses the history of our understanding of the lymphatic system and the development of the sentinel node concept and highlights the importance of early and minimally invasive regional lymph node staging. Contemporary data on sentinel node biopsy in each of the urologic malignancies are assessed. Current trends towards robot-assisted sentinel lymph node removal are discussed, and the diagnostic accuracy and oncologic safety of sentinel node procedures are addressed. In an era of several new sentinel node indications, the importance of proper case selection, protocolled regimen, consequent follow-up, and back-up strategies in the case of radiotracer-silent or nonvisualized regions is stressed. PMID:26409314

  16. 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

  17. 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

  18. Intraoperative examination of sentinel lymph nodes using scrape cytology.

    PubMed

    Mannell, Aylwyn; Wium, Brunton; Thatcher, Charles

    2014-08-08

    Background. In breast cancer, sentinel lymph node biopsy (SLNB) is widely used to assess the axilla when the nodes appear normal on palpation and ultrasonography. When the sentinel lymph nodes (SLNs) are negative, no further dissection is required. Surgical dissection or radiotherapy of the axilla is indicated for macrometastases, as well as adjuvant therapy for macrometastases and micrometastasic spread.Aim. To determine the accuracy of scrape cytology (SC) for intraoperative examination of the SLNs.Methods. SLNB was performed in 100 patients with early breast cancer in whom the axillary nodes appeared normal on clinical examination and ultrasonography. None of the patients with negative SLNs or SLNs with micrometastases only (N1mic, 0.2 - 2 mm) had further axillary dissection. Patients with SLNs containing macrometastases (N1, >2 mm) underwent axillary lymph node dissection. The results of intraoperative cytology were compared with the histopathological findings on examination of serial paraffin-embedded sections of the SLNs.Results. Intraoperative SC identified SLN metastases in 20 patients: 17 had macrometastases and 3 micrometastases. Histopathological examination of the SLNs found macrometastases in 18 patients and micrometastases in 6. SC had a sensitivity of 94% and specificity of 100% for the detection of macrometastases. For micrometastatic spread, the sensitivity and specificity were 50% and 100%, respectively.Conclusion. SC is a rapid, sensitive technique for detection of macrometastases in the SLNs of women with breast cancer. The overall accuracy in identification of any metastatic spread (N1mic, N1) to the SLNs was 85%, rising to 94% in SLNs with macrometastases.

  19. Factors Influencing Non-sentinel Node Involvement in Sentinel Node Positive Patients and Validation of MSKCC Nomogram in Indian Breast Cancer Population.

    PubMed

    Padmanabhan, Naveen; Ayub, Muhamed Faizal; Hussain, Khadher; Kurien, Ann; Radhakrishna, Selvi

    2015-12-01

    Current guidelines recommend completion axillary lymphnode dissection (ALND) when sentinel lymphnode (SLN) contains metastatic tumor deposit. In consequent ALND sentinel node is the only node involved by tumor in 40-70 % of cases. Recent studies demonstrate the oncologic safety of omitting completion ALND in low risk patients. Several nomograms (MSKCC, Stanford, MD Anderson score, Tenon score) had been developed in predicting the likelihood of additional nodes metastatic involvement. We evaluated accuracy of MSKCC nomogram and other clinicopathologic variables associated with additional lymph node metastasis in our patients. A total of 334 patients with primary breast cancer patients underwent SLN biopsy during the period Jan 2007 to June 2014. Clinicopathologic variables were prospectively collected. Completion ALND was done in 64 patients who had tumor deposit in SLN. The discriminatory accuracy of nomogram was analyzed using Area under Receiver operating characteristic curve (ROC). SLN was the only node involved with tumor in 69 % (44/64) of our patients. Additional lymph node metastasis was seen in 31 % (20/64). On univariate analysis, extracapsular infiltration in sentinel node and multiple sentinel nodes positivity were significantly associated (p < 0.05) with additional lymph node metastasis in the axilla. Area under ROC curve for nomogram was 0.58 suggesting poor performance of the nomogram in predicting NSLN involvement. Sentinel nodes are the only nodes to be involved by tumor in 70 % of the patients. Our findings indicate that multiple sentinel node positivity and extra-capsular invasion in sentinel node significantly predicted the likelihood of additional nodal metastasis. MSKCC nomogram did not reliably predict the involvement of additional nodal metastasis in our study population. PMID:27065658

  20. [Study of the Identification Rate of Sentinel Lymph Node Biopsy after Partial Breast Resection].

    PubMed

    Suzuki, Shuhei; Sakurai, Kenichi; Adachi, Keita; Masuo, Yuki; Nagashima, Saki; Hara, Yukiko; Amano, Sadao; Enomoto, Katsuhisa; Makishima, Makoto

    2015-11-01

    Sentinel lymph node biopsy using the dye method is generally performed for patients with breast cancer. However, identification of the sentinel lymph node in the mammary gland is occasionally difficult after breast partial resection, as lymph flow is changed under the influence of surgery. Sentinel lymph node biopsy for patients with breast cancer who underwent partial mastectomy without axillary lymph node dissection is grade C1 in the breast cancer clinical practice guideline ver.2 2013. We examined the identification rate of the sentinel lymph node for patients with breast cancer who underwent lumpectomy or partial mastectomy. Lumpectomy and partial mastectomy were performed in 4 and 3 patients, respectively. It was possible to identify the sentinel lymph node in 6 patients, and no metastasis of cancer cells was identified in any patient. In 1 patient who underwent partial mastectomy, it was impossible to identify the sentinel lymph node, and thus, Level Ⅰlymph node sampling was performed. However, the pathological diagnosis was no metastasis of cancer cells. This patient underwent partial mastectomy of the C area and a smaller volume of the mammary gland. Therefore, we consider that lymph flow changed under the influence of surgery. Sentinel lymph node biopsy using the dye method after partial breast resection is useful, but partial mastectomy of the C area makes it difficult to perform sentinel lymph node biopsy. PMID:26805174

  1. 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.

  2. Sentinel lymph node imaging by a fluorescently labeled DNA tetrahedron.

    PubMed

    Kim, Kyoung-Ran; Lee, Yong-Deok; Lee, Taemin; Kim, Byeong-Su; Kim, Sehoon; Ahn, Dae-Ro

    2013-07-01

    Sentinel lymph nodes (SLNs) are the first lymph nodes which cancer cells reach after traveling through lymphatic vessels from the primary tumor. Evaluating the nodal status is crucial in accurate staging of human cancers and accordingly determines prognosis and the most appropriate treatment. The commonly used methods for SLN identification in clinics are based on employment of a colloid of radionuclide or injection of a small dye. Although these methods have certainly contributed to improve surgical practice, new imaging materials are still required to overcome drawbacks of the techniques such as inconvenience of handling radioactive materials and short retention time of small dyes in SLNs. Here, we prepare a fluorescence-labeled DNA tetrahedron and perform SLN imaging by using the DNA nanoconstruct. With a successful identification of SLNs by the DNA nanoconstruct, we suggest that DNA tetrahedron hold great promises for clinical applications.

  3. 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

  4. Anatomy and physiology of lymphatic drainage of the breast from the perspective of sentinel node biopsy.

    PubMed

    Tanis, P J; Nieweg, O E; Valdés Olmos, R A; Kroon, B B

    2001-03-01

    Knowledge of the anatomy and physiology of the lymphatic system is helpful when considering a particular sentinel node biopsy technique. The delicate balance between internal and external pressures in a lymphatic channel can be influenced by the injection volume and by massage in a negative or positive way. The narrow openings in the interendothelial junctions determine the speed of clearance of particles with a certain size, and this has implications for the timing of lymphoscintigraphy and surgery. Tracer uptake and lymph flow are highly variable and depend on a number of factors, some of which are beyond our control. The lymphatic anatomy is not completely understood despite numerous studies since the end of the 18th century. Several topics have been elucidated in more recent studies and through experience with sentinel node biopsy. First, although axillary drainage is the principal lymphatic path of the breast, any drainage pattern from any quadrant of the breast can occur. Second, most lymph from the breast flows to the nodal basins with a direct course, not passing through the subareolar plexus. Another relevant point is that gentle massage encourages lymph flow and facilitates sentinel node detection. What problems do we still face in clinical practice? The optimum size and number of labeled colloid particles remain to be established. The optimum volume of the tracer also remains to be determined. But the main controversy concerns the injection site. Although the intradermal injection technique has attractive practical features, there is currently insufficient certainty that drainage of tracer injected anywhere in or underneath the skin of the breast reflects drainage from the cancer. Connections between collecting lymphatic vessels from the tumor site and the collecting vessels from the skin and subdermal lymphatics can explain the concordance between intraparenchymal and superficial injections in most patients. To determine the technique that yields the

  5. Sentinel node biopsy in breast cancer: short time results show appropriate regional control.

    PubMed

    Fait, V; Chrenko, V

    2007-01-01

    Sentinel node biopsy becomes a standard diagnostic and therapeutic tool in breast cancer in certain indications, while in other indications its validity is still reviewed. The authors present their experience with this method. In the years 2000-2006 700 patients underwent surgery. 704 sentinel node biopsies were performed (bilaterally in 4 cases), 7 times surgery was unsuccessful. In the unsuccessful cases immediate axillary lymph node dissection (ALND) was performed. 985 sentinel nodes were found, the average was 1.4 nodes, maximum 6 nodes. In 7 patients contralateral ALND for node positive contralateral cancer was necessary along with sentinel node biopsy. A positive sentinel lymph node (SLN) was found in 188 (26.9%) patients. A strong correlation between tumor size and lymph node positivity was found, 5.3% in pT1a, and 40.4% in pT2, respectively. The sentinel node metastases could be divided according to their size. The number of affected further nodes did correlate with this size, yet with the exception of isolated tumor cell detection, small size metastases did not exclude the possibility of further affection. Our findings support the role of sentinel node biopsy in breast cancer. 332 patients reached at least 2 years of follow up by the time of statistic evaluation, 2.5% of SLN negative and 5.6% of SLN positive patients experienced a recurrence. All of these recurrences were distant with no regional (axillary) involvement to this date. We conclude that sentinel node biopsy is not only a safe and accurate diagnostic tool, but it also provides acceptable regional control of the disease. PMID:17447860

  6. 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.

  7. 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

  8. [Interest of preoperative lymphoscintigraphy on sentinel lymph node identification in patients with breast cancer].

    PubMed

    Tulpin, L; Morel, O; Akerman, G; Malartic, C; Desfeux, P; Barranger, E

    2008-01-01

    Sentinel lymph node biopsy is nowadays an accepted method of staging breast cancer patients. In case of an injection of radioactive colloid, preoperative lymphoscintigraphy is recommended to establish a lymphatic mapping and to predict the number of sentinel lymph nodes identified during surgery. Preoperative lymphoscintigraphy does not decrease the false-negative rate. However, positive preoperative lymphoscintigraphy significantly improves the identification rate of intraoperative sentinel nodes comparing with negative preoperative lymphoscintigraphy. Detecting extra-axillary sentinel lymph nodes, because of its minimal therapeutic consequences, does not appear to be an indication for preoperative lymphoscintigraphy. Given logistics and cost required, preoperative lymphoscintigraphy should be only performed for patients with a high risk of intraoperative failed localization. In case of negative preoperative lymphoscintigraphy, sentinel lymph node biopsy must be tried because sentinel nodes are still identified in the majority of these patients. Another possibility, with important cost and logistic, should consist in performing a later lymphoscintigraphy on the day after radioactive injection to ameliorate sentinel lymph nodes identification.

  9. [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

  10. [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.

  11. Prediction of additional lymph node involvement in breast cancer patients with positive sentinel lymph nodes.

    PubMed

    Pohlodek, K; Bozikova, S; Meciarova, I; Mucha, V; Bartova, M; Ondrias, F

    2016-01-01

    Axillary lymph node dissection (ALND) has traditionally been the principal method for evaluating axillary lymph node status in breast cancer patients. In the past decades sentinel lymph nodes biopsy after lymphatic mapping has been used to stage the disease. The majority of sentinel lymph nodes (SLN) positive patients do not have additional metastases in non-sentinel nodes (non-SLN) after additional ALND. These patients are exposed to the morbidity of ALND without any benefit from additional axillary clearence. In the present study we would like to asses the criteria for selecting those patients, who have high risk for non-SLN metastases in the axilla in cases of positive SLN. In this retrospective analysis, clinical and pathologic data from 163 patients who underwent SLN biopsy followed by ALND were collected. Following clinical and pathological characteristics were analyzed to predict the likehood of non-SLN metastases: age, staging, histologic type and grading of the tumors, hormonal receptor status, HER-2 receptor status and Ki-67 protein, angioinvasion, metastases in SLN and non-SLN. Relative frequencies of individual characteristics between sample groups were statistically tested by Chi-square test at significance level p=0.5, when sample sizes in groups were small (≤5) by Fisher´s exact test. Metastasis in SLN were present in 67 (41%) of patients, 48 patients (29,4%) had metastasis also in non-SLN. The ratio between non-SLN positive / non-SLN negative lymph nodes in patients with positive SLN increases with the stage of the disease, the difference between values for the pT1c and pT2 stadium was statistically significant (p = 0.0296). The same applies to grading, but the differences were not significant (p>0.05). We could not find significant differences for angioinvasion of the tumor, probably for small number of patients with angioinvasion (p>0.05).Only the stage of the tumor was shown to be significant in predicting the metastasis in non-SLN in our

  12. 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

  13. Practical intraoperative pathologic evaluation of sentinel lymph nodes during sentinel node navigation surgery in gastric cancer patients - Proposal of the pathologic protocol for the upcoming SENORITA trial.

    PubMed

    Park, Ji Yeon; Kook, Myeong-Cherl; Eom, Bang Wool; Yoon, Hong Man; Kim, Soo Jin; Rho, Ji Yoon; Kim, Seok-Ki; Kim, Young-Il; Cho, Soo-Jeong; Lee, Jong Yeul; Kim, Chan Gyoo; Choi, Il Ju; Kim, Young-Woo; Ryu, Keun Won

    2016-09-01

    Over the last decade, as the number of patients with early gastric cancer increased and the subsequent survival rate improved, there has been a consistent effort to verify the applicability of the sentinel node concept in gastric cancer in a bid to improve postoperative quality of life in these patients. During sentinel node navigation surgery in gastric cancer patients, intraoperative pathologic examination of the retrieved sentinel nodes plays a critical role in determining the extent of surgery, but the optimal method is still under debate. Currently, a multicenter, phase III clinical trial is underway to compare laparoscopic sentinel basin dissection with stomach preserving surgery and standard laparoscopic gastrectomy in terms of oncologic outcomes in patients with clinical stage T1N0 gastric cancer. Herein, the currently available intraoperative pathologic techniques are reviewed and their clinical significance and applicability are appraised based on the published literature. The proper pathologic examination of the sentinel lymph nodes in an upcoming clinical trial (SENORITA trial) is also proposed here based on this review. PMID:27566014

  14. 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

  15. 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

  16. A critical assessment on the role of sentinel node mapping in endometrial cancer

    PubMed Central

    Ditto, Antonino; Martinelli, Fabio; Signorelli, Mauro; Perotto, Stefania; Lorusso, Domenica; Raspagliesi, Francesco

    2015-01-01

    Endometrial cancer is the most common gynecologic malignancy in the developed countries. Although the high incidence of this occurrence no consensus, about the role of retroperitoneal staging, still exists. Growing evidence support the safety and efficacy of sentinel lymph node mapping. This technique is emerging as a new standard for endometrial cancer staging procedures. In the present paper, we discuss the role of sentinel lymph node mapping in endometrial cancer, highlighting the most controversies features. PMID:26508591

  17. [INDOCYANINE GREEN (ICG) IN THE DETECTION OF SENTINEL LYMPH NODES IN ENDOMETRIAL AND CERVIX CANCER].

    PubMed

    Berlev, I V; Ulrikh, E A; Ibragimov, Z N; Guseinov, K D; Gorodnova, T V; Korolkova, E N; Trifanov, Yu N; Nekrasova, E A; Saparov, A B; Khadzhimba, A V; Mikaya, N A; Urmancheeva, A F

    2015-01-01

    We analyzed the international and our own experience of using different dyes in the identification of sentinel lymph nodes in oncogynecological practice. We evaluated the possibility of using indocyanine green (ICG) in the detection of sentinel lymph nodes in patients with endometrial and cervical cancer. The first results of the use of ICG at the Oncogynecology Department of the N.N.Petrov Research Institute of Oncology are presented.

  18. Sentinel lymph node identification by blue dye in patients with breast carcinoma

    PubMed Central

    Bakhtiar, Nighat; Jaleel, Farhat; Moosa, Foad Ali; Qureshi, Naeem Akhtar; Jawaid, Masood

    2016-01-01

    Objective: To determine the diagnostic accuracy of methylene blue dye to detect axillary lymph node metastases in patients with breast carcinoma by taking histopathology as gold standard. Methods: This quasi experimental study was done at Department of Surgery of Dow University Hospital Karachi during January 2013 to September 2015 after the approval of Hospital Ethical Committee. A total number of 85 patients with biopsy proven carcinoma were included in the study.1% methylene blue dye was infiltrated in the peri tumoural area of the diseased breast. The blue stained node called sentinel lymph node (SLN) was recognized and carefully dissected out. SLN and mastectomy with axillary clearance specimen was sent for histopathology in two separate bottles and the report of the histopathology was compared. Results: The axillary lymph nodes were positive for carcinoma in 61 cases out of 85(71.7%). Two of the patients had negative sentinel lymph node but positive non sentinel lymph node (false negative), and in three cases sentinel lymph node were involved only but not the rest of the axilla (False positive). The sensitivity, specificity and accuracy were 96.8%,86.36% and 94.1% respectively. Conclusion: Methylene blue dye technique is a reliable and safe diagnostic modality for detection of Sentinel lymph node in breast cancer patient because of its high accuracy. PMID:27182259

  19. Axillary Lymph Node Status in Early-Stage Breast Cancer Patients with Sentinel Node Micrometastases (0.2-2 mm)

    PubMed Central

    Bargehr, Johannes; Edlinger, Michael; Hubalek, Michael; Marth, Christian; Reitsamer, Roland

    2013-01-01

    Summary Background Omission of axillary lymph node dissection (ALND) is increasingly becoming the new standard of care for patients with sentinel lymph node micrometastases (SNMMs). However, a formidable proportion of patients is afflicted with non-sentinel node (NSN) macrometastatic tumor burden. Methods Over 1 decade 5,000 patients underwent sentinel node biopsies (SNB) at 2 certified breast cancer centers in Austria. All available cases of SNMM during this time period were reviewed. Clinical, tumor and lymph node parameters were analyzed using univariate and multivariate analysis to retrieve predictors for further NSN involvement. Results We identified 216 patients with SNMMs, of whom 181 subsequently underwent ALND. Of the latter patients, 16% (n = 29/181) presented with NSN axillary metastases. ALND revealed NSN macrometastases in 10.5% (n = 19/181) of all the investigated patients, and 66% of the NSN-positive patients (n = 19/29). In 28% (n = 8/29) of the NSN-positive patients, more than 1 macrometastasis was detected. The number of removed sentinel nodes was found to be a significant predictor (p = 0.007) for NSN involvement. Conclusion In this retrospective investigation of breast cancer patients with SNMMs, a substantial proportion exhibited involvement of NSNs. Macrometastases accounted for the largest fraction of NSN tumor burden. Refraining from ALND in the face of SNMMs may entail substantial micro- and macrometastatic tumor burden in the remaining axillary lymph node basin. PMID:24415968

  20. Evidence-based clinical practice guidelines on the use of sentinel lymph node biopsy in melanoma.

    PubMed

    Sondak, Vernon K; Wong, Sandra L; Gershenwald, Jeffrey E; Thompson, John F

    2013-01-01

    Sentinel lymph node biopsy (SLNB) was introduced in 1992 to allow histopathologic evaluation of the "sentinel" node, that is, the first node along the lymphatic drainage pathway from the primary melanoma. This procedure has less risk of complications than a complete lymphadenectomy, and if the sentinel node is uninvolved by tumor the likelihood a complete lymphadenectomy would find metastatic disease in that nodal basin is very low. SLNB is now widely used worldwide in the staging of melanoma as well as breast and Merkel cell carcinomas. SLNB provides safe, reliable staging for patients with clinically node-negative melanomas 1 mm or greater in thickness, with an acceptably low rate of failure in the sentinel node-negative basin. Evidence-based guidelines jointly produced by ASCO and the Society of Surgical Oncology (SSO) recommend SLNB for patients with intermediate-thickness melanomas and also state that SLNB may be recommended for patients with thick melanomas. Major remaining areas of uncertainty include the indications for SLNB in patients with thin melanomas, pediatric patients, and patients with atypical melanocytic neoplasms; the optimal radiotracers and dyes for lymphatic mapping; and the necessity of complete lymphadenectomy in all sentinel node-positive patients.

  1. 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.

  2. 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

  3. 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

    2015-06-03

    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.

  4. EFFECT OF TIME TO SENTINEL-NODE BIOPSY ON THE PROGNOSIS OF CUTANEOUS MELANOMA

    PubMed Central

    Tejera-Vaquerizo, Antonio; Nagore, Eduardo; Puig, Susana; Robert, Caroline; Saiag, Philippe; Martín-Cuevas, Paula; Gallego, Elena; Herrera-Acosta, Enrique; Aguilera, José; Malvehy, Josep; Carrera, Cristina; Cavalcanti, Andrea; Rull, Ramón; Vilalta-Solsona, Antonio; Lannoy, Emilie; Boutros, Celine; Benannoune, Naima; Tomasic, Gorana; Aegerte, Philippe; Vidal-Sicart, Sergi; Palou, Josep; Alos, LLúcia; Requena, Celia; Traves, Víctor; Pla, Ángel; Bolumar, Isidro; Soriano, Virtudes; Guillén, Carlos; Herrera-Ceballos, Enrique

    2016-01-01

    Instroduction In patients with primary cutaneous melanoma, there is generally a delay between excisional biopsy of the primary tumor and sentinel-node biopsy. The objective of this study is to analyze the prognostic implications of this delay. Patients and method This was an observational, retrospective, cohort study in four tertiary referral hospitals. A total of 1963 patients were included. The factor of interest was the interval between the date of the excisional biopsy of the primary melanoma and the date of the sentinel-node biopsy (delay time) in the prognosis. The primary outcome was melanoma-specific survival and disease-free survival. Results A delay time of 40 days or less (HR, 1.7; CI, 1.2 to 2.5) increased Breslow thickness (Breslow ≥2 mm, HR >3.7; CI 1.4 to 10.7), ulceration (HR 1.6; CI, 1.1 to 2.3), sentinel-node metastasis (HR, 2.9; CI, 1.9 to 4.2), and primary melanoma localized in the head or neck were independently associated with worse melanoma-specific survival (all P<0.03). The stratified analysis showed that the effect of delay time was at the expense of the patients with a negative sentinel-node biopsy and without regression. Conclusion Early sentinel-node biopsy is associated with worse survival in patients with cutaneous melanoma. PMID:26072362

  5. 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 %.

  6. [Lymph node staging in gastrointestinal cancer. Combination of methylene blue-assisted lymph node dissection and ex vivo sentinel lymph node mapping].

    PubMed

    Märkl, B; Arnholdt, H

    2012-11-01

    The histopathological lymph node staging is of crucial importance for the prognosis estimation and therapy stratification in gastrointestinal cancer. However, the recommended numbers of lymph nodes that should be evaluated are often not reached in routine practice. Methylene blue assisted lymph node dissection was introduced as a new, simple and efficient technique to improve lymph node harvest in gastrointestinal cancer. This method is inexpensive, causes no delay and needs no toxic substances. All studies performed revealed a highly significantly improved lymph node harvest in comparison to the conventional technique. Moreover, this technique can be combined with a new ex vivo sentinel lymph node mapping that for the first time is based on histological sentinel lymph node detection. The success rate of this method is similar to conventional techniques and it enables an efficient application of extended investigation methods, such as immunohistochemistry or the polymerase chain reaction.

  7. Blue dye can be safely omitted in most sentinel node procedures for melanoma.

    PubMed

    van der Ploeg, Iris M C; Madu, Max F; van der Hage, Jos A; Wouters, Michel W J M; Klop, W Martin C; van der Hiel, Bernies; van de Wiel, Bart A; van Akkooi, Alexander J C

    2016-10-01

    Sentinel node biopsy is a widely used staging procedure in melanoma. It is usually performed using the triple technique: lymphatic mapping after injection of a radiopharmaceutical, blue dye injection, and the use of a gamma probe. Blue dye offers visual confirmation of the location of the sentinel lymph node (SN). There are some disadvantages such as blurring of the surgical field, skin coloring, and possible anaphylactic reactions. We aimed to answer the question whether patent blue is truly necessary for correct intraoperative identification of the SN. One day preoperatively, lymphoscintigraphy (with or without single-photon emission computed tomography with integrated computed tomography) is performed and the location of the SN is marked on the skin. Perioperatively, patent blue is injected around the tumor. A handheld gamma-ray detection probe is used to determine the location of the incision and detect the SN during the operation. SNs are pursued in all regions indicated by imaging. In only six of the 681 patients (0.9%) a blue, not radioactive, sentinel node was removed. In one of them (0.15%), this was the only node excised. None of these lymph nodes harbored metastases. This study suggests that blue dye has no additional value in finding the sentinel node and is of low significance in detecting metastases. Therefore, blue dye can be safely omitted from the standardized triple technique. It may be useful in selected cases according to the surgeon's discretion.

  8. Sentinel node localization in patients with non-palpable breast cancer.

    PubMed

    Fernandez, A; Escobedo, A; Benito, E; Azpeitia, D; Guma, A; Prieto, L; Moreno, A; Martin-Comin, J

    2002-12-01

    The aim of this study was to demonstrate that radionuclide sentinel node detection can be applied to patients with non-palpable breast cancer. One hundred and ten consecutive women with unilateral breast cancer were studied. Group 1 was made up of 80 patients with palpable breast cancer (mean age, 58 years) and group 2 of 30 patients with non-palpable breast cancer detected mammographically (mean age, 55 years). Tc-nanocolloid (111 MBq) was injected peritumorally in palpable tumours, and in the tumour area (ultrasound guided) in non-palpable tumours. At 2 h post-injection, anterior and lateral scintigrams were obtained from patients in the supine position. The location of the sentinel node was marked on the patient's skin. Patients with non-palpable tumours were moved to the surgery room 3 h later, and those with palpable tumours 24 h later. The histopathological study included three haematoxylineosin sections and immunochemistry. All patients underwent axillary lymphadenectomy. The sentinel node was detected in 67 cases (84%) in group 1 and in 28 cases (93%) in group 2. In four patients (5%) in group 1 and two patients (7%) in group 2, no axillary sentinel node was detected in the surgical bed, although it had been seen in scintigraphy. In nine patients (11%) in group 1, neither scintigraphic nor surgical detection was successful. Skip metastasis was seen in six cases (10%) of palpable tumours and in one case (4%) of non-palpable tumours. It can be concluded that non-palpable breast tumours cannot be considered an exclusion criterion for sentinel node localization and biopsy. Ultrasonography-guided injection, followed by scintigraphic and surgical detection of the sentinel node, may help in the management of patients with non-palpable breast tumours. PMID:12464780

  9. Improvement of the sentinel lymph node detection rate of cervical sentinel lymph node biopsy using real-time fluorescence navigation with indocyanine green in head and neck skin cancer.

    PubMed

    Nakamura, Yasuhiro; Fujisawa, Yasuhiro; Nakamura, Yoshiyuki; Maruyama, Hiroshi; Furuta, Jun-ichi; Kawachi, Yasuhiro; Otsuka, Fujio

    2013-06-01

    The standard technique using lymphoscintigraphy, blue dye and a gamma probe has established a reliable method for sentinel node biopsy for skin cancer. However, the detection rate of cervical sentinel lymph nodes (SLN) is generally lower than that of inguinal or axillary SLN because of the complexity of lymphatic drainage in the head and neck region and the "shine-through" phenomenon. Recently, indocyanine green fluorescence imaging has been reported as a new method to detect SLN. We hypothesized that fluorescence navigation with indocyanine green in combination with the standard technique would improve the detection rate of cervical sentinel nodes. We performed cervical sentinel node biopsies using the standard technique in 20 basins of 18 patients (group A) and using fluorescence navigation in combination with the standard technique in 12 basins of 16 patients (group B). The mean number of sentinel nodes was two per basin (range, 1-4) in group A and three per basin (range, 1-5) in group B. The detection rate of sentinel nodes was 83% (29/35) in group A and 95% (36/38) in group B. The false-negative rate was 6% (1/18 patients) in group A and 0% in group B. Fluorescence navigation with indocyanine green may improve the cervical sentinel node detection rate. However, greater collection of data regarding the usefulness of cervical sentinel node biopsy using indocyanine green is necessary.

  10. 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

  11. Inguinal or inguino-iliac/obturator lymph node dissection after positive inguinal sentinel lymph node in patients with cutaneous melanoma

    PubMed Central

    Glumac, Nebojsa; Hocevar, Marko; Zadnik, Vesna; Snoj, Marko

    2012-01-01

    Background The aim of the study was to determine whether the presence of inguinal sentinel lymph node (SLN) metastases smaller than 2 mm (micrometastases) subdivided according to the number of micrometastases predicts additional, non-sentinel inguinal, iliac or obturator lymph node involvement in completion lymph node dissection (CLND). Patients and methods. Positive inguinal SLN was detected in 58 patients (32 female, 26 male, median age 55 years) from 743 consecutive and prospectively enrolled patients with primary cutaneous melanoma stage I and II who were treated with SLN biopsy between 2001 and 2007. Results Micrometastases in inguinal SLN were detected in 32 patients, 14 were single, 2 were double, and 16 were multiple. Twenty-six patients had macrometastases. Conclusions No patient with any micrometastases or a single SLN macrometastasis in the inguinal region had any iliac/obturator non-sentinel metastases after CLND in our series. Furthermore, no patient with single SLN micrometastasis in the inguinal region had any non-sentinel metastases at all after CLND in our series. In these cases respective CLND might be omitted. PMID:23077465

  12. 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.

  13. 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.

  14. Initial experience in a cancer hospital in Nepal with sentinel lymph node mapping and biopsy for evaluation of axillary lymph node status in palpable invasive breast cancer.

    PubMed

    Lamichhane, Nirmal; Pradhan, Manohar; Neupane, Prakash Raj; Shrestha, Bhakta Man; Dhakal, Hari Prasad; Thakur, Binay Kumar; Cox, Charles Evandor

    2007-03-01

    To evaluate the performance and feasibility of sentinel lymph node biopsy in early breast cancer patients using patent blue dye. From March 2004, we are consecutively enrolling breast cancer patients with tumor size less than 5 cm with no clinically palpable axillary lymph nodes in this feasibility study. So far, 21 patients underwent sentinel lymph node biopsy using 1.0% patent blue dye injection around the tumor followed by axillary dissection. Sentinel lymph node biopsy was compared with axillary dissection for its ability to accurately reflect the final pathological status of the axillary nodes. Age of patients ranged form 32-67 years old with mean age of 46.72 years. Fifty seven percent of patients were postmenopausal. Patients with T1 lesions were 8 and T2 were 13. The sentinel lymph node/s were successfully identified in 20 out of 21 patients (95.0%). The number of sentinel lymph nodes ranged from 1 to 5 (average 2.0) and non-sentinel nodes ranged from 5-22 (average 12.0). Infiltrating ductal carcinoma was diagnosed in 15 patients, DCIS with early invasion in 4 patients, invasive lobular carcinoma in 1 and medullary carcinoma in 1 patient. Of the 20 patients in whom sentinel lymph nodes were successfully identified, nodes were positive in 35.0% (7/20) of patients. All the positive nodes were detected in group with T2 lesions. SLNs were the only positive nodes in 2 patients. There were no false negative patients, yielding an accuracy of 100.0%. Lymphatic mapping using patent blue dye alone is technically feasible for patients with small (T1 or T2) palpable breast tumors. The sentinel node can be reliably identified in the majority of these patients, and its histology reflects that of the axilla with a high degree of accuracy. This method is very useful in economically backward countries as it involves less expensive material.

  15. 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

  16. 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.

  17. Scintigraphic visualization of an epigastric sentinel node in recurrent breast cancer after lumpectomy and postoperative radiation therapy.

    PubMed

    Milardovic, Renata; Castellon, Ivan; Mills, Christopher; Altinyay, M Erkan; Raphael, Barbara; Abdel-Dayem, Hussein M

    2006-04-01

    Sentinel node imaging and biopsy have become standard procedures for staging early breast cancer. Positive sentinel lymph node (SLN) biopsy necessitates the need for axillary lymph node dissection (ALND). Failure to visualize a sentinel lymph node in recurrent breast cancer after treatment by surgery, chemotherapy, and high-dose postoperative radiation therapy is almost the case in every patient. The reason for failure to visualize the sentinel node is the fibrosis that follows high-dose radiotherapy and blocks the lymphatics preventing spread of the tumor cells to the lymph nodes. Alternative pathways for the drainage of lymph from the breast are developed in these patients. We have previously reported on the alternative pathways of lymphatics to the contralateral axilla, supraclavicular area, and also reported on the development of intramammary lymph nodes. In this report, we are presenting another alternative pathway of lymphatics to the region of the epigastrium below the lower end of the sternum. PMID:16550014

  18. The role of sentinel lymph nodes in endometrial and cervical cancer.

    PubMed

    Smith, Blair; Backes, Floor

    2015-12-01

    Sentinel lymph node assessment aims to determine lymphatic spread while preventing unnecessary interventions and morbidity for those who will not benefit from lymphadenectomy. All detection methods have demonstrated reasonable sensitivity with a low false negative rate and high negative predictive value; as long as the surgeon removes all enlarged lymph nodes and a site-specific lymphadenectomy is performed if there is no mapping. The significance of micrometastases and long term outcomes are yet to be determined.

  19. [Role of sentinel lymph nodes and lymphatic mapping of colorectal cancer].

    PubMed

    Ivanov, K; Kolev, N; Ignatov, V; Temelkov, T; Madzhov, R

    2005-01-01

    The accuracy of staging of colorectal cancer is dependable of number of lymph nodes, colected and investegated from the pathologist. Moreover 50% of newfounded cases with colorectal cancer are diagnosed as I or II stage of the desease. Between 15% and 20% of these patients develop regional or distant metastases around 5 years after the examination, despite of the radical surgery. This may be due to pathological "understaging" (decrease of the stage), becouse of missed micrometastases, which size often is smaller than 5 mm. High accurate and specific pathologoanatomical methods for "ultrastaging" are cost-expensive, therefore their selective application to labeled sentinel lymph nodes has a economical benefit and saves a time. Moreover it is decreasing the understaging effect, assosiated with convectional pathologoanatomical investigaton. In the future, the technical progress will develop the intensive competiton between the sentinel lymph node mapping and the improved imaging diagnostic techniques as flurodeoxyglucose (18FDG), positron emision tomography (PET), or the other molecular imaging techniques. Unfortunately, the limited spatial resolution of these techniques, do not allow to be used for tumor staging as sentinel lymph node techniques. Therefore the sentinel lymphnode mapping become the choice of the lymphnode staging technique. PMID:18693514

  20. Can methylene blue only be used in sentinel lymph node biopsy for breast cancer?

    PubMed

    Golshan, Mehra; Nakhlis, Faina

    2006-01-01

    Sentinel lymph node biopsy (SLNB) has become an accepted standard of care to stage the axilla for clinically node-negative early stage breast cancer. In experienced hands, studies have shown an acceptable rate of identification of the sentinel lymph node (SLN) with blue dye only. Lymphazurin is occasionally associated with severe allergic reaction, including anaphylaxis and death. The use of methylene blue alone as a method of identifying the SLN in breast cancer has been reported once previously in the literature. Methylene blue may be an acceptable alternative with fewer deleterious side effects. Medical records of patients, who underwent sentinel node mapping between September 2003 and March 2005 by two surgeons at an academic medical center were reviewed. SLN mapping was performed by periareolar injection of 5 cc of 1% methylene blue. All patients with positive SLNs underwent completion axillary node dissection. During the study period, 141 consecutive patients with clinically node-negative axillas and without evidence of inflammatory breast cancer underwent SLNB with injection of methylene blue only. A SLN was identified in 136 of 141 patients (96.5%). Thirty-three of 136 SLNs (24%) harbored metastatic disease. No cases of anaphylaxis were noted. In experienced hands, methylene blue alone is a highly sensitive method of detecting SLNs. Avoiding the greater frequency of allergic reactions seen with lymphazurin is an important advantage of methylene blue.

  1. 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.

  2. 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.

  3. 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

  4. Shoulder and arm morbidity in sentinel node-negative breast cancer patients: a systematic review.

    PubMed

    Verbelen, Hanne; Gebruers, Nick; Eeckhout, Fau-Mei; Verlinden, Kim; Tjalma, Wiebren

    2014-02-01

    The purpose of this study was to assess which shoulder and arm impairments are common in sentinel node-negative breast cancer patients and to describe the incidence and time course of these impairments. A systematic literature search was performed using different electronic databases until October 2013. Inclusion criteria were (1) research studies that included breast cancer patients surgically treated using the sentinel lymph node biopsy (SLNB) technique, (2) sentinel node-negative patients, and (3) studies that investigated morbidities of shoulder and/or arm. The exclusion criteria were (1) reviews or case studies, (2) patients who have had a SLNB followed by an axillary lymph node dissection (ALND), (3) results of ALND patients and SLNB patients were not described separately, and (4) no follow-up described. Thirty articles were included, representing 5,448 patients. Shoulder and arm impairments among sentinel node-negative patients are loss of mobility, loss of strength, pain, axillary web syndrome, and sensory disorders. Within the first month after SLNB, the morbidities with the highest incidence are decreased abduction (range 40.8-100 %), forward flexion of the shoulder (range 37-100 %), pain (range 3.4-56.6 %), and numbness (range 2-64 %). Morbidities with the highest incidence after 2 years are pain (range 5.6-51.1 %), numbness (range 5.1-51.1 %), loss of strength (range 0-57.7 %), decreased internal rotation (44.4 %), and decreased abduction (range 0-41.4 %). In conclusion, although the shoulder and arm impairments are less common after SLNB alone compared to ALND, they cannot be neglected. A considerable amount of patients still suffer from those impairments more than 2 years after surgery. PMID:24496928

  5. 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.

  6. Internal Mammary Sentinel Lymph Node Biopsy With Modified Injection Technique: High Visualization Rate and Accurate Staging.

    PubMed

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

    2015-10-01

    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 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 mammary

  7. Internal Mammary Sentinel Lymph Node Biopsy With Modified Injection Technique: High Visualization Rate and Accurate Staging.

    PubMed

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

    2015-10-01

    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 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 mammary

  8. [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.

  9. [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

  10. Drainage across midline to sentinel nodes in the contralateral axilla in breast cancer.

    PubMed

    Lim, Ilhan; Shim, Jungho; Goyenechea, Martin; Kim, Chun K; Krynyckyi, Borys R

    2004-06-01

    The authors report a case of recurrent breast carcinoma in the right chest in a patient who earlier had a right breast mastectomy. Injection of Tc-99m sulfur colloid into the lesion site in the right midchest revealed drainage to a very faint node in the contralateral axilla on the left, an unexpected site, and none to the ipsilateral axilla, the expected site. Disease was found in the left axilla in the sentinel nodes. Lymphoscintigraphy added valuable information in the management of this patient. PMID:15166879

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

    PubMed

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

    2013-07-01

    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.

  12. 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

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

    PubMed

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

    2013-07-01

    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

  14. 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

  15. Sentinel lymph node biopsy in breast cancer: an analysis of the maximum number of nodes requiring excision.

    PubMed

    Gill, Jasper; Lovegrove, Richard; Naessens, Katrien; Pursell, Roslyn; Cominos, Timothy; McCormick, Colin; Umeh, Hilary; Courtney, Stephen; Smith, Brendan

    2011-01-01

    Sentinel lymph node biopsy (SNB) is now the standard of care in assessment of patients with clinically staged T1-2, N0 breast cancers. This study investigates whether there is a maximum number of sentinel lymph nodes (SLN) that need to be excised without compromising the false-negative (FN) rate of this procedure. Data were prospectively collected for 319 patients undergoing SNB between February 2001 and December 2006 at our institution. This data were analysed, both in terms of the order of SLN retrieval and relative isotope counts of the SLNs, in order to determine the maximum number of SLNs that need to be retrieved without increasing the FN rate. Furthermore, we investigated the relationship between SLN blue dye concentration and the presence of SLN metastases. The SLN identification rate was 97% with no false-negative cases amongst patients undergoing simultaneous axillary clearance historically during technique validation. In patients with SLN metastases, excision of the first 4 SLNs encountered results in the identification of a metastatic SLN in all cases. Although the majority (86%) of SNB metastases are in the hottest node, the SLN containing the metastasis is in the first 4 hottest nodes in 99% of patients with nodal metastases. The remaining 1% of SLN metastases were identified by blue dye. There was no statistically significant association between the SLN blue dye concentration and the presence of SLN metastases. A policy to remove a maximum of four blue and/or hot SLNs along with any palpably abnormal lymph nodes does not result in an increased false-negative rate of detection of SLN metastases.

  16. 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.

  17. 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

  18. [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

  19. 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.

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

    PubMed

    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

    2010-01-01

    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 20x20 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. PMID:20799832

  1. 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.

  2. 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.

  3. 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

  4. 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

  5. Prediction of lymph node metastasis and sentinel node navigation surgery for patients with early-stage gastric cancer

    PubMed Central

    Shida, Atsuo; Mitsumori, Norio; Nimura, Hiroshi; Takano, Yuta; Iwasaki, Taizou; Fujisaki, Muneharu; Takahashi, Naoto; Yanaga, Katsuhiko

    2016-01-01

    Accurate prediction of lymph node (LN) status is crucially important for appropriate treatment planning in patients with early gastric cancer (EGC). However, consensus on patient and tumor characteristics associated with LN metastasis are yet to be reached. Through systematic search, we identified several independent variables associated with LN metastasis in EGC, which should be included in future research to assess which of these variables remain as significant predictors of LN metastasis. On the other hand, even if we use these promising parameters, we should realize the limitation and the difficulty of predicting LN metastasis accurately. The sentinel LN (SLN) is defined as first possible site to receive cancer cells along the route of lymphatic drainage from the primary tumor. The absence of metastasis in SLN is believed to correlate with the absence of metastasis in downstream LNs. In this review, we have attempted to focus on several independent parameters which have close relationship between tumor and LN metastasis in EGC. In addition, we evaluated the history of sentinel node navigation surgery and the usefulness for EGC. PMID:27672266

  6. Prediction of lymph node metastasis and sentinel node navigation surgery for patients with early-stage gastric cancer.

    PubMed

    Shida, Atsuo; Mitsumori, Norio; Nimura, Hiroshi; Takano, Yuta; Iwasaki, Taizou; Fujisaki, Muneharu; Takahashi, Naoto; Yanaga, Katsuhiko

    2016-09-01

    Accurate prediction of lymph node (LN) status is crucially important for appropriate treatment planning in patients with early gastric cancer (EGC). However, consensus on patient and tumor characteristics associated with LN metastasis are yet to be reached. Through systematic search, we identified several independent variables associated with LN metastasis in EGC, which should be included in future research to assess which of these variables remain as significant predictors of LN metastasis. On the other hand, even if we use these promising parameters, we should realize the limitation and the difficulty of predicting LN metastasis accurately. The sentinel LN (SLN) is defined as first possible site to receive cancer cells along the route of lymphatic drainage from the primary tumor. The absence of metastasis in SLN is believed to correlate with the absence of metastasis in downstream LNs. In this review, we have attempted to focus on several independent parameters which have close relationship between tumor and LN metastasis in EGC. In addition, we evaluated the history of sentinel node navigation surgery and the usefulness for EGC. PMID:27672266

  7. Prediction of lymph node metastasis and sentinel node navigation surgery for patients with early-stage gastric cancer

    PubMed Central

    Shida, Atsuo; Mitsumori, Norio; Nimura, Hiroshi; Takano, Yuta; Iwasaki, Taizou; Fujisaki, Muneharu; Takahashi, Naoto; Yanaga, Katsuhiko

    2016-01-01

    Accurate prediction of lymph node (LN) status is crucially important for appropriate treatment planning in patients with early gastric cancer (EGC). However, consensus on patient and tumor characteristics associated with LN metastasis are yet to be reached. Through systematic search, we identified several independent variables associated with LN metastasis in EGC, which should be included in future research to assess which of these variables remain as significant predictors of LN metastasis. On the other hand, even if we use these promising parameters, we should realize the limitation and the difficulty of predicting LN metastasis accurately. The sentinel LN (SLN) is defined as first possible site to receive cancer cells along the route of lymphatic drainage from the primary tumor. The absence of metastasis in SLN is believed to correlate with the absence of metastasis in downstream LNs. In this review, we have attempted to focus on several independent parameters which have close relationship between tumor and LN metastasis in EGC. In addition, we evaluated the history of sentinel node navigation surgery and the usefulness for EGC.

  8. Risk of node metastasis of sentinel lymph nodes detected in level II/III of the axilla by single-photon emission computed tomography/computed tomography

    PubMed Central

    SHIMA, HIROAKI; KUTOMI, GORO; SATOMI, FUKINO; MAEDA, HIDEKI; TAKAMARU, TOMOKO; KAMESHIMA, HIDEKAZU; OMURA, TOSEI; MORI, MITSURU; HATAKENAKA, MASAMITSU; HASEGAWA, TADASHI; HIRATA, KOICHI

    2014-01-01

    In breast cancer, single-photon emission computed tomography/computed tomography (SPECT/CT) shows the exact anatomical location of sentinel nodes (SN). SPECT/CT mainly exposes axilla and partly exposes atypical sites of extra-axillary lymphatic drainage. The mechanism of how the atypical hot nodes are involved in lymphatic metastasis was retrospectively investigated in the present study, particularly at the level II/III region. SPECT/CT was performed in 92 clinical stage 0-IIA breast cancer patients. Sentinel lymph nodes are depicted as hot nodes in SPECT/CT. Patients were divided into two groups: With or without hot node in level II/III on SPECT/CT. The existence of metastasis in level II/III was investigated and the risk factors were identified. A total of 12 patients were sentinel lymph node biopsy metastasis positive and axillary lymph node dissection (ALND) was performed. These patients were divided into two groups: With and without SN in level II/III, and nodes in level II/III were pathologically proven. In 11 of the 92 patients, hot nodes were detected in level II/III. There was a significant difference in node metastasis depending on whether there were hot nodes in level II/III (P=0.0319). Multivariate analysis indicated that the hot nodes in level II/III and lymphatic invasion were independent factors associated with node metastasis. There were 12 SN-positive patients followed by ALND. In four of the 12 patients, hot nodes were observed in level II/III. Two of the four patients with hot nodes depicted by SPECT/CT and metastatic nodes were pathologically evident in the same lesion. Therefore, the present study indicated that the hot node in level II/III as depicted by SPECT/CT may be a risk of SN metastasis, including deeper nodes. PMID:25289038

  9. 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

  10. Sentinel lymph node metastasis after neoadjuvant treatment in breast cancer: Any size matters?

    PubMed Central

    Rubio, Isabel T

    2015-01-01

    One of the advantages of neoadjuvant chemotherapy (NAC) treatments is its ability to convert patients who need a mastectomy in breast conservative surgery. NAC has also increased the conversion of node positive patients into node negative in around 40% allowing the use of sentinel node biopsy (SLN) in this setting. Timing of SLN biopsy after NAC has been a subject of debate. In patients with clinically node negative before NAC, rates of success and false negative rates of SLN after NAC are similar to those in the adjuvant setting, so SLN after NAC in previous negative axilla has been incorporated in the staging of the axilla. More controversial is its use in patients with positive axillary nodes before NAC who convert to node negative after NAC. Several randomized studies have reported the identification rates and the false negative rates of the SLN after NAC, concordant in the importance of surgical technique. As there is an agreement in the abandon of the immunohistochemistry (IHC) for SLN in the adjuvant setting as SLN IHC detected metastasis appear to have no impact on overall survival, in patients with SLN after NAC the inclusion of isolated tumor cell (ITC) as positive nodes lowers the false negative rates of the technique, suggesting the importance of assessing the SLN by IHC after NAC and considering it as residual disease. Longer follow up is needed to determine the prognostic implications of ITC in the SLN after NAC. PMID:26677431

  11. 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

  12. Systematic review of studies investigating sentinel node navigation surgery and lymphatic mapping for gastric cancer.

    PubMed

    Can, Mehmet Fatih; Yagci, Gokhan; Cetiner, Sadettin

    2013-08-01

    Evolutions in minimally invasive surgical techniques and advances in sentinel node navigation surgery (SNNS) have had considerable impact on current insights into surgical treatment of gastric cancer. Extensive data on this method of surgical application have accumulated but have been principally derived from single-institute studies. Isosulfan blue and patent blue violet have been the most frequently used dye tracers in the past; however, indocyanine green has now is increasingly popular. The double-tracer method, where dye and radioisotope tracers are used together, seems to be more effective than any single tracer. Among newly emerging adjunct techniques and promising alternative in particular are infrared ray electronic endoscopy, florescence imaging, nanoparticles, and near-infrared technology. Hematoxylin and eosin (H&E) staining is still the method of choice for the detection of sentinel lymph node (SLN) metastases. Immunohistochemical staining can be used to support H&E findings, but the equipment costs of ultrarapid processing systems are currently slowing down their worldwide spread. We believe minimally invasive function-preserving resection of the stomach, together with lymphatic basin dissection navigated by SLNs, can represent the ideal approach for SNNS to detect clinically node-negative early gastric cancer, although this remains to be elucidated. Patients with cT3 or more advanced disease should still be treated by means of standard D2 dissection.

  13. Development and evaluation of sentinel node biopsy: a continuing professional development course.

    PubMed

    Jenkinson, Jodie; Woolridge, Nicholas; Wilson-Pauwels, Linda; McCready, David; Brierley, Meaghan

    2003-01-01

    The Interpretive Visualization (IVIS) Group at the Division of Biomedical Communications, Dept. of Surgery, University of Toronto has developed a visually-oriented, Internet-based Continuing Professional Development (CPD) course on Sentinel Node Biopsy. The site design methodology involved an extensive needs assessment, iterative formative evaluations of site and media design, a summative evaluation of the project, and a final evaluation for certification. Special emphasis was placed on asynchronous Web-based evaluation of the visual media-including still images, animations, and interactive figures-used in the course. Results reinforced the importance of: needs assessment; a user-centered design process; and rapid prototyping. PMID:15164569

  14. [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

  15. Laparoscopic Indocyanine Green Sentinel Lymph Node Mapping in Pregnant Cervical Cancer Patients.

    PubMed

    Papadia, Andrea; Mohr, Stefan; Imboden, Sara; Lanz, Susanne; Bolla, Daniele; Mueller, Michael D

    2016-02-01

    We present cases of 2 pregnant patients with early-stage cervical cancer who have undergone indocyanine green (ICG) sentinel lymph node (SLN) mapping followed by laparoscopic SLN biopsy, pelvic lymphadenectomy, and cervical conization. Eight milliliters of ICG were injected in the 4 quadrants of the cervix after having obtained an adequate pneumoperitoneum and having inspected the abdominal cavity. SLNs were identified in both hemipelvises in both patients. In the final pathologic analysis, both SLNs and non-SLNs were negative for metastatic disease. No adverse events from ICG injection were recorded. ICG SLN mapping seems to be feasible in pregnant cervical cancer patients.

  16. 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

  17. [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.

  18. A study of sentinel node biopsy in T1 breast cancer treatment: experience of 48 cases.

    PubMed

    Mechella, M; De Cesare, A; Di Luzio, E; Di Paolo, M; Bolognese, A; Scopinaro, F

    2000-01-01

    Axillary clearance in breast cancer has been proven to be unnecessary in more than 50% of cases. Sentinel node biopsy (SNB) is a new technique that can be used to avoid unnecessary axillary clearance in breast cancer surgery. Our integrated team, consisting of surgeons, pathologists and nuclear medicine physicians, studied 48 cases of T1 breast cancer with lymphoscintigraphy-guided SNB. Before starting this study, the team performed 20 SNBs as a learning procedure. 500 microCi of 99mTc-nanocoll in 0.2 mL were injected around the lesion, under US or x-ray guidance if necessary. Static images in anterior, lateral and lateral oblique view collected at the end of a 20 min dynamic study were used to mark the SN on the skin. During surgery a gamma probe was used to guide SN resection, and node invasion was assessed with cytokeratin immunohistochemistry. In 14 patients tracer uptake was observed in a single node, in 30 patients in 2-4 nodes, whereas in four patients the nodes were scintigraphically missed. Surgical resection was possible in 42 nodes out of 54. All but two patients with negative immunohistochemistry for cancer cell clusters showed metastasis-free axillary nodes. All patients with positive SNBs (13) showed involved axilla. In four patients the lymphatic drainage was towards the intramammary chain; one node was juxtaclavicular and one node was intramammary in the upper outer quadrant. The overall sensitivity of the method was about 80%, the specificity about 90% with a diagnostic accuracy about 80%. SNB is a promising method for surgical decision-making regarding axillary clearance in breast cancer. Adequate training of an interdisciplinary team is needed in order to successfully perform SNB and assess SN invasion. Its unusual anatomic location can be encountered and technical care is necessary to correctly identify and remove them.

  19. 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

  20. Single skip metastasis in sentinel lymph node: In an early gastric cancer.

    PubMed

    Bara, Tivadar; Gurzu, Simona; Jung, Ioan; Kadar, Zoltan; Sugimura, Haruhiko; Bara, Tivadar

    2015-09-01

    Lymph node status is considered a key prognostic and predictive factor in patients with gastric cancer (GC). Although there is a practical approach to the intraoperative detection of sentinel lymph nodes (SLNs), such a procedure is not included in the European surgical protocol. In this report, we present a practical approach to SLN mapping in a representative case with early gastric cancer (EGC). A 74-year-old female was hospitalized with an endoscopically observed, superficially ulcerated tumor located in the antral region. Subtotal gastrectomy with D2 lymphadenectomy and SLN mapping was performed by injecting methylene blue dye into the peritumoral submucosal layer. An incidentally detected blue-stained lymph node located along the middle colic artery was also removed. This was detected 40 min after injection of the methylene blue. Histopathologic examination showed a pT1b-staged well-differentiated HER-2-negative adenocarcinoma. All of the 41 LNs located at the first, third, and fifth station of the regional LN compartments were found to be free of tumor cells. The only lymph node with metastasis was located along the middle colic artery and was considered a non-regional lymph node. This incidentally identified skip metastasis indicated stage IV GC. A classic chemotherapy regimen was given, and no recurrences were observed six months after surgery. In this representative case, low-cost SLN mapping, with a longer intraoperative waiting time, totally changed the stage of the tumor in a patient with EGC.

  1. 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

  2. Is blue dye still required during sentinel lymph node biopsy for breast cancer?

    PubMed Central

    Peek, Mirjam CL; Kovacs, Tibor; Baker, Rose; Hamed, Hisham; Kothari, Ash; Douek, Michael

    2016-01-01

    Background In early breast cancer, the optimal technique for sentinel lymph node biopsy (SLNB) is the combined technique (radioisotope and Patent Blue V) which achieves high identification rates. Despite this, many centres have decided to stop using blue dye due to blue-dye-related complications (tattoo, anaphylaxis). We evaluated the SLNB identification rate using the combined technique with and without Patent Blue V and the blue-dye-related complication rates. Methods Clinical and histological data were analysed on patients undergoing SLNB between March 2014 and April 2015. SLNB was performed following standard hospital protocols using the combined technique. Results A total of 208 patients underwent SLNB and 160 patients (342 nodes) with complete operation notes were available for final analysis. The identification rate with the combined technique was 98.8% (n = 158/160), with blue dye alone 92.5% (n = 148/160) and with radioisotope alone 97.5% (n = 156/160). A total of 76.9% (263/342) of nodes were radioactive and blue, 15.5% (53/342) only radioactive and 2.3% (8/342) only blue, 5.3% (18/342) were neither radioactive nor blue. No anaphylactic reactions were reported and blue skin staining was reported in six (3.8%) patients. Conclusion The combined technique should continue be the preferred technique for SLNB and should be standardised. Radioisotope alone (but not blue dye alone) has comparable sentinel node identification rates in experienced hands. National guidelines are required to optimise operative documentation. PMID:27729939

  3. 5-year follow-up after sentinel node mapping for breast cancer demonstrates better than expected treatment outcomes.

    PubMed

    Fuhrman, George M; Gambino, Jamie; Bolton, John S; Farr, Gist; Jiang, Xiaozhang

    2005-07-01

    We conducted this study to provide one of the initial assessments of treatment outcomes for breast cancer patients evaluated with sentinel node mapping. All patients diagnosed with breast carcinoma, evaluated with sentinel node mapping, and followed for 5 years were divided into three groups depending on sentinel node(s) status. Group I (node negative) included 91 patients, 77 with invasive cancer, and 7 lost to follow-up. Of the remaining 70 patients, 3 (4.3%) suffered a distant recurrence and died, 1 developed an in-breast recurrence, and 9 (12.9%) developed a contralateral cancer during the study. Group II (IHC positive) included 28 patients. One (3.6%) developed a distant recurrence and died of breast cancer, and one developed a contralateral cancer during follow. Group III (H&E positive) included 36 patients with 1 lost to follow-up. Five patients (14.3%) died of breast cancer and two (5.7%) developed contralateral carcinomas during follow-up. The most striking observation was a lower than expected rate of distant recurrences in these patients followed for 5 years after a diagnosis of breast cancer and staging with sentinel node mapping. The ability to identify subtle nodal metastasis and design appropriate systemic therapeutic strategies may explain this finding. PMID:16089119

  4. 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

  5. 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

  6. [Detailed pathological examination of the sentinel lymph nodes in order to detect micrometastases: no clinical relevance in patients with breast cancer].

    PubMed

    Meijnen, Ph; Peterse, J L; Nieweg, O E; Rutgers, E J

    2004-12-01

    Staging of the axillary lymph nodes yields important prognostic information in patients with breast cancer. The characteristics of the primary tumour are more significant for prognosis if only micrometastases (diameter < or = 2.0 mm) are found. For staging purposes and to estimate the prognosis, pathological examination of axillary lymph nodes therefore need not be focused on the detection of micrometastases. Sentinel lymph node biopsy is increasingly being used as an alternate staging method and to determine the indication for axillary lymph node dissection. To reduce the risk of overlooking lymph node metastasis, the sentinel node is being more thoroughly investigated, resulting in the finding of micrometastases in 10-20% of sentinel node negative patients. The sentinel node tumour load correlates with the chance of detecting more metastases in the axilla: an average of 18% for micrometastases, 12% for submicrometastases (diameter < or = 0.2 mm). However, if detailed pathological examination of the sentinel node is omitted, this would result in a low false-negative percentage (1.1-2.5% of all patients undergoing a sentinel node examination), which is less than the percentage false negatives in the sentinel lymph node procedure itself (3.2% on average). Hence, the benefit of detailed pathologic examination with step sectioning and the application of immunohistochemical staining may be doubted.

  7. Intraoperative fluorescence imaging to localize tumors and sentinel lymph nodes in rectal cancer.

    PubMed

    Handgraaf, Henricus J M; Boogerd, Leonora S F; Verbeek, Floris P R; Tummers, Quirijn R J G; Hardwick, James C H; Baeten, Coen I M; Frangioni, John V; van de Velde, Cornelis J H; Vahrmeijer, Alexander L

    2016-01-01

    Tumor involvement at the resection margin remains the most important predictor for local recurrence in patients with rectal cancer. A careful description of tumor localization is therefore essential. Currently, endoscopic tattooing with ink is customary, but visibility during laparoscopic resections is limited. Near-infrared (NIR) fluorescence imaging using indocyanine green (ICG) could be an improvement. In addition to localize tumors, ICG can also be used to identify sentinel lymph nodes (SLNs). The feasibility of this new technique was explored in five patients undergoing laparoscopic low anterior resection for rectal cancer. Intraoperative tumor visualization was possible in four out of five patients. Fluorescence signal could be detected 32 ± 18 minutes after incision, while ink could be detected 42 ± 21 minutes after incision (p = 0.53). No recurrence was diagnosed within three months after surgery. Ex vivo imaging identified a mean of 4.2 ± 2.7 fluorescent lymph nodes, which were appointed SLNs. One out of a total of 83 resected lymph nodes contained a micrometastasis. This node was not fluorescent. This technical note describes the feasibility of endoscopic tattooing of rectal cancer using ICG:nanocolloid and NIR fluorescence imaging during laparoscopic resection. Simultaneous SLN mapping was also feasible, but may be less reliable due to neoadjuvant therapy.

  8. Immune cell profile of sentinel lymph nodes in patients with malignant melanoma – FOXP3+ cell density in cases with positive sentinel node status is associated with unfavorable clinical outcome

    PubMed Central

    2013-01-01

    Background Besides being a preferential site of early metastasis, the sentinel lymph node (SLN) is also a privileged site of T-cell priming, and may thus be an appropriate target for investigating cell types involved in antitumor immune reactions. Methods In this retrospective study we determined the prevalence of OX40+ activated T lymphocytes, FOXP3+ (forkhead box P3) regulatory T cells, DC-LAMP+ (dendritic cell-lysosomal associated membrane protein) mature dendritic cells (DCs) and CD123+ plasmacytoid DCs by immunohistochemistry in 100 SLNs from 60 melanoma patients. Density values of each cell type in SLNs were compared to those in non-sentinel nodes obtained from block dissections (n = 37), and analyzed with regard to associations with clinicopathological parameters and disease outcome. Results Sentinel nodes showed elevated amount of all cell types studied in comparison to non-sentinel nodes. Metastatic SLNs had higher density of OX40+ lymphocytes compared to tumor-negative nodes, while no significant difference was observed in the case of the other cell types studied. In patients with positive sentinel node status, high amount of FOXP3+ cells in SLNs was associated with shorter progression-free (P = 0.0011) and overall survival (P = 0.0014), while no significant correlation was found in the case of sentinel-negative patients. The density of OX40+, CD123+ or DC-LAMP+ cells did not show significant association with the outcome of the disease. Conclusions Taken together, our results are compatible with the hypothesis of functional competence of sentinel lymph nodes based on the prevalence of the studied immune cells. The density of FOXP3+ lymphocytes showed association with progression and survival in patients with positive SLN status, while the other immune markers studied did not prove of prognostic importance. These results, together with our previous findings on the prognostic value of activated T cells and mature DCs infiltrating primary

  9. 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

  10. 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.

  11. Enhancement of the photostability and retention time of indocyanine green in sentinel lymph node mapping by anionic polyelectrolytes.

    PubMed

    Noh, Young-Woock; Park, Hye Sun; Sung, Moon-Hee; Lim, Yong Taik

    2011-09-01

    Sentinel lymph node (SLN) biopsy techniques have been widely used in the diagnosis of cancer metastasis because lymph node metastasis is one of the most important prognostic signs. Indocyanine green (ICG) has potential application as a molecular imaging probe for SLN mapping due to its fluorescent properties emitting in the near-infrared (NIR) region, where light transmission through biological tissue is maximized. However, its low photostability in an aqueous solution at the physiological temperature and its rapid diffusion behavior through SLN into the second lymph node have limited its wide use in real clinical fields. In this study, we developed a new NIR imaging contrast system consisting of ICG and poly (γ-glutamic acid) (γ-PGA) polymers for efficient sentinel lymph node mapping. By a combination of clinically used ICG and the biocompatible anionic polyelectrolyte, γ-PGA, the photostabilities of aqueous ICG solutions at room and body temperatures were drastically enhanced. When the ICG/γ-PGA complex was injected subcutaneously into the front paw of a mouse, it entered the lymphatics and migrated to the axillary sentinel lymph node (SLN) within 2 min. Furthermore, the NIR fluorescent signal intensity and retention time of ICG/γ-PGA complex in lymph node were superior to those of ICG only. In addition, a histofluorescentstudy of the SLN resected under NIR imaging revealed that ICG and γ-PGA were co-localized in the lymph node.Taken together, the experimental results on the enhanced photostability and retention time of the ICG/γ-PGA complex provide strong evidence that it has promising potential for improved sentinel lymph node mapping.

  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.

  13. Our experience of melanoma thickness as a predictor of outcome of sentinel node biopsy.

    PubMed

    Homolak, Damir; Vucetić, Borki; Puljiz, Zvonimir; Blajć, Iva; Vurnek Zivković, Maja; Situm, Mirna

    2008-10-01

    All follow up protocols for patients with malignant melanoma (MM) are oriented to early detection of metastases. As most of the relapses happened in regional lymph nodes, special attention is given to this region, using different diagnostic tools. Sentinel lymph node biopsy (SLNB) is generally accepted method in determining status of lymph nodes in MM patients, in their staging. This method provides valuable prognostic information, facilitates early therapeutical lymphadenectomy and so provides good base for identification of those patients who are candidates for different adjuvant modalities of treatment. (In 2001 American Joint Committee on Cancer introduced new staging system for melanoma patients which presents good frame for prognosis and therapeutical approach. Inclusion of new criteria will allow better and more individualized prognosis and treatment.) The most important predictor of SLNB outcome is thickness of tumor according to Breslow, while there is no sufficient data to show correlation with other factors. We retrospectively studded 431 patients, out of which SLNB was performed on 188. Forty patients or 21.3% had positive lymph nodes. Our results showed strong correlation of tumor thickness and Clark level of invasion with SLNB outcome. Metastatic lymph nodes were founded in all acral-lentiginous melanoma patients, followed by nodular melanoma--55.6% and superficial spreading melanoma--14.1%. Results showed statistically significant predilection of positive SLNB in male patients and no correlation of positive SLNB with histological type of tumor. On the contrary, it showed significant correlation with development of metastases. Thus our results are similar to other comparable studies. PMID:19138008

  14. The sentinel node concept in prostate cancer: Present reality and future prospects

    PubMed Central

    Egawa, M.; Fukuda, M.; Takashima, H.; Misaki, T.; Kinuya, K.; Terahata, S.

    2008-01-01

    A sentinel node (SN) is defined as the first site where cancer cells are carried by lymph flow from a tumor. If this definition (SN concept) correctly reflects the clinical reality, intraoperative SN biopsy would facilitate precise nodal staging. In malignant melanoma, a prolonged survival has been evidenced by a large-scale randomized controlled study. On the contrary, research on SN concept in deeply located cancers including prostate cancer, is still investigative, and no concrete data from clinical trials are yet available. Since 1993, several investigators have demonstrated that the SN concept could be applied in prostate cancer patients as well with high accuracy. Although promising and technically feasible in pre-clinical settings, many hurdles remain to be cleared before clinical application can be recommended. This review addresses the current status and related issues of the SN concept in prostate cancer, and discusses the future directions. PMID:19468495

  15. Implications of transaxillary breast augmentation: lifetime probability of breast cancer development and sentinel node mapping interference.

    PubMed

    Prado, Arturo; Andrades, Patricio; Leniz, Patricio

    2007-01-01

    After the "fifth-generation" breast implants with ultracohesive silicone gel technology are introduced, the Food and Drug Administration (FDA) will sooner or later retire the ban on the use of these devices in the United States. When this happens, the plastic surgery community must be prepared to face a massive demand for reoperations to change saline-filled breast implants because cohesive gel devices have the potential to provide a more natural breast shape, to minimize the risk of postoperative rippling, and to provide a greater degree of safety if the implant loses its integrity. Despite these advantages and extensive use throughout the rest of the world during the ban in the United States, silicone implants also have disadvantages. One drawback is that transaxillary breast augmentation with more "rigid" gel-filled implants may produce trauma to the armpit, may interfere with sentinel node mapping for breast cancer treatment, and may have future medicolegal implications. PMID:17549559

  16. The effect of mannosylation of liposome-encapsulated indocyanine green on imaging of sentinel lymph node.

    PubMed

    Jeong, Hwan-Seok; Lee, Chang-Moon; Cheong, Su-Jin; Kim, Eun-Mi; Hwang, Hyosook; Na, Kyung Sook; Lim, Seok Tae; Sohn, Myung-Hee; Jeong, Hwan-Jeong

    2013-12-01

    The imaging of sentinel lymph nodes (SLN) has been researched for its role in assessing cancer progression and postsurgical lymphedema. Indocyanine green (ICG) is a near-infrared (NIR) optical dye that has been approved by the Food and Drug Administration. It is known that liposome-encapsulated ICG (LP-ICG) has improved stability and fluorescence signal compared with ICG. We designed mannosylated liposome-encapsulated ICG (M-LP-ICG) as an optical contrast agent for SLN. M-LP-ICG has a higher UV absorbance spectrum and fluorescence intensity than LP-ICG. The stability of M-LP-ICG measured in 50% fetal bovine serum solution by a dialysis method was better than that of LP-ICG. M-LP-ICG demonstrated a high uptake in RAW 264.7 macrophage cell because the density of mannose is high. There were differences between M-LP-ICG and glucosylated liposome-encapsulated ICG (G-LP-ICG), which are geometrical isomers. The result of an inhibition study of M-LP-ICG showed a statistically significant decrease in uptake in RAW 264.7 cells after either co-treatment or pre-treatment with D-(+)-mannose as an inhibitor. Results from an in vitro experiment demonstrated that M-LP-ICG was specifically taken up by macrophage cells through the mannose receptor on its surface. The time-series images acquired from a normal mouse model after subcutaneous injection showed that the signal from M-LP-ICG in SLN and other organs appeared early and disappeared quickly in comparison with signals from LP-ICG. Not only the sentinel but also the draining lymph nodes were observed partly in M-LP-ICG. M-LP-ICG appears to increase the specificity of uptake and retention in macrophages, making it a good candidate contrast agent for an optic imaging system for SLN and the lymphatic system.

  17. 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

  18. Fluorescence tomographic imaging of sentinel lymph node using near-infrared emitting bioreducible dextran nanogels.

    PubMed

    Li, Jiejing; Jiang, Beiqi; Lin, Chao; Zhuang, Zhigang

    2014-01-01

    Sentinel lymph node (SLN) mapping is a critical procedure for SLN biopsy and its diagnosis as tumor metastasis in clinical practice. However, SLN mapping agents used in the clinic frequently cause side effects and complications in the patients. Here, we report the development of a near-infrared (NIR) emitting polymeric nanogel with hydrodynamic diameter of ~28 nm - which is the optimal size for SLN uptake - for noninvasive fluorescence mapping of SLN in a mouse. This polymeric nanogel was obtained by coupling Cy7, an NIR dye, to the self-assembled nanogel from disulfide-linked dextran-deoxycholic acid conjugate with the dextran of 10 kDa, denoted as Dex-Cy7. Fluorescence imaging analysis showed that Dex-Cy7 nanogels had an enhanced photostability when compared to Cy7 alone. After intradermal injection of Dex-Cy7 nanogel into the front paw of a mouse, the nanogels were able to migrate into the mouse's axillary lymph node, exhibiting longer retention time and higher fluorescence intensity in the node when compared to Cy7 alone. An immunohistofluorescence assay revealed that the nanogels were localized in the central region of lymph node and that the uptake was largely by the macrophages. In vitro and in vivo toxicity results indicated that the dextran-based nanogels were of low cytotoxicity at a polymer concentration up to 1,000 μg/mL and harmless to normal liver and kidney organs in mice at an intravenous dose of 1.25 mg/kg. The results of this study suggest that NIR-emitting polymeric nanogels based on bioreducible dextran-deoxycholic acid conjugates show high potential as fluorescence nanoprobes for safe and noninvasive SLN mapping.

  19. 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.

  20. In vivo photoacoustic and ultrasonic mapping of rat sentinel lymph nodes with a modified commercial ultrasound imaging system

    NASA Astrophysics Data System (ADS)

    Erpelding, Todd N.; Kim, Chulhong; Pramanik, Manojit; Guo, Zijian; Dean, John; Jankovic, Ladislav; Maslov, Konstantin; Wang, Lihong V.

    2010-02-01

    Sentinel lymph node biopsy (SLNB) has become the standard method for axillary staging in breast cancer patients, relying on invasive identification of sentinel lymph nodes (SLNs) following injection of blue dye and radioactive tracers. While SLNB achieves a low false negative rate (5-10%), it is an invasive procedure requiring ionizing radiation. As an alternative to SLNB, ultrasound-guided fine needle aspiration biopsy has been tested clinically. However, ultrasound alone is unable to accurately identify which lymph nodes are sentinel. Therefore, a non-ionizing and noninvasive detection method for accurate SLN mapping is needed. In this study, we successfully imaged methylene blue dye accumulation in vivo in rat axillary lymph nodes using a Phillips iU22 ultrasound imaging system adapted for photoacoustic imaging with an Nd:YAG pumped, tunable dye laser. Photoacoustic images of rat SLNs clearly identify methylene blue dye accumulation within minutes following intradermal dye injection and co-registered photoacoustic/ultrasound images illustrate lymph node position relative to surrounding anatomy. To investigate clinical translation, the imaging depth was extended up to 2.5 cm by adding chicken breast tissue on top of the rat skin surface. These results raise confidence that photoacoustic imaging can be used clinically for accurate, noninvasive SLN mapping.

  1. 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.

  2. 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

  3. Role of Indocyanine Green in Sentinel Node Mapping in Gynecologic Cancer: Is Fluorescence Imaging the New Standard?

    PubMed

    Darin, María Cecilia; Gómez-Hidalgo, Natalia Rodriguez; Westin, Shannon N; Soliman, Pamela T; Escobar, Pedro F; Frumovitz, Michael; Ramirez, Pedro T

    2016-02-01

    Sentinel lymph node biopsy has proven safe and feasible in a number of gynecologic cancers such as vulvar cancer, cervical cancer, and endometrial cancer. The proposed aim of lymphatic mapping and sentinel node identification is to decrease the associated morbidity of a complete lymphadenectomy, particularly the rate of lymphedema, while also increasing the detection of small tumor deposits in the node. Different tracers have been shown to be useful, including technetium-99 and blue dye, with a detection reported in 66% to 86%. Recently, there has been increasing interest in the use of fluorescent dies such as indocyanine green (ICG). In this report we provide a review of the existing literature regarding the use of ICG in cervical or endometrial cancer with the goal to provide details on its utility and compare it with other tracers.

  4. 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

  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.

  6. Evaluation of Breast Sentinel Lymph Node Coverage by Standard Radiation Therapy Fields

    SciTech Connect

    Rabinovitch, Rachel Ballonoff, Ari; Newman, Francis M.S.; Finlayson, Christina

    2008-04-01

    Background: Biopsy of the breast sentinel lymph node (SLN) is now a standard staging procedure for early-stage invasive breast cancer. The anatomic location of the breast SLN and its relationship to standard radiation fields has not been described. Methods and Materials: A retrospective review of radiotherapy treatment planning data sets was performed in patients with breast cancer who had undergone SLN biopsy, and those with a surgical clip at the SLN biopsy site were identified. The location of the clip was evaluated relative to vertebral body level on an anterior-posterior digitally reconstructed radiograph, treated whole-breast tangential radiation fields, and standard axillary fields in 106 data sets meeting these criteria. Results: The breast SLN varied in vertebral body level position, ranging from T2 to T7 but most commonly opposite T4. The SLN clip was located below the base of the clavicle in 90%, and hence would be excluded from standard axillary radiotherapy fields where the inferior border is placed at this level. The clip was within the irradiated whole-breast tangent fields in 78%, beneath the superior-posterior corner multileaf collimators in 12%, and outside the tangent field borders in 10%. Conclusions: Standard axillary fields do not encompass the lymph nodes at highest risk of containing tumor in breast cancer patients. Elimination of the superior-posterior corner MLCs from the tangent field design would result in inclusion of the breast SLN in 90% of patients treated with standard whole-breast irradiation.

  7. Prognostic Significance of Molecular Upstaging of Paraffin-Embedded Sentinel Lymph Nodes in Melanoma Patients

    PubMed Central

    Takeuchi, Hiroya; Morton, Donald L.; Kuo, Christine; Turner, Roderick R.; Elashoff, David; Elashoff, Robert; Taback, Bret; Fujimoto, Akihide; Hoon, Dave S.B.

    2010-01-01

    Purpose Detection of micrometastases in sentinel lymph nodes (SLNs) is important for accurate staging and prognosis in melanoma patients. However, a significant number of patients with histopathology-negative SLNs subsequently develop recurrent disease. We hypothesized that a quantitative realtime reverse transcriptase polymerase chain reaction (qRT) assay using multiple specific mRNA markers could detect occult metastasis in paraffin-embedded (PE) SLNs to upstage and predict disease outcome. Patients and Methods qRT was performed on retrospectively collected PE SLNs from 215 clinically node-negative patients who underwent lymphatic mapping and sentinel lymphadenectomy for melanoma and were followed up for at least 8 years. PE SLNs (n = 308) from these patients were sectioned and assessed by qRT for mRNA of four melanoma-associated genes: MART-1 (antigen recognized by T cells-1), MAGE-A3 (melanoma antigen gene-A3 family), GalNAc-T (β1→4-N-acetylgalactosaminyl-transferase), and Pax3 (paired-box homeotic gene transcription factor 3). Results Fifty-three (25%) patients had histopathology-positive SLNs by hemotoxylin and eosin and/or immunohistochemistry. Of the 162 patients with histopathology-negative SLNs, 48 (30%) had nodes that expressed at least one of the four qRT markers, and these 48 patients also had a significantly increased risk of disease recurrence by a Cox proportional hazards model analysis (P < .0001; risk ratio, 7.48; 95% CI, 3.70 to 15.15). The presence of ≥ one marker in histopathology-negative SLNs was also a significant independent prognostic factor by multivariate analysis for overall survival (P = .0002; risk ratio, 11.42; 95% CI, 3.17 to 41.1). Conclusion Molecular upstaging of PE histopathology-negative SLNs by multiple-marker qRT assay is a significant independent prognostic factor for long-term disease recurrence and overall survival of patients with early-stage melanoma. PMID:15226334

  8. [Assessment of sentinel lymph node biopsy in patients receiving neoadjuvant chemotherapy in breast cancer: before or after?].

    PubMed

    Coutant, C; Jankowski, C; Portha, H; Barranger, E

    2016-06-01

    The main goal of preoperative chemotherapy is to reduce the size of the tumor and allow conservative treatment. Neoadjuvant treatment can affect axillary status with a downstaging in one third of the cases. For these patients, the benefit of axillary node dissection is questioned and the sentinel node biopsy (SLNB) seems to be a relevant option. However, the timing of performing SLNB is still debated especially for clinical negative patients with negative axillary ultrasound before preoperative chemotherapy. For axillary positive nodes proved by biopsy/cytology before preoperative chemotherapy, SLNB can be an option if there is a good clinical and radiological response. PMID:27234216

  9. 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.

  10. The effect of excisional biopsy on the accuracy of sentinel lymph node mapping in early stage breast cancer: comparison with core needle biopsy.

    PubMed

    Forghani, Mohammad Naser; Memar, Bahram; Jangjoo, Ali; Zakavi, Rasoul; Mehrabibahar, Mostafa; Kakhki, Vahid Reza Dabbagh; Kashani, Ida; Hashemian, Farnaz; Sadeghi, Ramin

    2010-11-01

    Despite the successful application of sentinel node mapping in breast cancer patients, its use in patients with a history of previous excisional biopsy of the breast tumors is a matter of controversy. In the present study we evaluated the accuracy of sentinel node biopsy in this group of patients and compared the results with those in whom the diagnosis of breast cancer was established by core needle biopsy. Eighty patients with early stage breast carcinoma were included into our study. Forty patients had a history of previous excisional biopsy and the remainder 40 had undergone core needle biopsy. Intradermal injections of 99mTc-antimony sulfide colloid as well as patent blue were both used for sentinel node mapping. Sentinel nodes were harvested during surgery with the aid of surgical gamma probe. All patients underwent standard axillary lymph node dissection subsequently. Detection rate was 97.5 per cent for both groups of the study. Number of detected sentinel node during surgery was not significantly different between groups. False negative rate was 0 per cent for both groups of the study. In conclusion sentinel node biopsy is reliable in patients with previous history of excisional biopsy of the breast tumors and has a low false negative rate.

  11. Double sentinel lymph node mapping with indocyanine green and 99m-technetium-tin colloid in oral squamous cell carcinoma.

    PubMed

    Murase, R; Tanaka, H; Hamakawa, T; Goda, H; Tano, T; Ishikawa, A; Hino, S; Sumida, T; Nakashiro, K; Hamakawa, H

    2015-10-01

    Oral squamous cell carcinoma (OSCC) frequently metastasizes to cervical lymph nodes, which is the most known prognostic factor. Screening methods to identify sentinel lymph nodes (SLNs) are therefore of great interest for the management of potential neck metastasis. The purpose of this study was to evaluate the clinical benefit of double SLN mapping with indocyanine green (ICG) and 99m-technetium-tin colloid ((99m)Tc-tin colloid) for sentinel node navigation surgery (SNNS). Between 2007 and 2010, 16 patients diagnosed with OSCC were investigated by SLN biopsy using the double mapping method. (99m)Tc-tin colloid was injected into the peri-tumoural region on the preoperative day, and ICG was administered intraoperatively in the same position to assist in detecting nodes during surgery. Based on the gamma-ray signal and near-infrared (NIR) fluorescence of ICG, SLNs were identified and thereafter assessed pathologically and genetically for cancer involvement. Radio-guided detection was successful for all patients. ICG mapping identified a relatively larger number of nodes, suggesting that several non-SLNs were potentially involved. The double mapping method assisted surgeons to explore SLNs. Since the ICG fluorescence was shielded by the subcutaneous fatty tissue and the muscle layer including platysma and sternocleidomastoid, it was necessary to retract the tissue away from nodes.

  12. 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

  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. 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

  15. Photoacoustic sentinel lymph node imaging with self-assembled copper neodecanoate nanoparticles.

    PubMed

    Pan, Dipanjan; Cai, Xin; Yalaz, Ceren; Senpan, Angana; Omanakuttan, Karthik; Wickline, Samuel A; Wang, Lihong V; Lanza, Gregory M

    2012-02-28

    Photoacoustic tomography (PAT) is emerging as a novel, hybrid, and non-ionizing imaging modality because of its satisfactory spatial resolution and high soft tissue contrast. PAT combines the advantages of both optical and ultrasonic imaging methods. It opens up the possibilities for noninvasive staging of breast cancer and may replace sentinel lymph node (SLN) biopsy in clinic in the near future. In this work, we demonstrate for the first time that copper can be used as a contrast metal for near-infrared detection of SLN using PAT. A unique strategy is adopted to encapsulate multiple copies of Cu as organically soluble small molecule complexes within a phospholipid-entrapped nanoparticle. The nanoparticles assumed a size of 80-90 nm, which is the optimum hydrodynamic diameter for its distribution throughout the lymphatic systems. These particles provided at least 6-fold higher signal sensitivity in comparison to blood, which is a natural absorber of light. We also demonstrated that high SLN detection sensitivity with PAT can be achieved in a rodent model. This work clearly demonstrates for the first time the potential use of copper as an optical contrast agent.

  16. Feeling blue, going green and finding other attractive alternatives: a case of biphasic anaphylaxis to patent blue and a literature review of alternative sentinel node localisation methods.

    PubMed

    Iqbal, Fahad Mujtaba; Basit, Abdul; Salem, Fathi; Vidya, Raghavan

    2015-12-15

    Patent blue dye is used for sentinel lymph node localisation in order to stage the axilla in patients with breast cancer. Patent blue is one of the most common dyes used across the UK, however, the incidence of adverse effects seems to be increasing. This case highlights our experience of a biphasic anaphylactic reaction to patent blue dye, and we conduct a brief literature review of alternative and more novel methods to adequately visualise the lymphatics for sentinel lymph node biopsy.

  17. 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.

  18. 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

  19. Nodal combined blue nevus and benign nevus cells in multiple axillary sentinel nodes in a patient with breast carcinoma: report of a case.

    PubMed

    Begum, S M K Nahar; Lomme, Michele; Quddus, M Ruhul

    2014-09-01

    Combined blue nevus and benign nevus cells were identified in the same sentinel lymph node. Blue nevus alone was also present in an additional sentinel lymph node in the same axilla in a patient who underwent needle localization, wide local excision, and sentinel lymph node biopsy for her pT1cN1mi(sn)M(na) invasive duct carcinoma of the breast. Of the 4 sentinel lymph nodes, 1 showed micrometastasis and 2 other lymph nodes showed blue nevus involving the capsule and trabeculae of the nodes. The patient had no significant previous clinical history of any skin tumors and had a negative clinical examination for malignant melanoma or pigmented skin lesions after the diagnosis of nodal blue nevus. To our knowledge, this is the first case report of combined blue nevi involving multiple sentinel lymph nodes in the same axilla. An equally interesting finding is the presence of benign nonpigmented nevus cells in continuation with the blue nevus in the same node.

  20. Magnetic Resonance Sentinel Lymph Node Imaging of the Prostate with Gadofosveset trisodium-albumin: Preliminary results in a Canine Model

    PubMed Central

    Turkbey, Baris; Hoyt, Robert F.; Agarwal, Harsh K.; Bernardo, Marcelino; Sankineni, Sandeep; Johnson, Linda; Grant, Kinzya B.; Rais-Bahrami, Soroush; Kobayashi, Hisataka; Wood, Bradford J.; Pinto, Peter A.; Griffiths, Gary L.; Choyke, Peter L.

    2015-01-01

    Objective To determine if intraprostatic injection of gadofosveset trisodium mixed with human serum albumin (HSA) can identify sentinel lymph nodes draining the prostate on magnetic resonance imaging (MRI) in a canine model. Material-Methods Three male canines weighing between 25.7 and 41.3 kg were anesthetized, placed in a 3T MRI and a needle was placed transrectally into one side of the prostate using a commercially available intrarectal needle guide. Gadofosveset trisodium premixed with 10% HSA was then administered at doses ranging from 0.1 to 2.5ml. T1W MRI was performed immediately after injection and two readers evaluated images for visualization of LNs draining the prostate. Results Intraprostatic injection of 0.2 ml gadofosveset trisodium premixed with HSA identified the draining periprostatic lymph nodes in all cases. Delayed images demonstrated upper echelon nodes in the pelvis and abdomen. Higher volume injections resulted in excessive periprostatic extravasation whereas lower volume injections resulted in suboptimal visualization of LNs. Conclusion We demonstrate that gadofosveset trisodium (premixed with 10% HSA) injected intraprostatically at 0.2ml visualized lymph nodes draining the prostate. This approach can be readily adapted for clinical applications such as sentinel lymph node imaging in prostate cancer patients prior to surgery. PMID:25683498

  1. Injection site radioactivity of (99m)Tc-labeled mannosylated dextran for sentinel lymph node mapping.

    PubMed

    Yamaguchi, Aiko; Hanaoka, Hirofumi; Pirmettis, Ioannis; Uehara, Tomoya; Tsushima, Yoshito; Papadopoulos, Minas; Arano, Yasushi

    2015-02-01

    The high and persistent radioactivity at the injection site hinders the accuracy and expansion of sentinel lymph node (SLN) mapping. We investigated the mechanism underlying the undesirable radioactivity after subcutaneous injection of (99m)Tc-labeled mannosylated dextran ((99m)Tc(CO)3-DCM20), a SLN mapping agent targeting mannose receptors on macrophages and dendritic cells, in a mouse model. Biodistribution studies were performed 1 h after subcutaneous injection of (99m)Tc(CO)3-DCM20 from the rear footpad of mice in the presence of varying molar amounts of DCM20 or DC15, a modified dextran without mannose. Biodistribution studies were also conducted after subcutaneous injection of [(125)I]radioiodinated mannosyl-neoglycoalbumin ((125)I-NMA) from the rear footpad. The distribution of fluorescence-labeled DCM20 and DC15 at the injection site was also compared 1 h after subcutaneous injection by immunofluorescent histochemistry. The radioactivity levels of (99m)Tc(CO)3-DCM20 at the injection site and popliteal lymph node, a SLN in this model, decreased with an increase in the molar amounts of DCM20, whereas no significant changes in biodistribution were observed after injection of (99m)Tc(CO)3-DCM20 with varying molar amounts of DC15. (125)I-NMA exhibited rapid elimination of radioactivity from both the popliteal lymph node and the injection site. The fluorescence-labeled DCM20 colocalized well with CD68-positive cells such as macrophages and dendritic cells at the injection site. While partial colocalization was observed between DC15 and CD68-positive cells, the signal intensity was very weak. These findings suggest that specific binding of (99m)Tc(CO)3-DCM20 to the mannose receptor on macrophages and dendritic cells would be responsible for the sustained radioactivity levels at the injection site. These results also imply that discriminated blockage of (99m)Tc(CO)3-DCM20 binding to mannose receptors at the injection sites would reduce the radioactivity at the

  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. 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

  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. 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

  6. 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

  7. 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

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

    PubMed

    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

    Near-infrared (NIR) fluorescence imaging using indocyanine green (ICG) has the potential to improve the sentinel lymph node (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 NIR fluorescence for 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 (99)Technetium-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 one 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.

  9. 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.

  10. 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.

  11. 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.

  12. The Central-European SentiMag study: sentinel lymph node biopsy with superparamagnetic iron oxide (SPIO) vs. radioisotope.

    PubMed

    Thill, Marc; Kurylcio, Andrzej; Welter, Rebekka; van Haasteren, Viviana; Grosse, Britta; Berclaz, Gilles; Polkowski, Wojciech; Hauser, Nik

    2014-04-01

    Sentinel lymph node biopsy (SLNB) is the standard surgical procedure for the axilla in early node-negative breast cancer. To date, the "gold standard" to localize the sentinel lymph node (SLN) is the radiotracer (99m)Tc with or without blue dye. The aim of this study was to evaluate potential equivalency of the new SentiMag(®) technique in comparison to the "gold standard". Within this prospective, multicentric and multinational non-inferiority study including 150 patients (99m)Tc was compared with the magnetic technique, using superparamagnetic iron oxide particles (SPIOs, Sienna+(®)) for localization of SLNs. The results showed a detection rate per patient of 97.3% (146/150) for (99m)Tc vs. 98.0% (147/150) for Sienna+(®) with a similar average number of removed SLNs per patient and a higher per patient malignancy detection rate for the SPIO tracer. We obtained convincing results that magnetic SLNB can be performed easily, safely and equivalently well in comparison to the radiotracer method.

  13. 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

  14. 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

  15. Sequential dermal-peritumoral radiocolloid injection for sentinel node biopsy for breast cancer: the University of Florida experience.

    PubMed

    Feezor, Robert J; Kasraeian, Ali; Copeland, Edward M; Schell, Scott R; Hochwald, Steven N; Cendan, Juan; Drane, Walter; Mastin, Suzanne; Wilkinson, Edward; Lind, D Scott

    2002-08-01

    Although sentinel lymph node (SLN) biopsy is rapidly becoming the standard of care for small breast cancers the optimal radiocolloid injection technique remains controversial. We report our experience with sequential dermal-peritumoral radiocolloid injection that takes advantage of both techniques. One hundred eighteen patients with clinical stage T(is), T1, T2 and N0 breast cancer underwent SLN biopsy at the University of Florida. Twelve to 18 hours before surgery patients received either an injection of 0.5 to 1.0 mCi 50:50 filtered:unfiltered technetium sulfur colloid into the dermis overlying the tumor and/or a peritumoral injection of a 3 to 4-mCi of radiocolloid 30 minutes later. Dynamic lymphoscintigraphy was performed and the topographical location of all imaged lymph nodes was marked on the skin. The next morning the surgeon utilized a hand-held gamma probe to remove all SLN(s) defined as any lymph node with radioactive counts 10 per cent or more of the ex vivo counts of the most radioactive SLN [internal mammary (IM) nodes were not removed]. The SLN identification rate was 98.5 per cent (3 IM nodes) for dermal injection (d.), 83.3 per cent (1 IM node) for peritumoral injection (p.), and 100 per cent (14 IM nodes) for sequential dermal-peritumoral injection (d.p.) (p < 0.05 DP versus D). Sequential d.p. 50:50 filtered:unfiltered technetium sulfur colloid injection results in a rapid, high SLN identification rate that persists until surgery the next morning. Delineation of nonaxillary SLNs may lead to more accurate breast cancer staging and may also influence the delivery of IM node radiation.

  16. Validation of the sentinel lymph node biopsy technique in head and neck cancers of the oral cavity.

    PubMed

    Radkani, Pejman; Mesko, Thomas W; Paramo, Juan C

    2013-12-01

    The purpose of this study was to present our experience and validate the use of sentinel lymph node (SLN) mapping in patients with head and neck cancers. A retrospective review of a prospectively collected database of patients with a diagnosis of squamous cell carcinomas of the head and neck from 2008 to 2011 was done. The group consisted of a total of 20 patients. The first node(s) highlighted with blue, or identified as radioactive by Tc99-sulfur radioactive colloid, was (were) identified as the SLNs. In the first seven patients, formal modified neck dissection was performed. In the remaining 13 patients, only a SLN biopsy procedure was done. At least one SLN was identified in all 20 patients (100%). Only one patient (5%) had positive nodes. In this case, the SLN was also positive. In the remaining 19 cases, all lymph nodes were negative. After an average of 24 months of follow-up, there have been three local recurrences (15%) but no evidence of distant metastatic disease. SLN mapping in head and neck cancers is a feasible technique with a high identification rate and a low false-negative rate. Although the detection rate of regional metastatic disease compares favorably with published data as well as the disease-free and overall survival, further studies are warranted before considering this technique to be the "gold standard" in patients with oral squamous cell carcinoma and a negative neck by clinical examination and imaging studies. PMID:24351359

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

    PubMed

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

    2015-09-01

    γ-Tilmanocept ((99m)Tc-labeled-tilmanocept or [(99m)Tc]-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.

  18. Saccharide substituted zinc phthalocyanines: optical properties, interaction with bovine serum albumin and near infrared fluorescence imaging for sentinel lymph nodes.

    PubMed

    Lu, Li; Lv, Feng; Cao, Bo; He, Xujun; Liu, Tianjun

    2014-01-03

    Saccharide-substituted zinc phthalocyanines, [2,9(10),16(17),23(24)-tetrakis((1-(β-D-glucose-2-yl)-1H-1,2,3-triazol-4-yl)methoxy)phthalocyaninato]zinc(II) and [2,9(10), 16(17),23(24)-tetrakis((1-(β-D-lactose-2-yl)-1H-1,2,3-triazol-4-yl)methoxy)phthalocyaninato] zinc(II), were evaluated as novel near infrared fluorescence agents. Their interaction with bovine serum albumin was investigated by fluorescence and circular dichroism spectroscopy and isothermal titration calorimetry. Near infrared imaging for sentinel lymph nodes in vivo was performed using nude mice as models. Results show that saccharide- substituted zinc phthalocyanines have favourable water solubility, good optical stability and high emission ability in the near infrared region. The interaction of lactose-substituted phthalocyanine with bovine serum albumin displays obvious differences to that of glucose- substituted phthalocyanine. Moreover, lactose-substituted phthalocyanine possesses obvious imaging effects for sentinel lymph nodes in vivo.

  19. In house development of (99m)Tc-Rhenium sulfide colloidal nanoparticles for sentinel lymph node detection.

    PubMed

    Dar, Ume-Kalsoom; Khan, Irfanullah; Javed, Muhammad; Ali, Muhammad; Hyder, Syed Waqar; Murad, Sohail; Anwar, Jamil

    2013-03-01

    In this study, rhenium sulfide colloidal nanoparticles were developed as radiopharmaceutical for sentinel lymph node detection. We directly used rhenium sulfide as a starting material for the preparation of colloidal nanoparticles. UV-visible spectrophotometry was used for characterization of in house developed colloidal particles. The size distribution of radioactive particles was studied by using membrane filtration method. The percentage of radiolabeled colloidal nanoparticles was determined by paper chromatography (PC). The study also includes in vitro stability, protein binding in human blood and bioevaluation in a rabbit model. The results indicate that 77.27 ± 3.26 % particles of size less than 20nm (suitable for lymphoscintigraphy) were radiolabeled. (99m)Tc labeled rhenium sulfide labeling efficacy with the radiometal is 98.5 ± 0.5%, which remains considerably stable beyond 5h at room temperature. Furthermore, it was observed that 70.2 ± 1.3% radiolabeled colloid complex showed binding with the blood protein. Bioevaluation results show the remarkable achievement of our radiopharmaceutical. The in house prepared (99m)Tc labeled rhenium sulfide colloidal nanoparticles reached the sentinel node within 15 min of post injection. These results indicate that (99m)Tc labeled rhenium sulfide colloid nanoparticles kit produced by a novel procedure seems of significant potential as a feasible candidate for further development to be used in clinical practice.

  20. 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

  1. Prediction of Extracapsular Invasion at Metastatic Sentinel Nodes and Non-sentinel Lymph Nodal Metastases by FDG-PET in Cases with Breast Cancer.

    PubMed

    Fujii, Takaaki; Yajima, Reina; Tatsuki, Hironori; Kuwano, Hiroyuki

    2016-04-01

    We have previously reported that the presence of an extracapsular invasion (ECI) at sentinel lymph nodes (SLNs) is a strong predictor of non-SLN metastasis in breast cancer. We hypothesized that(18)F-fluorodeoxyglucose (FDG) uptake by metastatic SLNs reflects invasive disease, or ECI. In this study, we evaluated the association of FDG uptake with ECI on SLNs and the possibility of FDG-positron-emission tomography (PET) assessment of axillary non-SLN metastases. We retrospectively investigated the cases of 156 consecutive patients with primary breast cancer who underwent SLN biopsy and FDG-PET preoperatively. Among 35 patients (22.4%) in whom the presence of SLN metastases was diagnosed, 10 cases (28.6%) had FDG uptake in the axillary lesion. The sensitivity, specificity, overall accuracy, and false-negative rates in the diagnosis of SLN status by FDG-PET were 28.6%, 99.2%, 83.3%, and 71.4%, respectively. The false-positive rate of FDG-PET evaluation was 0.8%. The 35 cases with lymph node metastases were divided into two groups based on the presence of FDG uptake in the axillary lesions. None of the clinicopathological features of the primary tumor were significantly associated with FDG uptake in the axillary lesion. The present analysis revealed that only tumor size of the metastatic lymph node was significantly associated with FDG uptake in the axillary lesion. The two groups were not significantly different in terms of presence of ECI and non-SLN metastasis. Among the 35 cases with SLN metastases, 13 cases (37.1%) had non-SLN metastasis. Only ECI was a predictor of non-SLN involvement. FDG uptake in the axilla was not associated with non-SLN metastasis in this study. In conclusion, FDG-PET evaluation of lymph nodes is not a sufficient indicator of ECI at SLN metastasis or non-SLN metastasis, suggesting that axillary lymph node dissection cannot be avoided. However, since the positive predictive value for SLN metastasis is high, positive FDG uptake in the axillary

  2. [Prospect and guideline update of sentinel lymph node biopsy for patients with early-stage breast carcinoma].

    PubMed

    Zhou, Mei-qi; Chen, Hai-long; Hu, Yue; Deng, Yong-chuan; Zheng, Shu

    2014-07-01

    Axillary lymph nodes are the most common and initial site of metastasis of breast carcinoma. Precise axillary staging of breast carcinoma before initial treatment is crucial as it allows efficient identification for local and systemic treatment options, and provides prognostic information. Sentinel lymph node biopsy (SLNB) is an accurate minimally invasive technology for axillary staging. Although top evidence of high-quality clinical trials showed that SLNB could safely and effectively replace axillary lymph node dissection (ALND) for axillary negative patients with decrease in complications and improvement in quality of life, there are specific indications and contraindications for SLNB. Clinicians should balance the compliance of guideline and native clinical practice, especially for the circumstance of multifocal/multicentric lesion, breast biopsy history, and neoadjuvant chemotherapy. With the accumulation of clinical practice and new results of clinical trials, axillary therapy has changed from unique surgery to patient-tailored multi-disciplinary intervention, although ALND should be recommended traditionally if SLNB is positive. Intensive and accurate preoperative axillary staging is gradually valued by clinicians. Development of imaging modality especially ultrasonography and ultrasound-guided biopsy can identify some extra lymph node positive patients directly to ALND with avoidance of unnecessary SLNB. Thus, the positive rate of SLNB will decline significantly. It seems possible that axillary management will step into a noninvasive era abandoning SLNB in some patients with small breast cancer. In this article we review the prospect and guideline update of SLNB for patients with early-stage breast cancer.

  3. Supervised automated microscopy increases sensitivity and efficiency of detection of sentinel node micrometastases in patients with breast cancer

    PubMed Central

    Mesker, W E; Torrenga, H; Sloos, W C R; Vrolijk, H; Tollenaar, R A E M; de Bruin, P C; van Diest, P J; Tanke, H J

    2004-01-01

    Aims: To investigate the practicality and sensitivity of supervised automated microscopy (AM) for the detection of micrometastasis in sentinel lymph nodes (SLNs) from patients with breast carcinoma. Methods: In total, 440 SLN slides (immunohistochemically stained for cytokeratin) from 86 patients were obtained from two hospitals. Samples were selected on the basis of: (1) a pathology report mentioning micrometastases or isolated tumour cells (ITCs) and (2) reported as negative nodes (N0). Results: From a test set of 29 slides (12 SLN positive patients, including positive and negative nodes), 18 slides were scored positive by supervised AM and 11 were negative. Routine examination revealed 17 positive slides and 12 negative. Subsequently, automated reanalysis of 187 slides (34 patients; institute I) and 216 slides (40 patients; institute II) from reported node negative (N0) patients showed that two and seven slides (from two and five patients, respectively) contained ITCs, respectively, all confirmed by the pathologists, corresponding to 5.9% and 12.5% missed patients. In four of the seven missed cases from institute II, AM also detected clusters of four to 30 cells, but all with a size ⩽ 0.2 mm. Conclusions: Supervised AM is a more sensitive method for detecting immunohistochemically stained micrometastasis and ITCs in SLNs than routine pathology. However, the clinical relevance of detecting cytokeratin positive cells in SLNs of patients with breast cancer is still an unresolved issue and is at the moment being validated in larger clinical trials. PMID:15333658

  4. 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.

  5. 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.

  6. 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

  7. The Feasibility and Accuracy of Sentinel Lymph Node Biopsy in Initially Clinically Node-Negative Breast Cancer after Neoadjuvant Chemotherapy: A Systematic Review and Meta-Analysis

    PubMed Central

    Geng, Chong; Chen, Xiao; Pan, Xiaohua; Li, Jiyu

    2016-01-01

    Background With the increased use of neoadjuvant chemotherapy (NAC) in breast cancer, the timing of sentinel lymph node biopsy (SLNB) has become increasingly important. In this study, we aimed to evaluate the feasibility and accuracy of SLNB for initially clinically node-negative breast cancer after NAC by conducting a systematic review and meta-analysis. Methods We searched PubMed, Embase, and the Cochrane Library from January 1, 1993 to November 30, 2015 for studies on initially clinically node-negative breast cancer patients who underwent SLNB after NAC followed by axillary lymph node dissection (ALND). Results A total of 1,456 patients from 16 studies were included in this review. The pooled identification rate (IR) for SLNB was 96% [95% confidence interval (CI): 95%-97%], and the false negative rate (FNR) was 6% (95% CI: 3%-8%). The pooled sensitivity, negative predictive value (NPV) and accuracy rate (AR) were 94% (95% CI: 92%-97%, I2 = 27.5%), 98% (95% CI: 98%-99%, I2 = 42.7%) and 99% (95% CI: 99%-100%, I2 = 32.6%), respectively. In the subgroup analysis, no significant differences were found in either the IR of an SLNB when different mapping methods were used (P = 0.180) or in the FNR between studies with and without immunohistochemistry (IHC) staining (P = 0.241). Conclusion Based on current evidence, SLNB is technically feasible and accurate enough for axillary staging in initially clinically node-negative breast cancer patients after NAC. PMID:27606623

  8. 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

  9. 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

  10. Detecting Ferrite Nanobeads for Sentinel Lymph Node Mapping with a Highly Sensitive Hall Differential Magnetic Field Sensor

    NASA Astrophysics Data System (ADS)

    Abe, M.; Ueda, T.; Masaki, T.; Kitamoto, Y.; Matsushita, N.; Handa, H.

    2012-03-01

    We fabricated a novel type of Hall differential magnetic field sensor for anti-cancer sentinel lymph node (SLN) mapping using ferrofluid as a marker. A pair of Hall devices are mounted on both end surfaces of a ferrite core (10 mm phi ×32 mm) of an electromagnetic coil which generates an AC exciting magnetic field at 2.5 kHz. The signals are retrieved by a digital phase sensitive detection circuit. Mapping a ferrofluid (ResovistR) sample of l00μg in Fe atomic amount (comparable to that accumulated in human SLNs) was attained when the sample was placed within 6 mm distance from the sensor head. The detectable distance is limited primarily due to the magnetic induction effect of the metal XYZ stage which held the sample.

  11. 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.

  12. 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

  13. 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

  14. 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

  15. Magnetic sentinel lymph node biopsy and localization properties of a magnetic tracer in an in vivo porcine model.

    PubMed

    Anninga, Bauke; Ahmed, Muneer; Van Hemelrijck, Mieke; Pouw, Joost; Westbroek, David; Pinder, Sarah; Ten Haken, Bennie; Pankhurst, Quentin; Douek, Michael

    2013-08-01

    The standard for the treatment of early non-palpable breast cancers is wide local excision directed by wire-guided localization and sentinel lymph node biopsy (SLNB). This has drawbacks technically and due to reliance upon radioisotopes. We evaluated the use of a magnetic tracer for its localization capabilities and concurrent performance of SLNB using a handheld magnetometer in a porcine model as a novel alternative to the current standard. Ethical approval by the IRCAD Ethics Review Board, Strasbourg (France) was received. A magnetic tracer was injected in varying volumes (0.1-5 mL) subcutaneously into the areolar of the left and right 3rd inguinal mammary glands in 16 mini-pigs. After 4 h magnetometer counts were taken at the injection sites and in the groins. The magnetometer was used to localize any in vivo signal from the draining inguinal lymph nodes. Magnetic SLNB followed by excision of the injection site was performed. The iron content of sentinel lymph nodes (SLNs) were graded and quantified. All excised specimens were weighed and volumes were calculated. Univariate analyses were performed to evaluate correlation. Magnetic SLNB was successful in all mini-pigs. There was a significant correlation (r = 0.86; p < 0.01) between magnetometer counts and iron content of SLNs. Grading of SLNs on both H&E and Perl's staining correlated significantly with the iron content (p = 0.001; p = 0.003) and magnetometer counts (p < 0.001; p = 0.004). The peak counts corresponded to the original magnetic tracer injection sites 4 h after injection in all cases. The mean volume and weight of excised injection site specimens was 2.9 cm(3) (SD 0.81) and 3.1 g (SD 0.85), respectively. Injection of ≥0.5 mL magnetic tracer was associated with significantly greater volume (p = 0.05) and weight of excision specimens (p = 0.01). SLNB and localization can be performed in vivo using a magnetic tracer. This could provide a viable alternative for lesion localization and concurrent SLNB

  16. 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

    2010-10-20

    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

  17. 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

  18. A prospective study on sentinel lymph node biopsy in early oral cancers using methylene blue dye alone.

    PubMed

    Ramamurthy, Rajaraman; Kottayasamy Seenivasagam, Rajkumar; Shanmugam, Subbiah; Palanivelu, Kathirvelkumaran

    2014-09-01

    Sentinel Lymph Node (SLN) biopsy using a combination of radioisotopes and blue dyes have a good accuracy rate in predicting subclinical neck nodal metastases in head and neck cancers. However, the limited availability of lymphoscintigraphy facilities in India requires exploration of alternative methods of SLN detection. We evaluated the feasibility of using methylene blue dye alone in detecting SLN in cN0 early oral cancers. 32 patients with cN0 early (T1, T2) oral squamous cell cancers underwent SLN biopsy using peri tumoural methylene blue dye injection. Blue dye stained (SLN) nodes were sent for frozen section analyses. Patients who had microscopic metastases in SLN underwent modified radical neck dissections and the rest underwent selective neck dissections. Paraffin sections and IHC studies were done on all nodes. SLN was identified in 29 patients (Identification rate = 90.6 %) of which SLN was positive for metastases on frozen section in 5 patients. The sensitivity, specificity and NPV of SLN with frozen section were 80 %, 95.8 % and 95.8 % respectively. IHC with cytokeratins increased the sensitivity (100 %) and NPV (100 %) at the loss of specificity (87.5 %). Methylene blue dye alone can be successfully used for SLN identification in early oral cancers with a good accuracy and sensitivity. This method will be of use especially in resource limited countries and centres where nuclear medicine facilities are not widely available. However, it has to be validated by larger randomised multi institutional trials for wider applicability. Immunohistochemistry increases the sensitivity and negative predictive value of SLN but its applicability in real time decision making is limited.

  19. COMPLICATION RATES IN PATIENTS WITH NEGATVE AXILLARY NODES 10-YEARS AFTER LOCAL BREAST RADIOTHERAPY FOLLOWING EITHER SENTINEL LYMPH NODE DISSECTION OR AXILLARY CLEARANCE

    PubMed Central

    Wernicke, A.Gabriella; Shamis, Michael; K.Sidhu, Kulbir; Turner, Bruce C.; Goltser, Yevgenyia; Khan, Imraan; Christos, Paul J.; Komarnicky-Kocher, Lydia T.

    2014-01-01

    Background We assess complication rates in node negative breast cancer patients treated with breast radiotherapy (RT) only after sentinel lymph node dissection (SLND) or axillary lymph node dissection (ALND). Materials and Methods Between 1995 and 2001, 226 women with AJCC stage I-II breast cancer were treated with lumpectomy, either SLND or SLND+ALND, and had available toxicities in follow-up: 111/136 (82%) and 115/129 (89%) in SLND and ALND groups, respectively. RT targeted the breast to median dose of 48.2Gy (range, 46.0-50.4Gy) without axillary RT. Chi-square tests compared complication rates of two groups for axillary web syndrome (AWS), seroma, wound infection, decreased range of motion (ROM) of the ipsilateral shoulder, paresthesia, and lymphedema. Results Median follow-up was 9.9 years (range, 8.3 -15.3 years). Median number of nodes assessed was 2 (range, 1-5) in SLND and 18 (range, 7-36) in ALND (p<0.0001). Acute complications occurred during the first 2 years and were AWS, seroma, and wound infection. Incidences of seroma 5/111 (4.5%) in SLND and 16/115 (13.9%) in ALND (p<0.02, respectively) and wound infection 3/111 (2.7%) in SLND and 10/115 (8.7%) in ALND (p<0.05, respectively) differed significantly. AWS was not statistically different between the groups. At 10-years, the only chronic complications were decreased ROM of the shoulder 46/111 (41.4%) in SLND and 92/115 (80.0%) in ALND (p<0.0001), paresthesia 12/111 (10.8%) in SLND and 39/115 (33.9%) in ALND (p<0.0001), and lymphedema assessed by patients 10/111 (10.0%) in SLND and 39/115 (33.9%) in ALND (p<0.0001). Chronic lymphedema, assessed by clinicians, occurred in 6/111 (5.4%) in SLND and 21/115 (18.3%) in ALND cohorts, respectively (p<0.0001). Conclusion Our mature findings support that in patients with negative axillary nodal status SLND and breast RT provide excellent long-term cure rates while avoiding morbidities associated with ALND or addition of axillary RT field. PMID:22134519

  20. Use of a PEG-conjugated bright near-infrared dye for functional imaging of rerouting of tumor lymphatic drainage after sentinel lymph node metastasis

    PubMed Central

    Proulx, Steven T.; Luciani, Paola; Christiansen, Ailsa; Karaman, Sinem; Blum, Katrin S.; Rinderknecht, Matthias; Leroux, Jean-Christophe; Detmar, Michael

    2013-01-01

    Tumor lymphangiogenesis promotes metastatic cancer spread to lymph nodes and beyond. However, the potential remodeling and functionality of tumor-draining lymphatic vessels has remained unclear. Thus, we aimed to develop non-invasive imaging methods for repeated quantitative imaging of lymphatic drainage and of contractile collecting lymphatic vessel function in mice, with colloidal near-infrared (NIR) tracers and a custom fluorescence stereomicroscope specially adapted for NIR sensitive imaging. Using these tools, we quantitatively determined pulse rates and valvular function of collecting lymphatic vessels with high resolution. Unexpectedly, we found that tumor-draining lymphatic vessels in a melanoma footpad model initially were dilated but remained functional, despite lower pulse rates. In two independent tumor models, impaired lymphatic function was detected once metastases were present in draining lymph nodes. Importantly, we found that lymphatic dysfunction, induced by metastatic tumor spread to sentinel lymph nodes, can lead to a rerouting of lymphatic flow away from the metastatic lymph node, via collateral lymphatic vessels, to alternate lymph nodes. These findings might have important clinical implications for the procedure of sentinel lymph node mapping that represents the standard of care for determining prognosis and treatment of melanoma and breast cancer patients. PMID:23566803

  1. Impact of Tumor Localization and Method of Preoperative Biopsy on Sentinel Lymph Node Mapping After Periareolar Nuclide Injection

    PubMed Central

    Krammer, Julia; Dutschke, Anja; Kaiser, Clemens G.; Schnitzer, Andreas; Gerhardt, Axel; Radosa, Julia C.; Brade, Joachim; Schoenberg, Stefan O.; Wasser, Klaus

    2016-01-01

    Background To evaluate whether tumor localization and method of preoperative biopsy affect sentinel lymph node (SLN) detection after periareolar nuclide injection in breast cancer patients. Methods and Findings 767 breast cancer patients were retrospectively included. For lymphscintigraphy periareolar nuclide injection was performed and the SLN was located by gamma camera. Patient and tumor characteristics were correlated to the success rate of SLN mapping. SLN marking failed in 9/61 (14.7%) patients with prior vacuum-assisted biopsy and 80/706 (11.3%) patients with prior core needle biopsy. Individually evaluated, biopsy method (p = 0.4) and tumor localization (p = 0.9) did not significantly affect the SLN detection rate. Patients with a vacuum-assisted biopsy of a tumor in the upper outer quadrant had a higher odds ratio of failing in SLN mapping (OR 3.8, p = 0.09) compared to core needle biopsy in the same localization (OR 0.9, p = 0.5). Conclusions Tumor localization and preoperative biopsy method do not significantly impact SLN mapping with periareolar nuclide injection. However, the failure risk tends to rise if vacuum-assisted biopsy of a tumor in the upper outer quadrant is performed. PMID:26867137

  2. Use of indocyanine green for detecting the sentinel lymph node in breast cancer patients: from preclinical evaluation to clinical validation.

    PubMed

    Chi, Chongwei; Ye, Jinzuo; Ding, Haolong; He, De; Huang, Wenhe; Zhang, Guo-Jun; Tian, Jie

    2013-01-01

    Assessment of the sentinel lymph node (SLN) in patients with early stage breast cancer is vital in selecting the appropriate surgical approach. However, the existing methods, including methylene blue and nuclides, possess low efficiency and effectiveness in mapping SLNs, and to a certain extent exert side effects during application. Indocyanine green (ICG), as a fluorescent dye, has been proved reliable usage in SLN detection by several other groups. In this paper, we introduce a novel surgical navigation system to detect SLN with ICG. This system contains two charge-coupled devices (CCD) to simultaneously capture real-time color and fluorescent video images through two different bands. During surgery, surgeons only need to follow the fluorescence display. In addition, the system saves data automatically during surgery enabling surgeons to find the registration point easily according to image recognition algorithms. To test our system, 5 mice and 10 rabbits were used for the preclinical setting and 22 breast cancer patients were utilized for the clinical evaluation in our experiments. The detection rate was 100% and an average of 2.7 SLNs was found in 22 patients. Our results show that the usage of our surgical navigation system with ICG to detect SLNs in breast cancer patients is technically feasible.

  3. 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.

  4. Detection of Superior Markers for Polymerase Chain Reaction Diagnosis of Breast Cancer Micrometastasis in Sentinel Lymph Nodes.

    PubMed

    Alizadeh Shargh, Shohreh; Movafagh, Abolfazl; Zarghami, Nosratolah; Sayad, Arezou; Mansouri, Neda; Taheri, Mohammad; Heidary Pour, Atefeh; Iranpour, Mostafa; Ghaedi, Hamid; Montazeri, Vahid; Massoudi, Nilofar; Hashemi, Mehrdad; Mortazavi-Tabatabaei, S A

    2016-01-01

    Breast cancer is the most prevalent type of cancer among women around the world, and mortality is primarily caused by micro-metastatic disease. The complex mechanisms of breast cancer invasion and metastasis are intrinsically related to the malignant cell type so that early detection of micro-metastases can help prolongation of survival for patient. The aim of the present research work was evaluation of the expression status of mammoglobin protein as a candidate molecular marker in the negative sentinel lymph node (SLN). Fifty tumor specimens, and 50 normal adjacent breast tissue samples from the same patients were selected on the basis of having more than 10% tumor content for RNA extraction from SLNs. Tumor samples and normal adjacent breast tissue were archived in the form of frozen fresh tissue in liquid nitrogen. Real-time PCR was performed on a Bioner life express gradient thermal cycler system. Mammoglobin gene overexpression in breast cancer metastasis was investigated. Single marker results were mammaglobin 66.7% and CK19 50.0%, with 58.3% for the two in combination. Due to improved outcome with at least 3 genes (83.3%), it seems, triple marker evaluation will be most likely useful for detecting micro-metastases instead of studying separate genes. PMID:27165222

  5. In vivo targeted cancer imaging, sentinel lymph node mapping and multi-channel imaging with biocompatible silicon nanocrystals.

    PubMed

    Erogbogbo, Folarin; Yong, Ken-Tye; Roy, Indrajit; Hu, Rui; Law, Wing-Cheung; Zhao, Weiwei; Ding, Hong; Wu, Fang; Kumar, Rajiv; Swihart, Mark T; Prasad, Paras N

    2011-01-25

    Quantum dots (QDs) have size-dependent optical properties that make them uniquely advantageous for in vivo targeted fluorescence imaging, traceable delivery, and therapy. The use of group II-VI (e.g., CdSe) QDs for these applications is advancing rapidly. However, group II-VI QDs contain toxic heavy metals that limit their in vivo applications. Thus, replacing these with QDs of a biocompatible semiconductor, such as silicon (Si), is desirable. Here, we demonstrate that properly encapsulated biocompatible Si QDs can be used in multiple cancer-related in vivo applications, including tumor vasculature targeting, sentinel lymph node mapping, and multicolor NIR imaging in live mice. This work overcomes dispersibility and functionalization challenges to in vivo imaging with Si QDs through a unique nanoparticle synthesis, surface functionalization, PEGylated micelle encapsulation, and bioconjugation process that produces bright, targeted nanospheres with stable luminescence and long (>40 h) tumor accumulation time in vivo. Upon the basis of this demonstration, we anticipate that Si QDs can play an important role in more sophisticated in vivo models, by alleviating QD toxicity concerns while maintaining the key advantages of QD-based imaging methods.

  6. RT-PCR for mammaglobin genes, MGB1 and MGB2, identifies breast cancer micrometastases in sentinel lymph nodes.

    PubMed

    Ouellette, Rodney J; Richard, Dominique; Maïcas, Emmanuel

    2004-05-01

    In the present study, we examined the expression of the mammaglobin genes, MGB1 and MGB2, in the sentinel lymph nodes (SLNs) of patients with breast cancer and compared our results with the histologic status of the same SLNs. Compared with immunohistochemical staining for cytokeratin 8, which detected metastases in 17 of 42 patients, reverse transcription-polymerase chain reaction (RT-PCR) for MGB1 or MGB2 genes was positive in 22 patients. The concordance between the expression of any mammaglobin and histologic status was 79% (33/42), with a sensitivity of 88% and specificity of 72%. The detection of patients with metastases was more sensitive when testing for both MGB1 and MGB2 (P < .0001) rather than MGB2 (P < .0005) or MGB1 (P < .05) alone. The increased detection rate relative to histologic examination suggests that using RT-PCR for the mammaglobin genes might identify patients at higher risk compared with patients with negative RT-PCR results.

  7. A Comprehensive Approach to Pediatric Atypical Melanocytic Neoplasms with Comment on the Role of Sentinel Lymph Node Biopsy.

    PubMed

    Sondak, Vernon K; Reed, Damon; Messina, Jane L

    2016-01-01

    Pediatric melanoma has been rising in incidence in recent years and its management poses challenges that are frequently exacerbated by diagnostic uncertainty about the benign or malignant nature of many pediatric melanocytic neoplasms. Sentinel lymph node biopsy (SLNB), originally described by Dr. Donald L. Morton, has been incorporated selectively into the management of pediatric atypical melanocytic neoplasms (AMNs), but its value and significance in this scenario have been controversial. Herein, we describe a comprehensive approach to the evaluation and management of pediatric AMNs that involves SLNB as a diagnostic, staging, and potentially therapeutic tool. We also describe our approach to educating patients and their families about the inherent uncertainties involved in diagnosing and predicting the ultimate behavior of pediatric melanocytic lesions. In addition, we stress the importance of long-term follow-up, as well as ongoing research to improve our understanding of the prognostic factors and histopathologic characteristics that may one day allow us to minimize or eliminate entirely this diagnostically uncertain category of skin lesions. PMID:27481000

  8. 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

  9. 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

  10. 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.

  11. 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

  12. 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

  13. Sentinel lymph node detection by intranipple injection of patent blue dye in breast cancer: a preliminary report of a feasibility study.

    PubMed

    Zervoudis, S; Iatrakis, G; Paschopoulos, M; Dousias, V; Geahchan, N; Stefos, T; Pechlivani, F; Navrozoglou, I

    2012-01-01

    Sentinel lymph node (SLN) biopsy is a well established option for assessing axillary lymph node status in breast cancer. Several techniques have been applied so far (superficial or deeper ones). Based on anatomical features of the lymphatic drainage in the breast, we assessed the feasibility of an intranipple approach for SLN mapping. Our data support the feasibility of SLN detection by our technique, with a high rate of SLN identification, which could be used in clinical practice as an alternative to the peri-areolar approach.

  14. Pelvic Lymph Node Irradiation Including Pararectal Sentinel Nodes for Prostate Cancer Patients: Treatment Optimization Comparing Intensity Modulated X-rays, Volumetric Modulated Arc Therapy, and Intensity Modulated Proton Therapy.

    PubMed

    Vees, Hansjörg; Dipasquale, Giovanna; Nouet, Philippe; Zilli, Thomas; Cozzi, Luca; Miralbell, Raymond

    2015-04-01

    We aimed to assess the dosimetric impact of advanced delivery radiotherapy techniques using either intensity modulated x-ray beams (IMXT), volumetric modulated arc therapy (VMAT), or intensity modulated proton therapy (IMPT), for high-risk prostate cancer patients with sentinel nodes in the pararectal region. Twenty high-risk prostate cancer patients were included in a prospective trial evaluating sentinel nodes on pelvic SPECT acquisition. To be eligible for the dosimetric study, patients had to present with pararectal sentinel nodes usually not included in the clinical target volume encompassing the pelvic lymph nodes. Radiotherapy-plans including the prostate, the seminal vesicles, and the pelvic lymph nodes with the pararectal sentinel nodes were optimized for 6 eligible patients. IMXT and IMPT were delivered with 7 and 3 beams respectively and VMAT with 2 arcs. Results were assessed with Dose-Volume Histograms and predictive normal tissue complication probabilities (NTCPs) models between the three competing treatment modalities aiming to deliver a total dose of 50.4 Gy in 1.8 Gy daily fractions. Target coverage was optimized with IMPT when compared to IMXT and VMAT. Coverage of the sentinel node was slightly better with IMXT (D98% 5 57.3 ± 5.1 Gy) when compared with VMAT (D98% 5 56.2 ± 4.1 Gy). The irradiation of rectal, bladder, small bowel, and femoral heads volumes was significantly reduced with IMPT when compared to IMXT and VMAT. NTCPs rates for rectal and bladder ≥ grade-3 late toxicity were better with IMPT (0.4 ± 0.0% and 0.0 ± 0.0%) compared with IMXT (4.6 ± 3.3% and 1.4 ± 1.1%), and VMAT (4.5 ± 4.0% and 1.6 ± 1.6%), respectively. Acceptable dose-volume distributions and low rectal and urinary NTCPs were estimated to geometrically complex pelvic volumes such as the ones proposed in this study using IMXT, VMAT and IMPT. IMPT succeeded, however, to propose the best physical and biological treatment plans compared to both X-ray derived plans.

  15. Quantification of melanoma mRNA markers in sentinel nodes: pre-clinical evaluation of a single-step real-time reverse transcriptase-polymerase chain reaction assay.

    PubMed

    Abrahamsen, Helene N; Nexo, Ebba; Steiniche, Torben; Hamilton-Dutoit, Stephen J; Sorensen, Boe S

    2004-08-01

    Although reverse transcriptase-polymerase chain reaction (RT-PCR) analysis of melanocyte-associated mRNA can detect sentinel node melanoma metastases, most published assays are semi-quantitative methods of unknown sensitivity and precision, unsuitable for clinical use. We describe a single-step real-time quantitative RT-PCR assay for MART-1 and tyrosinase mRNAs, suitable for sentinel node analysis in a clinical setting. Using serial dilutions of melanoma cell line SK-MEL-28 RNA in water as a calibrator, we obtained linear calibration curves covering the range 0.5 to 10,000 arbitrary units (SK-MEL-28 melanoma cell equivalents). The sensitivity limit was 0.32 (MART-1) and 5 (tyrosinase) arbitrary units. Analytical imprecision was between 11% and 34%. MART-1 PCR efficiency was unaffected when samples were diluted with negative lymph node RNA rather than water, whereas tyrosinase PCR efficiency was halved. To evaluate the clinical suitability of our assay, we quantified melanocyte mRNAs in sentinel nodes with histologically verified micrometastases (n = 10) and benign nevus inclusions (n = 10), and in sentinel nodes without evidence of intranodal melanocytes (n = 10). We found significant differences in median melanocyte-derived mRNA levels comparing the three types of lymph nodes, suggesting that this quantitative molecular protocol may increase assay precision and be useful for the clinical evaluation of sentinel nodes.

  16. 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

  17. High-speed dynamic 3D photoacoustic imaging of sentinel lymph node in a murine model using an ultrasound array.

    PubMed

    Song, Liang; Kim, Chulhong; Maslov, Konstantin; Shung, K Kirk; Wang, Lihong V

    2009-08-01

    Noninvasive photoacoustic sentinel lymph node (SLN) mapping with high spatial resolution has the potential to improve the false negative rate and eliminate the use of radioactive tracers in SLN identification. In addition, the demonstrated high spatial resolution may enable physicians to replace SLN biopsy with fine needle aspiration biopsy, and thus reduce the risk of associated morbidity. The primary goal of this study is to demonstrate the feasibility of high-speed 3D photoacoustic imaging of the uptake and clearance dynamics of Evans blue dye in SLNs. The photoacoustic imaging system was developed with a 30 MHz ultrasound array and a kHz repetition rate laser system. It acquires one 3D photoacoustic image of 166 B-scan frames in 1 s, with axial, lateral, and elevational resolutions of 25, 70, and 200 microm, respectively. With optic-fiber based light delivery, the entire system is compact and is convenient to use. Upon injection of Evans blue, a blue dye currently used in clinical SLN biopsy, SLNs in mice and rats were accurately and noninvasively mapped in vivo using our imaging system. In our experiments, the SLNs were found to be located at approximately 0.65 mm below the skin surface in mice and approximately 1.2 mm in rats. In some cases, lymph vessels and lymphatic valves were also imaged. The dye dynamics--accumulation and clearance--in SLNs were quantitatively monitored by sequential 3D imaging with temporal resolution of as high as approximately 6 s. The demonstrated capability suggests that high-speed 3D photoacoustic imaging should facilitate the understanding of the dynamics of various dyes in SLNs and potentially help identify SLNs with high accuracy. PMID:19746805

  18. 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.

  19. 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

  20. NOTE: Localization of sentinel nodes in breast cancer: novel method and device to help pen marking of active nodes during gamma camera imaging

    NASA Astrophysics Data System (ADS)

    Laasanen, Mikko S.; Heikkinen, Jari O.; Saarakkala, Simo; Paajanen, Hannu

    2005-04-01

    Gamma camera imaging with Tc-99m marking is a widely used method to locate sentinel lymph nodes (SNs) in breast cancer patients. Prior to SN biopsy, the anterior and lateral location of the SN is marked on the patient's skin using an ink pen. The pen marks guide the surgeon during an operation. However, in many cases the marking is difficult due to limited space under the detectors of a gamma camera. The aim of this study was to improve the pen marking method. Eleven female patients were imaged 3 4 h after injection of Tc-99m labelled Nanocol©. Injection was performed to parenchyma surrounding the breast tumour. To facilitate pen marking, two polycarbonate (PC) plates with 40 × 32 holes (spacing = 10 mm) were engineered for anterior and lateral side imaging and then installed on the bed of a dual-head gamma camera. Two drops of Tc-99m were placed into the top corners of both the PC plates, in order to trace the corresponding x y coordinates first from the acquired images and then from the plates. After imaging, the x y coordinates of the SN(s) were determined from the anterior and lateral side images. Subsequently, the location of each SN was marked with an ink pen on the skin through the small holes in the PC plates. According to the surgeon's evaluation, the distance between the marks and the true location of the SNs was 4.5 ± 6.9 mm. Measurements with a custom made phantom revealed that the accuracy of the novel method was significantly (P = 0.06) higher as compared with the traditional method (2.7 ± 3.0 mm versus 9.2 ± 3.0 mm). In addition, we were not able to mark the weakest activity (0.02 MBq) with the traditional method. Taken together, the marking process was considerably easier with the novel method, it had better accuracy and sensitivity than the traditional method and the device is simple enough to be adapted for most gamma cameras.

  1. 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

  2. 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.

  3. 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

  4. 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 ...

  5. 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

  6. Sentinel lymph node (SLN) procedure with patent V blue dye in 153 patients with papillary thyroid carcinoma (PTC): is it an accurate staging method?

    PubMed

    Rubello, D; Nanni, C; Merante Boschin, I; Toniato, A; Piotto, A; Rampin, L; Mariani, G; Al-Nahhas, A; Pelizzo, M R

    2006-12-01

    The present study aims to evaluate the accuracy of sentinel lymph node (SLN) mapping performed by intratumoral injection of blue dye in a large series of patients with papillary thyroid cancer (PTC). 153 consecutive patients were enrolled in the study. All patients had a preoperative cytological diagnosis of PTC, and none had clinical or ultrasonographic (US) evidence of nodal involvement. At surgery, vital patent V blue dye was injected into the malignant thyroid nodule. Subsequently, total thyroidectomy, central compartment (CC) node dissection, and median inferior jugulocarotid node dissection of laterocervical compartment, ipsilateral to the primary tumour, were performed. The excised thyroid, the blue-positive SLN and blue-negative lymph nodes were sent for frozen section and definitive histophatologic analysis. At surgery, blue-positive SLN were found in 107/153 patients (69.9%), of whom 36 (33.6%) had micrometastasis in SLN; moreover, in 13 of these 36 patients (36.1%), other nodes were found to be metastatic. In the remaining 71/107 blue-positive SLN patients, both the SLN itself and the other removed nodes were found negative for the presence of metastatic disease. In 4 cases, a normal parathyroid gland and in 3 cases fibro-adipous tissue were blue-stained and mistakenly removed as SLN (7 false positive results). On the other hand, SLN was blue-negative in 46/153 patients (30.1%), of whom 7 patients (15.2%) had micrometastases in blue-negative lymph nodes. On the basis of these data, the blue dye procedure for SLN detection appears inappropriate as a standard of care in PTC due to a relatively high number of false negative and false positive results.

  7. 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.

  8. 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

  9. 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

  10. 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.

  11. 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.

  12. Positive versus negative sentinel nodes in early breast cancer patients: axillary or loco-regional relapse and survival. A study spanning 2000-2012.

    PubMed

    García Fernández, A; Chabrera, C; García Font, M; Fraile, M; Lain, J M; Barco, I; González, C; Gónzalez, S; Reñe, A; Veloso, E; Cassadó, J; Pessarrodona, A; Giménez, N

    2013-10-01

    Sentinel Node Biopsy (SNB) is a minimally invasive alternative to elective axillary lymph node dissection (ALND) for nodal staging in early breast cancer. The present study was conducted to evaluate prognostic implications of a negative sentinel node (SN) versus a positive SN (followed by completion ALND) in a closely followed-up sample of early breast cancer patients. We studied 889 consecutive breast cancer patients operated for 908 primaries. Patients received adjuvant therapy with chemotherapy, hormone therapy and eventually trastuzumab. Radiation therapy was based on tangential radiation fields that usually included axillary level I. Median follow-up was 47 months. Axillary recurrence was seen in 1.2% (2/162) of positive SN patients, and 0.8% (5/625) of negative SN patients (p = n.s.). There was an overall 3.2% loco-regional failure rate (29/908). Incidence of distant recurrence was 3.3% (23/693) for negative SN patients, and 4.6% (9/196) for positive SN patients (p = n.s.). Overall mortality rate was 4% (8/198) for positive SN patients, while the corresponding specific mortality rate was 2.5% (5/198). For patients with negative SNs, overall mortality was 4.9% (34/693), and the specific mortality was 1.4% (19/693) (p = n.s.). We did not find significant differences in axillary/loco-regional relapse, distant metastases, disease-free interval or mortality between SN negative and SN positive patients, with a follow-up over 4 years.

  13. 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

  14. Lymph node biopsy

    MedlinePlus

    Biopsy - lymph nodes; Open lymph node biopsy; Fine needle aspiration biopsy; Sentinel lymph node biopsy ... then sent to the laboratory for examination. A needle biopsy involves inserting a needle into a lymph ...

  15. Sentinel Lymph Node Mapping With Near-Infrared Fluorescent Imaging Using Indocyanine Green: A New Tool for Laparoscopic Platform in Patients With Endometrial and Cervical Cancer.

    PubMed

    Buda, Alessandro; Bussi, Beatrice; Di Martino, Giampaolo; Di Lorenzo, Paolo; Palazzi, Sharon; Grassi, Tommaso; Milani, Rodolfo

    2016-02-01

    Indocyanine green (ICG) represents a feasible alternative to the more traditional methods of sentinel lymph node (SLN) mapping, and interest in this promising tracer is growing. This report outlines our experience with ICG in a minimally invasive laparoscopic approach in women with endometrial cancer and cervical cancer using the Storz SPIES ICG near-infrared fluorescence imaging technology. A total of 49 patients with clinical stage I endometrial cancer (n = 40) or stage I cervical cancer (n = 9) were retrospectively reviewed. All patients had undergone simple or radical laparoscopic hysterectomy with pelvic and/or aortic lymphadenectomy and SLN mapping by means of an intracervical injection of ICG dye at the 3 o'clock and 9 o'clock locations after the induction of general anesthesia. The detection rate of ICG was 100% (49 of 49). The rate of bilateral SLN detection was 86% (42 of 49). Positive lymph nodes were found in 6 patients (12%), with at least 1 positive SLN. The sensitivity and negative predictive value of SLN detection were 100%. All procedures were successfully completed without conversion to open laparotomy, and no intraoperative or postoperative complications occurred. In our preliminary experience, ICG showed a high overall detection rate, and bilateral mapping appears to be a feasible alternative to the more traditional methods of SLN mapping in patients with endometrial cancer and cervical cancer. Laparoscopic SLN mapping with ICG appears to be safe, easy, and reproducible, with a positive impact on patient management.

  16. Radiotherapy or surgery of the axilla after a positive sentinel node in breast cancer (EORTC 10981-22023 AMAROS):a randomised, multicentre, open-label, phase 3 non-inferiority trial

    PubMed Central

    Donker, Mila; van Tienhoven, Geertjan; Straver, Marieke E; Meijnen, Philip; van de Velde, Cornelis J H; Mansel, Robert E; Cataliotti, Luigi; Westenberg, A Helen; Klinkenbijl, Jean H G; Orzalesi, Lorenzo; Bouma, Willem H; van der Mijle, Huub C J; Nieuwenhuijzen, Grard A P; Veltkamp, Sanne C; Slaets, Leen; Duez, Nicole J; de Graaf, Peter W; van Dalen, Thijs; Marinelli, Andreas; Rijna, Herman; Snoj, Marko; Bundred, Nigel J; Merkus, Jos W S; Belkacemi, Yazid; Petignat, Patrick; Schinagl, Dominic A X; Coens, Corneel; Messina, Carlo G M; Bogaerts, Jan; Rutgers, Emiel J T

    2014-01-01

    Summary Background If treatment of the axilla is indicated in patients with breast cancer who have a positive sentinel node, axillary lymph node dissection is the present standard. Although axillary lymph node dissection provides excellent regional control, it is associated with harmful side-effects. We aimed to assess whether axillary radiotherapy provides comparable regional control with fewer side-effects. Methods Patients with T1–2 primary breast cancer and no palpable lymphadenopathy were enrolled in the randomised, multicentre, open-label, phase 3 non-inferiority EORTC 10981-22023 AMAROS trial. Patients were randomly assigned (1:1) by a computer-generated allocation schedule to receive either axillary lymph node dissection or axillary radiotherapy in case of a positive sentinel node, stratified by institution. The primary endpoint was non-inferiority of 5-year axillary recurrence, considered to be not more than 4% for the axillary radiotherapy group compared with an expected 2% in the axillary lymph node dissection group. Analyses were by intention to treat and per protocol. The AMAROS trial is registered with ClinicalTrials.gov, number NCT00014612. Findings Between Feb 19, 2001, and April 29, 2010, 4823 patients were enrolled at 34 centres from nine European countries, of whom 4806 were eligible for randomisation. 2402 patients were randomly assigned to receive axillary lymph node dissection and 2404 to receive axillary radiotherapy. Of the 1425 patients with a positive sentinel node, 744 had been randomly assigned to axillary lymph node dissection and 681 to axillary radiotherapy; these patients constituted the intention-to-treat population. Median follow-up was 6·1 years (IQR 4·1–8·0) for the patients with positive sentinel lymph nodes. In the axillary lymph node dissection group, 220 (33%) of 672 patients who underwent axillary lymph node dissection had additional positive nodes. Axillary recurrence occurred in four of 744 patients in the axillary

  17. 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.

  18. 68Ga-labeled superparamagnetic iron oxide nanoparticles (SPIONs) for multi-modality PET/MR/Cherenkov luminescence imaging of sentinel lymph nodes

    PubMed Central

    Madru, Renata; Tran, Thuy A; Axelsson, Johan; Ingvar, Christian; Bibic, Adnan; Ståhlberg, Freddy; Knutsson, Linda; Strand, Sven-Erik

    2014-01-01

    The aim of this study was to develop 68Ga-SPIONs for use as a single contrast agent for dynamic, quantitative and high resolution PET/MR imaging of Sentinel Lymph Node (SLN). In addition 68Ga enables Cherenkov light emission which can be used for optical guidance during resection of SLN. SPIONs were labeled with 68Ga in ammonium acetate buffer, pH 5.5. The labeling yield and stability in human serum were determined using instant thin layer chromatography. An amount of 0.07-0.1 mL (~5-10 MBq, 0.13 mg Fe) of 68Ga-SPIONs was subcutaneously injected in the hind paw of rats. The animals were imaged at 0-3 h and 25 h post injection with PET/CT, 9.4 T MR and CCDbased Cherenkov optical systems. A biodistribution study was performed by dissecting and measuring the radioactivity in lymph nodes, kidneys, spleen, liver and the injection site. The labeling yield was 97.3 ± 0.05% after 15 min and the 68Ga-SPIONs were stable in human serum. PET, MR and Cherenkov luminescence imaging clearly visualized the SLN. Biodistribution confirmed a high uptake of the 68Ga-SPIONs within the SLN. We conclude that generator produced 68Ga can be labeled to SPIONs. Subcutaneously injected 68Ga-SPIONs can enhance the identification of the SLNs by combining sensitive PET and high resolution MR imaging. Clinically, hybrid PET/MR cameras are already in use and 68Ga-SPIONs have a great potential as a single-dose, tri-modality agent for diagnostic imaging and potential Cherenkov luminescent guided resection of SLN. PMID:24380046

  19. Prognostic value of HPV-mRNA in sentinel lymph nodes of cervical cancer patients with pN0-status

    PubMed Central

    Dürst, Matthias; Hoyer, Heike; Altgassen, Christoph; Greinke, Christiane; Häfner, Norman; Fishta, Alba; Gajda, Mieczyslaw; Mahnert, Ute; Hillemanns, Peter; Dimpfl, Thomas; Lenhard, Miriam; Petry, K. Ulrich; Runnebaum, Ingo B.; Schneider, Achim

    2015-01-01

    Up to 15% of patients with cervical cancer and pN0-status develop recurrent-disease. This may be due to occult metastatic spread of tumor cells. We evaluated the use of human-papillomavirus-(HPV)-mRNA as a molecular marker for disseminated tumor cells to predict the risk of recurrence. For this prospective, multi-center prognostic study, 189 patients free of lymphnode metastases by conventional histopathology could be analyzed. All patients underwent complete lymphadenectomy. Of each sentinel node (SLN) a biopsy was taken for the detection of HPV-E6-E7-mRNA. Median follow-up time after surgery was 8.1 years. HPV-mRNA could be detected in SLN of 52 patients (27.5%). Recurrence was observed in 22 patients. Recurrence-free-survival was significantly longer for patients with HPV-negative SLN (log rank p = 0.002). By Cox regression analysis the hazard ratio (95%CI) for disease-recurrence was 3.8 (1.5 – 9.3, p = 0.004) for HPV-mRNA-positive compared to HPV-mRNA-negative patients. After adjustment for tumor size as the most influential covariate the HR was still 2.8 (1.1 – 7.0, p = 0.030). In patients with cervical cancer and tumor-free lymph nodes by conventional histopathology HPV-mRNA-positive SLN were of prognostic value independent of tumor size. Particularly, patients with tumors larger than 20mm diameter could possibly benefit from further risk stratification using HPV-mRNA as a molecular marker. PMID:26008982

  20. Optimization via specific fluorescence brightness of a receptor-targeted probe for optical imaging and positron emission tomography of sentinel lymph nodes.

    PubMed

    Qin, Zhengtao; Hall, David J; Liss, Michael A; Hoh, Carl K; Kane, Christopher J; Wallace, Anne M; Vera, David R

    2013-10-01

    The optical properties of a receptor-targeted probe designed for dual-modality mapping of the sentinel lymph node (SLN) was optimized. Specific fluorescence brightness was used as the design criterion, which was defined as the fluorescence brightness per mole of the contrast agent. Adjusting the molar ratio of the coupling reactants, IRDye 800CW-NHS-ester and tilmanocept, enabled us to control the number of fluorescent molecules attached to each tilmanocept, which was quantified by H1 nuclear magnetic resonance spectroscopy. Quantum yields and molar absorptivities were measured for unconjugated IRDye 800CW and IRDye 800CW-tilmanocept (800CW-tilmanocept) preparations at 0.7, 1.5, 2.3, 2.9, and 3.8 dyes per tilmanocept. Specific fluorescence brightness was calculated by multiplication of the quantum yield by the molar absorptivity and the number of dyes per tilmanocept. It predicted that the preparation with 2.3 dyes per tilmanocept would exhibit the brightest signal, which was confirmed by fluorescence intensity measurements using three optical imaging systems. When radiolabeled with Ga68 and injected into the footpads of mice, the probe identified SLNs by both fluorescence and positron emission tomography (PET) while maintaining high percent extraction by the SLN. These studies demonstrated the feasibility of 800CW-tilmanocept for multimodal SLN mapping via fluorescence and PET-computed tomography imaging.

  1. 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

  2. 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.

  3. 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.

  4. Optimization via specific fluorescence brightness of a receptor-targeted probe for optical imaging and positron emission tomography of sentinel lymph nodes

    PubMed Central

    Qin, Zhengtao; Hall, David J.; Liss, Michael A.; Hoh, Carl K.; Kane, Christopher J.; Wallace, Anne M.

    2013-01-01

    Abstract. The optical properties of a receptor-targeted probe designed for dual-modality mapping of the sentinel lymph node (SLN) was optimized. Specific fluorescence brightness was used as the design criterion, which was defined as the fluorescence brightness per mole of the contrast agent. Adjusting the molar ratio of the coupling reactants, IRDye 800CW-NHS-ester and tilmanocept, enabled us to control the number of fluorescent molecules attached to each tilmanocept, which was quantified by H1 nuclear magnetic resonance spectroscopy. Quantum yields and molar absorptivities were measured for unconjugated IRDye 800CW and IRDye 800CW-tilmanocept (800CW-tilmanocept) preparations at 0.7, 1.5, 2.3, 2.9, and 3.8 dyes per tilmanocept. Specific fluorescence brightness was calculated by multiplication of the quantum yield by the molar absorptivity and the number of dyes per tilmanocept. It predicted that the preparation with 2.3 dyes per tilmanocept would exhibit the brightest signal, which was confirmed by fluorescence intensity measurements using three optical imaging systems. When radiolabeled with Ga68 and injected into the footpads of mice, the probe identified SLNs by both fluorescence and positron emission tomography (PET) while maintaining high percent extraction by the SLN. These studies demonstrated the feasibility of 800CW-tilmanocept for multimodal SLN mapping via fluorescence and PET–computed tomography imaging. PMID:23958947

  5. The impact of sentinel lymph node biopsy and magnetic resonance imaging on important outcomes among patients with ductal carcinoma in situ.

    PubMed

    Tuttle, Todd M; Shamliyan, Tatyana; Virnig, Beth A; Kane, Robert L

    2010-01-01

    The objective of this systematic review was to determine the impact of sentinel lymph node (SLN) biopsy and breast magnetic resonance imaging (MRI) on important outcomes for patients with ductal carcinoma in situ. We identified no study that directly evaluated important outcomes for SLN biopsy. So, we determined the incidence of SLN metastases among patients with ductal carcinoma in situ. Using American Joint Committee on Cancer criteria, the incidence of pN1 and pN1(mic) SLN metastases were 0.9% and 1.5%, respectively. Because the incidence of SLN metastasis is very low, SLN biopsy is not likely to affect important outcomes. We identified one study that directly evaluated important outcomes after breast MRI. In this study, the use of MRI did not affect local recurrence rates after breast-conserving surgery and radiation. Although MRI may identify occult multicentric or contralateral breast cancer in some patients, it may also lead to unnecessary biopsies and overtreatment. PMID:20956814

  6. 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.

  7. 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.

  8. 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

  9. 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

  10. 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.

  11. 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.

  12. 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

  13. Lymphatic mapping and sentinel lymphadenectomy for breast cancer.

    PubMed Central

    Giuliano, A E; Kirgan, D M; Guenther, J M; Morton, D L

    1994-01-01

    OBJECTIVE: The authors report the feasibility and accuracy of intraoperative lymphatic mapping with sentinel lymphadenectomy in patients with breast cancer. SUMMARY BACKGROUND DATA: Axillary lymph node dissection (ALND) for breast cancer generally is accepted for its staging and prognostic value, but the extent of dissection remains controversial. Blind lymph node sampling or level I dissection may miss some nodal metastases, but ALND may result in lymphedema. In melanoma, intraoperative lymph node mapping with sentinel lymphadenectomy is an effective and minimally invasive alternative to ALND for identifying nodes containing metastases. METHODS: One hundred seventy-four mapping procedures were performed using a vital dye injected at the primary breast cancer site. Axillary lymphatics were identified and followed to the first ("sentinel") node, which was selectively excised before ALND. RESULTS: Sentinel nodes were identified in 114 of 174 (65.5%) procedures and accurately predicted axillary nodal status in 109 of 114 (95.6%) cases. There was a definite learning curve, and all false-negative sentinel nodes occurred in the first part of the study; sentinel nodes identified in the last 87 procedures were 100% predictive. In 16 of 42 (38.0%) clinically negative/pathologically positive axillae, the sentinel node was the only tumor-involved lymph node identified. The anatomic location of the sentinel node was examined in the 54 most recent procedures; ten cases had only level II nodal metastases that could have been missed by sampling or low (level I) axillary dissection. CONCLUSIONS: This experience indicates that intraoperative lymphatic mapping can accurately identify the sentinel node--i.e., the axillary lymph node most likely to contain breast cancer metastases--in some patients. The technique could enhance staging accuracy and, with further refinements and experience, might alter the role of ALND. Images Figure 1. Figure 2. Figure 3. PMID:8092905

  14. Gene promoter hypermethylation is found in sentinel lymph nodes of breast cancer patients, in samples identified as positive by one-step nucleic acid amplification of cytokeratin 19 mRNA.

    PubMed

    Martín-Sánchez, E; Pernaut-Leza, E; Mendaza, S; Cordoba, A; Vicente-Garcia, F; Monreal-Santesteban, I; Vizcaino, J Pérez; De Cerio, M J Díaz; Perez-Janices, N; Blanco-Luquin, I; Escors, D; Ulazia-Garmendia, A; Guerrero-Setas, D

    2016-07-01

    We analysed the promoter methylation status of five genes, involved in adhesion (EPB41L3, TSLC-1), apoptosis (RASSF1, RASSF2) or angiogenesis (TSP-1), in intraoperative sentinel lymph node (SLN) biopsy samples from patients with breast cancer, that had been processed by the one-step nucleic acid amplification (OSNA) technique. SLN resection is performed to estimate the risk of tumour cells in the clinically negative axilla, to avoid unnecessary axillary lymph node dissection. OSNA is currently one of the eligible molecular methods for detecting tumour cells in SLNs. It is based on the quantitative evaluation of cytokeratin 19 mRNA which allows distinguishing between macrometastasis, micrometastasis and isolated tumour cells, on the basis of the quantity of tumour cells present. There have been no prior studies on the question whether or not samples processed by OSNA can be used for further molecular studies, including epigenetic abnormalities which are some of the most important molecular alterations in breast cancer. Genomic DNA was extracted from samples obtained from 50 patients diagnosed with primary breast cancer. The content of tumour cells in SLNs was evaluated by OSNA, and the promoter methylation status of the selected genes was analysed by methylation-specific PCR. All were found to be hypermethylated to a variable degree, and RASSF1 hypermethylation was significantly associated with macrometastasis, micrometastasis and isolated tumour cells (p = 0.002). We show that samples used for OSNA are suitable for molecular studies, including gene promoter methylation. These samples provide a new source of material for the identification of additional biomarkers. PMID:27097811

  15. Large-scale synthesis of bioinert tantalum oxide nanoparticles for X-ray computed tomography imaging and bimodal image-guided sentinel lymph node mapping.

    PubMed

    Oh, Myoung Hwan; Lee, Nohyun; Kim, Hyoungsu; Park, Seung Pyo; Piao, Yuanzhe; Lee, Jisoo; Jun, Samuel Woojoo; Moon, Woo Kyung; Choi, Seung Hong; Hyeon, Taeghwan

    2011-04-13

    Ever since Au nanoparticles were developed as X-ray contrast agents, researchers have actively sought alternative nanoparticle-based imaging probes that are not only inexpensive but also safe for clinical use. Herein, we demonstrate that bioinert tantalum oxide nanoparticles are suitable nanoprobes for high-performance X-ray computed tomography (CT) imaging while simultaneously being cost-effective and meeting the criteria as a biomedical platform. Uniformly sized tantalum oxide nanoparticles were prepared using a microemulsion method, and their surfaces were readily modified using various silane derivatives through simple in situ sol-gel reaction. The silane-modified surface enabled facile immobilization of functional moieties such as polyethylene glycol (PEG) and fluorescent dye. PEG was introduced to endow the nanoparticles with biocompatibility and antifouling activity, whereas immobilized fluorescent dye molecules enabled simultaneous fluorescence imaging as well as X-ray CT imaging. The resulting nanoparticles exhibited remarkable performances in the in vivo X-ray CT angiography and bimodal image-guided lymph node mapping. We also performed an extensive study on in vivo toxicity of tantalum oxide nanoparticles, revealing that the nanoparticles did not affect normal functioning of organs.

  16. 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.

  17. Gamma-probe-guided lymph node localization in malignant melanoma.

    PubMed

    Alex, J C; Weaver, D L; Fairbank, J T; Rankin, B S; Krag, D N

    1993-10-01

    The initial draining lymph node (sentinel node) has been successfully localized using intraoperative vital dye mapping and reportedly is predictive of regional nodal metastases in Clinical- Stage 1 melanoma. In an animal model, we previously established the technique of gamma-probe-guided localization of the technetium-99 sulfur colloid labelled sentinel node and found its sensitivity equal to vital dye mapping. We now report our initial experience using gamma-probe-guided localization to identify and then surgically remove the first draining lymph node(s) in 10 malignant melanoma patients. Lymphoscintigraphy was used to confirm localization. We conclude that this technique: (a) reliably localizes the sentinel node draining the site of a primary melanoma, (b) allows the lymphatic bed to be checked intraoperatively verifying complete sentinel node biopsy, and (c) is relatively simple and can be performed under local anaesthesia.

  18. 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).

  19. Inner Heliospheric Sentinels Spacecraft Concept

    NASA Astrophysics Data System (ADS)

    Conde, R. F.; Potocki, K. A.; Szabo, A.; Kirby, K. W.; Maldonado, H. M.; Adamsen, P. B.; Bokulic, R. S.; Dakermanji, G.; Dellinger, W. F.; Downing, J. P.; Ercol, C. J.; Folta, D. C.; Fielhauer, K. B.; Kelley, J. S.; Le, B. Q.; Leary, B. A.; Lewis, W. S.; Ling, S. X.; Marr, G.; Malouf, P. M.; Napollilo, D. H.; Persons, D. F.; Troll, J. R.; Wallis, R. E.; Lin, R. P.

    2007-01-01

    The Sentinels mission is a key component of NASA's Living With a Star (LWS) program. The Sentinels Science and Technology Definition Team (STDT) has completed a study to define the science objectives, measurement requirements and observational strategies, and mission design for the Sentinels mission. The Inner Heliospheric Sentinels (IHS) are one of the three flight elements [the others are the Near Earth Sentinel and Far Side Sentinel] that make up the Sentinels mission. The four spin-stabilized IHS spacecraft are in elliptical heliocentric orbit with perihelia at ~0.25 AU and aphelia at ~0.75 AU. This orbit presents unique spacecraft thermal control and power challenges. This study has demonstrated mission feasibility by developing a spacecraft design concept using conventional technologies that satisfies the science and mission requirements defined by the Sentinels STDT.

  20. 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.

  1. 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

  2. Sentinel-1 And Sentinel-3 OLCI PAC At DLR

    NASA Astrophysics Data System (ADS)

    Hahmann, Thomas; Weber, Hans; Diedrich, Erhard; Schreier, Gunter

    2013-12-01

    GMES / Copernicus is the European Earth Observation Programme, conducted jointly by the EC, ESA, EUMETSAT and the member states. The Sentinel satellites (Copernicus space segment) are expected to be launched in 2014 (Sentinel-1A, -2A, and -3A). The core payload data ground segment (PDGS) is managed by ESA and operated by national partners. In this core ground segment, the DLR German Remote Sensing Data Center (DFD) was selected to install and operate Processing and Archiving Centers (PACs) for Sentinel-1 and Sentinel-3-OLCI. This paper describes the current status of the project “Preparation and Operations of the Sentinel-1 and Sentinel-3 OLCI Off- line Processing and Archiving Centre at DLR Oberpfaffenhofen (S1-PAC / S3-OLCI-PAC)”.

  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. 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).

  5. 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).

  6. 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

  7. Gamma-probe guided localization of lymph nodes.

    PubMed

    Alex, J C; Krag, D N

    1993-01-01

    The initial draining lymph node (Sentinel node) of a tumour may reflect the status of the tumours spread to the remaining lymphatic bed. The sentinel node, which has been reported to predict metastatic melanoma, has recently been localized by a new invasive technique [1]. The goal of our pre-clinical trial was to test a non-invasive technique to localize the sentinel node. Gamma-probe guided localization was used to identify and then surgically remove the first draining lymph node(s) in 16 inguinal lymphatic basins of eight cats. This method was found to be comparable to an invasive method using a blue dye. Gamma-probe localization has several potential advantages in that it can: (a) precisely locate on the surface of the skin the position of an underlying lymph node, (b) intraoperatively guide the surgeon to the lymph node during dissection, (c) verify that the correct node has been biopsied, (d) determine the possible presence of residual lymph nodes, (e) allow lymph nodes to be harvested through a small incision as opposed to raising a skin flap, and (f) be rapidly and easily performed.

  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. 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 ...

  10. The NASA LWS Sentinels Mission

    NASA Astrophysics Data System (ADS)

    Lin, Robert P.; Science, Sentinels; DefinitionTeam, Technology

    2006-06-01

    One of the primary goals of NASA's Sentinels mission, the heliospheric element of the integrated LWS (Living With a Star) program, is to provide the observations necessary for an understanding of the physics of the Sun/inner heliosphere processes that produce Solar Energetic Particle (SEP) events, so the requirements for eventual predictive capability can be defined. We present the results of the study by the Sentinels Science and Technology Definition Team (STDT) that recommends a combination of the Inner Heliosphere Sentinels (IHS),consisting of four identical spacecraft that utilize Venus gravity assists to achieve 0.25-0.75 AU orbits, primarily for in situ particles and fields measurements; a Near-Earth Sentinel (NES) with a spectroscopic coronagraph to provide the physical conditions in the SEP acceleration region and a wide field (>0.3AU) coronagraph to connect to the HIS measurements, and a Farside Sentinel (FS) with a magnetograph to provide near global photospheric magnetic field measurements for modeling the structure of the inner heliosphere. We show how the combined measurements are designed to lead to an understanding of SEP origin and to improve our predictive capability for large SEP events.

  11. 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.

  12. 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

  13. 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

  14. 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

  15. 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.

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

    PubMed

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

    2016-03-01

    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.

  17. 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

  18. 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.

  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. Contralateral axillary node metastasis from recurrence after conservative breast cancer surgery.

    PubMed

    Nishimura, Satoko; Koizumi, Mitsuru; Kawakami, Junko; Koyama, Masamichi

    2014-02-01

    Sentinel lymph node detection (SLND) with radiocolloid has become widely used for evaluation of nodal metastasis in primary breast cancer. However, the procedure for recurrent breast cancer is not well established. Contralateral axillary node metastasis is uncommon. We report 2 cases of contralateral axillary node metastasis with recurrent breast cancer. In the first case, contralateral node metastasis was found by SLND. In the other case without SLND, contralateral node metastasis developed after resection of local recurrence. FDG-avid contralateral node was pathologically diagnosed as metastasis. The SLND might be useful in patients with local recurrence after conservative breast cancer surgery. PMID:24368539

  1. 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.

  2. Copernicus POD Service: Ready for Sentinel-3

    NASA Astrophysics Data System (ADS)

    Peter, H.; Fernández, J.; Escobar, D.; Féménias, P.; Flohrer, C.; Otten, M.

    2015-12-01

    The Copernicus POD Service is part of the Copernicus PDGS Ground Segment of the Sentinel 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. The Sentinel-1, -2 & -3 missions have different but very demanding requirements in terms of orbital accuracy and timeliness. Orbital products in Near Real Time (latency: 30 min), Short Time Critical (1.5 days) and Non-time Critical (20-30 days) are required. The accuracy requirements are very challenging, targeting 5 cm in 3D for Sentinel-1 and 2-3 cm in radial direction for Sentinel-3. Sentinel-3A carries, in addition to a GPS receiver a laser retro reflector and a DORIS receiver. On the one hand, the three different techniques GPS, SLR and DORIS make POD more complex but, on the other hand, it is very helpful to have independent techniques available for validation of the orbit results. The successful POD processing for Sentinel-1A is a good preparation for Sentinel-3A due to the similar demanding orbit accuracy requirements. The Copernicus POD Service is ready for Sentinel-3A and the service will process GPS and SLR data routinely and has the capacity to process DORIS in NTC and reprocessing campaigns. The three independent orbit determination techniques on Sentinel-3 offer big potential for scientific exploitation. Carrying all three techniques together makes the satellite, e.g., very useful for combining all the techniques on observation level as it could only be done for Jason-2 until now. The Sentinel POD Quality Working Group strongly supporting the CPOD Service delivers additional orbit solutions to validate the CPOD results independently. The recommendations from this body guarantee that the CPOD Service is updated following state-of-the-art algorithms, models and conventions. The QWG also focuses on the scientific exploitation of the

  3. 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.

  4. Sentinel-3 Solar Array Design

    NASA Astrophysics Data System (ADS)

    Combet, Y.; Reutenauer, X.; Mouret, G.; Guerrere, S.; Ergan, A.; Ferrando, E.; Riva, S.; Hodgetts, P.; Levesque, D.; D'Accolti, G.

    2011-10-01

    Sentinel-3 is primarily a mission to support services relating to the marine environment, with capability to serve numerous land-, atmospheric- and cryospheric- based application areas. The mission's main objective is to determine parameters, such as sea-surface topography, sea- and land-surface temperatures, as well as ocean- and land-surface colours with high-end accuracy and reliability. For this mission, Thales Alenia Space has been selected as the spacecraft prime contractor and is also responsible for the solar array. In this frame, TAS leads a European industrial team, comprising Selex Galileo for the photovoltaic assembly and Patria for the panel substrate.

  5. Discovering Sentinel Rules for Business Intelligence

    NASA Astrophysics Data System (ADS)

    Middelfart, Morten; Pedersen, Torben Bach

    This paper proposes the concept of sentinel rules for multi-dimensional data that warns users when measure data concerning the external environment changes. For instance, a surge in negative blogging about a company could trigger a sentinel rule warning that revenue will decrease within two months, so a new course of action can be taken. Hereby, we expand the window of opportunity for organizations and facilitate successful navigation even though the world behaves chaotically. Since sentinel rules are at the schema level as opposed to the data level, and operate on data changes as opposed to absolute data values, we are able to discover strong and useful sentinel rules that would otherwise be hidden when using sequential pattern mining or correlation techniques. We present a method for sentinel rule discovery and an implementation of this method that scales linearly on large data volumes.

  6. 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.

  7. 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

  8. 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

  9. Molecular and functional imaging for detection of lymph node metastases in prostate cancer.

    PubMed

    Fortuin, Ansje; Rooij, Maarten de; Zamecnik, Patrik; Haberkorn, Uwe; Barentsz, Jelle

    2013-07-03

    Knowledge on lymph node metastases is crucial for the prognosis and treatment of prostate cancer patients. Conventional anatomic imaging often fails to differentiate benign from metastatic lymph nodes. Pelvic lymph node dissection is an invasive technique and underestimates the extent of lymph node metastases. Therefore, there is a need for more accurate non-invasive diagnostic techniques. Molecular and functional imaging has been subject of research for the last decades, in this respect. Therefore, in this article the value of imaging techniques to detect lymph node metastases is reviewed. These techniques include scintigraphy, sentinel node imaging, positron emission tomography/computed tomography (PET/CT), diffusion weighted magnetic resonance imaging (DWI MRI) and magnetic resonance lymphography (MRL). Knowledge on pathway and size of lymph node metastases has increased with molecular and functional imaging. Furthermore, improved detection and localization of lymph node metastases will enable (focal) treatment of the positive nodes only.

  10. Sexually selected sentinels? Evidence of a role for intrasexual competition in sentinel behavior

    PubMed Central

    Walker, Lindsay A.; York, Jenny E.

    2016-01-01

    Although the evolutionary mechanisms that favor investment in cooperative behaviors have long been a focus of research, comparatively few studies have considered the role that sexual selection may play. For example, evolutionary explanations for sentinel behavior (where 1 individual assumes an elevated position and scans the surroundings while other group members forage nearby) have traditionally focused on the inclusive fitness benefits arising from its effects on predation risk, while its potential role in defense against intrasexual competitors remains largely unexplored. Here, we provide experimental evidence of a role for sentinel behavior in intrasexual competition, in a cooperatively breeding songbird, the white-browed sparrow weaver (Plocepasser mahali). First, dominant males sentinel substantially more than other group members (even when controlling for variation in age and body condition), consistent with a role for sentineling in intrasexual competition for mates and/or territory. Second, experimental playback of an unfamiliar male’s solo song elicited a marked increase in sentineling by the dominant male, and the vocal response to the playback also positively predicted his sentinel effort following the simulated intrusion. A second experiment also suggests that sentineling may facilitate mounting rapid anti-intruder responses, as responses to intruder-playback occurred significantly earlier when the dominant male was sentineling rather than foraging at playback onset. Together, our findings provide rare support for the hypothesis that sentinel behavior plays a role in intrasexual competition, and so highlight the potential for sexually selected direct benefits to shape its expression in this and other social vertebrates.

  11. Sexually selected sentinels? Evidence of a role for intrasexual competition in sentinel behavior

    PubMed Central

    Walker, Lindsay A.; York, Jenny E.

    2016-01-01

    Although the evolutionary mechanisms that favor investment in cooperative behaviors have long been a focus of research, comparatively few studies have considered the role that sexual selection may play. For example, evolutionary explanations for sentinel behavior (where 1 individual assumes an elevated position and scans the surroundings while other group members forage nearby) have traditionally focused on the inclusive fitness benefits arising from its effects on predation risk, while its potential role in defense against intrasexual competitors remains largely unexplored. Here, we provide experimental evidence of a role for sentinel behavior in intrasexual competition, in a cooperatively breeding songbird, the white-browed sparrow weaver (Plocepasser mahali). First, dominant males sentinel substantially more than other group members (even when controlling for variation in age and body condition), consistent with a role for sentineling in intrasexual competition for mates and/or territory. Second, experimental playback of an unfamiliar male’s solo song elicited a marked increase in sentineling by the dominant male, and the vocal response to the playback also positively predicted his sentinel effort following the simulated intrusion. A second experiment also suggests that sentineling may facilitate mounting rapid anti-intruder responses, as responses to intruder-playback occurred significantly earlier when the dominant male was sentineling rather than foraging at playback onset. Together, our findings provide rare support for the hypothesis that sentinel behavior plays a role in intrasexual competition, and so highlight the potential for sexually selected direct benefits to shape its expression in this and other social vertebrates. PMID:27656086

  12. 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.

  13. 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.

  14. 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

  15. 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…

  16. Lymph node staging in colorectal cancer: Old controversies and recent advances

    PubMed Central

    Resch, Annika; Langner, Cord

    2013-01-01

    Outcome prediction based on tumor stage reflected by the American Joint Committee on Cancer (AJCC)/Union for International Cancer Control (UICC) tumor node metastasis (TNM) system is currently regarded as the strongest prognostic parameter for patients with colorectal cancer. For affected patients, the indication for adjuvant therapy is mainly guided by the presence of regional lymph node metastasis. In addition to the extent of surgical lymph node removal and the thoroughness of the pathologist in dissecting the resection specimen, several parameters that are related to the pathological work-up of the dissected nodes may affect the clinical significance of lymph node staging. These include changing definitions of lymph nodes, involved lymph nodes, and tumor deposits in different editions of the AJCC/UICC TNM system as well as the minimum number of nodes to be dissected. Methods to increase the lymph node yield in the fatty tissue include methylene blue injection and acetone compression. Outcome prediction based on the lymph node ratio, defined as the number of positive lymph nodes divided by the total number of retrieved nodes, may be superior to the absolute numbers of involved nodes. Extracapsular invasion has been identified as additional prognostic factor. Adding step sectioning and immunohistochemistry to the pathological work-up may result in higher accuracy of histological diagnosis. The clinical value of more recent technical advances, such as sentinel lymph node biopsy and molecular analysis of lymph nodes tissue still remains to be defined. PMID:24379568

  17. 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.

  18. Proceedings of GLaSS: Global Lakes Sentinel Services

    NASA Astrophysics Data System (ADS)

    Peters, Steef; Hommersom, Annelies; Alikas, Krista; Heege, Thomas; Schenk, Karin; Ruescas, Ana; Eleveld, Marieke; Giardino, Claudia; Koponen, Sampsa; Kallio, Kari; Philipson, Petra

    2015-12-01

    Global Lakes Sentinel Services (GLaSS) is developing a prototype Sentinel service infrastructure to ingest and process Sentinel-2 and Sentinel-3 data into validated ecological water quality parameters for lakes, plus training material. GLaSS is an EU-funded R&D project within the Copernicus framework. The project is well on its way to reach its goals. Some results on comparisons on atmospheric correction methods for inland waters are presented here.

  19. 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.

  20. 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.

  1. 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.

  2. Accurate diagnosis of axillary lymph node metastasis using contrast-enhanced ultrasonography with Sonazoid

    PubMed Central

    MATSUZAWA, FUMIHIKO; EINAMA, TAKAHIRO; ABE, HIRONORI; SUZUKI, TAKASHI; HAMAGUCHI, JUN; KAGA, TERUMI; SATO, MAMI; OOMURA, MASAKO; TAKATA, YUMIKO; FUJIBE, AYAKO; TAKEDA, CHIE; TAMURA, ETSUYA; TAKETOMI, AKINOBU; KYUNO, KENICHI

    2015-01-01

    Axillary lymph node enlargement following sentinel lymph node biopsy (SLNB) is often difficult to accurately diagnose. In keeping with the characteristically tortuous and aberrant pattern of tumor neovasculature, metastatic lymph nodes exhibit peripheral and mixed vascularity, resulting in a microvasculature that is often difficult to visualize. Contrast-enhanced ultrasonography (CEUS) with Sonazoid, a new generation contrast agent for ultrasonography, allows for the visualization of lymph node microvessels and may enable a more accurate evaluation of lymph node metastasis. This is a case report of axillary lymph node enlargement following SLNB, in which CEUS with Sonazoid resulted in an accurate diagnosis. On the basis of our experience with this case, we have initiated a clinical trial to evaluate the detection of lymph node metastasis through the use of CEUS in breast cancer patients. PMID:25798257

  3. Use of released pigs as sentinels for Mycobacterium bovis.

    PubMed

    Nugent, Graham; Whitford, Jackie; Young, Nigel

    2002-10-01

    Identifying the presence of bovine tuberculosis (TB; Mycobacterium bovis) in wildlife is crucial in guiding management aimed at eradicating the disease from New Zealand. Unfortunately, surveys of the principal wildlife host, the introduced brushtail possum (Trichosurus vulpecula), require large samples (> 95% of the population) before they can provide reasonable confidence that the disease is absent. In this study, we tested the feasibility of using a more wide-ranging species, feral pig (Sus scrofa), as an alternative sentinel capable of indicating TB presence. In January 2000, 17 pigs in four groups were released into a forested area with a low density of possums in which TB was known to be present. The pigs were radiotracked at 2 wk intervals from February to October 2000, and some of them were killed and necropsied at various intervals after release. Of the 15 pigs successfully recovered and necropsied, one killed 2 mo after release had no gross lesions typical of TB, and the only other pig killed at that time had greatly enlarged mandibular lymph nodes. The remainder were killed at longer intervals after release and all had gross lesions typical of TB. Mycobacterium bovis was isolated from all 15 pigs by mycobacterial culture. Home range sizes of pigs varied widely and increased with the length of time the pigs were in the forest, with minimum convex polygon range-size estimates averaging 10.7 km2 (range 4.7-20.3 km2) for the pigs killed after 6 mo. A 6 km radius around the kill site of each pig would have encompassed 95% of all of their previous locations at which they could have become infected. However, one pig shifted 35 km, highlighting the main limitation of using unmarked feral pigs as sentinels. This trial indicates use of resident and/or released free-ranging pigs is a feasible alternative to direct prevalence surveys of possums for detecting TB presence.

  4. 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.

  5. 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.

  6. 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

  7. 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…

  8. 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.

  9. 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.

  10. 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

  11. 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.

  12. Multi-pass microscopy

    NASA Astrophysics Data System (ADS)

    Juffmann, Thomas; Klopfer, Brannon B.; Frankort, Timmo L. I.; Haslinger, Philipp; Kasevich, Mark A.

    2016-09-01

    Microscopy of biological specimens often requires low light levels to avoid damage. This yields images impaired by shot noise. An improved measurement accuracy at the Heisenberg limit can be achieved exploiting quantum correlations. If sample damage is the limiting resource, an equivalent limit can be reached by passing photons through a specimen multiple times sequentially. Here we use self-imaging cavities and employ a temporal post-selection scheme to present full-field multi-pass polarization and transmission micrographs with variance reductions of 4.4+/-0.8 dB (11.6+/-0.8 dB in a lossless setup) and 4.8+/-0.8 dB, respectively, compared with the single-pass shot-noise limit. If the accuracy is limited by the number of detected probe particles, our measurements show a variance reduction of 25.9+/-0.9 dB. The contrast enhancement capabilities in imaging and in diffraction studies are demonstrated with nanostructured samples and with embryonic kidney 293T cells. This approach to Heisenberg-limited microscopy does not rely on quantum state engineering.

  13. Multi-pass microscopy

    PubMed Central

    Juffmann, Thomas; Klopfer, Brannon B.; Frankort, Timmo L.I.; Haslinger, Philipp; Kasevich, Mark A.

    2016-01-01

    Microscopy of biological specimens often requires low light levels to avoid damage. This yields images impaired by shot noise. An improved measurement accuracy at the Heisenberg limit can be achieved exploiting quantum correlations. If sample damage is the limiting resource, an equivalent limit can be reached by passing photons through a specimen multiple times sequentially. Here we use self-imaging cavities and employ a temporal post-selection scheme to present full-field multi-pass polarization and transmission micrographs with variance reductions of 4.4±0.8 dB (11.6±0.8 dB in a lossless setup) and 4.8±0.8 dB, respectively, compared with the single-pass shot-noise limit. If the accuracy is limited by the number of detected probe particles, our measurements show a variance reduction of 25.9±0.9 dB. The contrast enhancement capabilities in imaging and in diffraction studies are demonstrated with nanostructured samples and with embryonic kidney 293T cells. This approach to Heisenberg-limited microscopy does not rely on quantum state engineering. PMID:27670525

  14. 78 FR 35625 - Sabine Pass Liquefaction Expansion, LLC; Sabine Pass Liquefaction, LLC; Sabine Pass LNG, L.P...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-13

    ... Federal Energy Regulatory Commission Sabine Pass Liquefaction Expansion, LLC; Sabine Pass Liquefaction... Environmental Assessment for the Planned Sabine Pass Liquefaction Expansion Project and Cheniere Creole Trail... Sabine Pass Liquefaction Expansion, LLC; Sabine Pass Liquefaction, LLC; and Sabine Pass LNG,...

  15. Intramammary lymph nodes.

    PubMed

    Egan, R L; McSweeney, M B

    1983-05-15

    Radiographic, gross, and histopathologic studies on 158 whole breasts with primary operable carcinoma revealed intramammary lymph nodes in 28%, and of these breasts, 10% contained a metastatic deposit of carcinoma. Cancerous and noncancerous nodes were found in all quadrants of the breast with the positive ones being in the same quadrant as the carcinoma only 50% of the time. There was no demonstrable connection with the usual lymphatic drainage of the breast. With Stage II carcinoma, positive intramammary lymph nodes had no direct effect on prognosis, merely representing advanced disease and indicating a greater likelihood of axillary metastatic disease. There was a trend toward poorer prognosis in Stage I lesions with positive intramammary lymph nodes. This may indicate the Stage I carcinomas that have a similar prognosis as Stage II tumors. Conceivably, a Stage Ia, positive intramammary lymph node(s) but normal axillary lymph nodes, could be defined and used.

  16. [Inadvertent adolescent pregnancy: a sentinel analysis].

    PubMed

    Marciano, Beatriz E; García Arrigoni, Patricia; Challer, Eduardo; Califano, Paula; Dackiewicz, Nora

    2014-02-01

    A sentinel event is an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof.The sentinel event identified was undiagnosed adolescent pregnancy before the indication of potentially harmful treatments or diagnostic methods. The team performed a root -cause analysis where the following causes were identified: a) Paediatrician bias: not thinking about adolescent sexual behaviour, incomplete questionnaires, insufficient training in adolescent interviews. b) Social factors: legal issues, ambiguous contraceptive recommendations. c) Hospital factors: lack of guidelines for counselling adolescents. d) Host risk factors: cultural barriers, lack of confidence. Regardless of any previous negative pregnancy test results, any time that a new potentially harmful procedure is indicated in a fertile female patient, a test of pregnancy diagnosed might be performed.

  17. 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.

  18. 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.; Kendall, Ronald J.; Dickerson, Richard L.; Giesy, John P.; Suk, William P.

    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.

  19. 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.

  20. 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.

  1. 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.

  2. Near-infrared-fluorescence imaging of lymph nodes by using liposomally formulated indocyanine green derivatives.

    PubMed

    Toyota, Taro; Fujito, Hiromichi; Suganami, Akiko; Ouchi, Tomoki; Ooishi, Aki; Aoki, Akira; Onoue, Kazutaka; Muraki, Yutaka; Madono, Tomoyuki; Fujinami, Masanori; Tamura, Yutaka; Hayashi, Hideki

    2014-01-15

    Liposomally formulated indocyanine green (LP-ICG) has drawn much attention as a highly sensitive near-infrared (NIR)-fluorescence probe for tumors or lymph nodes in vivo. We synthesized ICG derivatives tagged with alkyl chains (ICG-Cn), and we examined NIR-fluorescence imaging for lymph nodes in the lower extremities of mice by using liposomally formulated ICG-Cn (LP-ICG-Cn) as well as conventional liposomally formulated ICG (LP-ICG) and ICG. Analysis with a noninvasive preclinical NIR-fluorescence imaging system revealed that LP-ICG-Cn accumulates in only the popliteal lymph node 1h after injection into the footpad, whereas LP-ICG and ICG accumulate in the popliteal lymph node and other organs like the liver. This result indicates that LP-ICG-Cn is a useful NIR-fluorescence probe for noninvasive in vivo bioimaging, especially for the sentinel lymph node.

  3. Do Porins Pass CAPs?

    NASA Astrophysics Data System (ADS)

    Hanna, C. B.; Pink, D. A.; Gill, T. A.; Beveridge, T. J.; Quinn, B. E.; Durrant, J. J.; Jericho, M. H.

    2008-03-01

    The cationic antimicrobial peptide (CAP) protamine is known to inhibit bacterial survival (Pink et al., Langmuir 19, 8852 (2003), and references therein), but the mechanism of attack is as yet undetermined. For Gram-negative bacteria, two pathways have been proposed: (a) self-promoted uptake, and (b) passage through porins. Here, we study the latter possibility, and model part of the outer membrane of a Gram-negative bacterium in an aqueous solution containing multivalent ions and CAPs. The intent is to determine whether CAPs could pass through porins and, if so, what aspects of external (e.g., ionic concentration) and internal (e.g., porin and O-sidechain characteristics) parameters affect their passage. This study is accomplished via Monte Carlo computer simulations of a ``minimal model'' of the outer membrane of a Gram-negative bacterium with an embedded porin.

  4. 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.

  5. 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.

  6. Vital nodes identification in complex networks

    NASA Astrophysics Data System (ADS)

    Lü, Linyuan; Chen, Duanbing; Ren, Xiao-Long; Zhang, Qian-Ming; Zhang, Yi-Cheng; Zhou, Tao

    2016-09-01

    Real networks exhibit heterogeneous nature with nodes playing far different roles in structure and function. To identify vital nodes is thus very significant, allowing us to control the outbreak of epidemics, to conduct advertisements for e-commercial products, to predict popular scientific publications, and so on. The vital nodes identification attracts increasing attentions from both computer science and physical societies, with algorithms ranging from simply counting the immediate neighbors to complicated machine learning and message passing approaches. In this review, we clarify the concepts and metrics, classify the problems and methods, as well as review the important progresses and describe the state of the art. Furthermore, we provide extensive empirical analyses to compare well-known methods on disparate real networks, and highlight the future directions. In spite of the emphasis on physics-rooted approaches, the unification of the language and comparison with cross-domain methods would trigger interdisciplinary solutions in the near future.

  7. MIGRATION OF INTRADERMALLY INJECTED QUANTUM DOTS TO SENTINEL ORGANS IN MICE

    PubMed Central

    Gopee, Neera V.; Roberts, Dean W.; Webb, Peggy; Cozart, Christy R.; Siitonen, Paul H.; Warbritton, Alan R.; Yu, William W.; Colvin, Vicki L.; Walker, Nigel J.; Howard, Paul C.

    2012-01-01

    Topical exposure to nanoscale materials is likely from a variety of sources including sunscreens and cosmetics. Because the in vivo disposition of nanoscale materials is not well understood, we have evaluated the distribution of quantum dots (QD) following intradermal injection into female SKH-1 hairless mice as a model system for determining tissue localization following intradermal infiltration. The QD [CdSe core, CdS capped, poly(ethylene glycol) (PEG) coated, 37 nm diameter, 621 nm fluorescence emission] were injected intradermally on the right dorsal flank. Within minutes following intradermal injection, the highly UV fluorescent QD could be observed moving from the injection sites apparently through the lymphatic duct system to regional lymph nodes. Residual fluorescent QD remained at the site of injection until necropsy at 24 hours. Quantification of cadmium and selenium levels after 0, 4, 8, 12 or 24 hours in multiple tissues, using inductively coupled plasma mass spectrometry (ICP-MS) showed a time-dependent loss of cadmium from the injection site, and accumulation in the liver, regional draining lymph nodes, kidney, spleen, and hepatic lymph node. Fluorescence microscopy corroborated the ICP-MS results regarding the tissue distribution of QD. The results indicated that (a) intradermally injected nanoscale QD remained as a deposit in skin and penetrated the surrounding viable subcutis, (b) QD were distributed to draining lymph nodes through the subcutaneous lymphatics and to the liver and other organs, and (c) sentinel organs are effective locations for monitoring transdermal penetration of nanoscale materials into animals. PMID:17404394

  8. 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.

  9. 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

  10. Message Passing on GPUs

    NASA Astrophysics Data System (ADS)

    Stuart, J. A.

    2011-12-01

    This paper explores the challenges in implementing a message passing interface usable on systems with data-parallel processors, and more specifically GPUs. As a case study, we design and implement the ``DCGN'' API on NVIDIA GPUs that is similar to MPI and allows full access to the underlying architecture. We introduce the notion of data-parallel thread-groups as a way to map resources to MPI ranks. We use a method that also allows the data-parallel processors to run autonomously from user-written CPU code. In order to facilitate communication, we use a sleep-based polling system to store and retrieve messages. Unlike previous systems, our method provides both performance and flexibility. By running a test suite of applications with different communication requirements, we find that a tolerable amount of overhead is incurred, somewhere between one and five percent depending on the application, and indicate the locations where this overhead accumulates. We conclude that with innovations in chipsets and drivers, this overhead will be mitigated and provide similar performance to typical CPU-based MPI implementations while providing fully-dynamic communication.

  11. A systematic review of tests for lymph node status in primary endometrial cancer

    PubMed Central

    Selman, Tara J; Mann, Christopher H; Zamora, Javier; Khan, Khalid S

    2008-01-01

    Background The lymph node status of a patient is a key determinate in staging, prognosis and adjuvant treatment of endometrial cancer. Despite this, the potential additional morbidity associated with lymphadenectomy makes its role controversial. This study systematically reviews the accuracy literature on sentinel node biopsy; ultra sound scanning, magnetic resonance imaging (MRI) and computer tomography (CT) for determining lymph node status in endometrial cancer. Methods Relevant articles were identified form MEDLINE (1966–2006), EMBASE (1980–2006), MEDION, the Cochrane library, hand searching of reference lists from primary articles and reviews, conference abstracts and contact with experts in the field. The review included 18 relevant primary studies (693 women). Data was extracted for study characteristics and quality. Bivariate random-effect model meta-analysis was used to estimate diagnostic accuracy of the various index tests. Results MRI (pooled positive LR 26.7, 95% CI 10.6 – 67.6 and negative LR 0.29 95% CI 0.17 – 0.49) and successful sentinel node biopsy (pooled positive LR 18.9 95% CI 6.7 – 53.2 and negative LR 0.22, 95% CI 0.1 – 0.48) were the most accurate tests. CT was not as accurate a test (pooled positive LR 3.8, 95% CI 2.0 – 7.3 and negative LR of 0.62, 95% CI 0.45 – 0.86. There was only one study that reported the use of ultrasound scanning. Conclusion MRI and sentinel node biopsy have shown similar diagnostic accuracy in confirming lymph node status among women with primary endometrial cancer than CT scanning, although the comparisons made are indirect and hence subject to bias. MRI should be used in preference, in light of the ASTEC trial, because of its non invasive nature. PMID:18457596

  12. 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

  13. 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.

  14. 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

  15. 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.

  16. 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

  17. 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.

  18. [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

  19. [Sentinel lymph node metastasis in patients with ductal breast carcinoma in situ].

    PubMed

    Ruvalcaba-Limón, Eva; de Jesús Garduño-Raya, María; Bautista-Piña, Verónica; Trejo-Martínez, Claudia; Maffuz-Aziz, Antonio; Rodríguez-Cuevas, Sergio

    2014-01-01

    Antecedentes: en pacientes con carcinoma ductal in situ la biopsia de ganglio centinela es motivo de controversia porque se reportan ganglios positivos en 1.4-12.5% debido al carcinoma invasor oculto en la pieza quirúrgica. Objetivo: conocer la frecuencia de metástasis en ganglio centinela en pacientes con carcinoma ductal in situ e identificar las diferencias entre los casos positivos y negativos. Material y métodos: estudio retrospectivo, transversal, analítico de pacientes con carcinoma ductal in situ a quienes se realizó una biopsia de ganglio centinela por requerir mastectomía, tener un tumor palpable, lesión radiológica = 5 cm, inadecuada relación mama-tumor o porque la escisión pudiera afectar el flujo linfático. Resultados: de 168 carcinomas in situ, se incluyeron 50 casos con carcinoma ductal in situ y biopsia de ganglio centinela, de pacientes con edad promedio de 51.6 años, 30 (60%) de ellas asintomáticas. Los signos reportados fueron: nódulo palpable (18%), secreción por el pezón (12%) o ambos (8%). Predominaron las microcalcificaciones (72%), comedonecrosis (62%) y grado histológico -2 (44%) con 28% de receptores hormonales negativos. En el estudio transoperatorio 4 (8%) pacientes tuvieron ganglio centinela positivo y un caso en estudio histopatológico definitivo (60% micrometástasis, 40% macrometástasis), todos con carcinoma invasor en la pieza quirúrgica. Las pacientes con ganglio centinela transoperatorio positivo eran más jóvenes (44.5 vs 51 años), con más tumores palpables (50 vs 23.1%), más grandes (3.5 vs 2 cm), más comedonecrosis (75 vs 60.8%), más indiferenciados (75% vs 39.1%) y menos receptores hormonales (50 vs 73.9%), que las que tenían ganglio centinela negativo, sin que estas diferencias tuvieran significación estadística. Conclusiones: puesto que 1 de cada 12 pacientes con carcinoma ductal in situ tiene afectación ganglionar en el ganglio centinela, se recomienda seguir tomando la biopsia para evitar segundas cirugías por un carcinoma invasor oculto.

  20. The prognostic value of sentinel lymph node micrometastases in patients with invasive breast carcinoma.

    PubMed

    Cipolla, Calogero; Graceffa, Giuseppa; La Mendola, Roberta; Fricano, Salvatore; Fricano, Martina; Vieni, Salvatore

    2015-01-01

    Il significato prognostico delle micrometastasi nel linfonodo sentinella nelle pazienti affette da carcinoma della mammella è ancora ampiamente dibattuto. Anche se, in assenza di univoche linee guida, nella pratica clinica la linfadenectomia ascellare in queste pazienti non viene più eseguita di routine. Abbiamo condotto uno studio retrospettivo su 746 patienti affette da carcinoma invasivo della mammella con linfonodi ascellari negativi, sottoposte a chirurgia conservativa o a mastectomia totale con biopsia del linfonodo sentinella. Le pazienti in cui è stata diagnostica la presenza di micrometastasi del linfonodo sentinella sono state considerate in due diversi gruppi. In un primo gruppo, trattato con linfadenectomia ascellare totale è stata valutata l’incidenza di metastasi a carico dei rimanenti linfonodi ascellari. Un secondo gruppo non ha ricevuto alcun trattamento aggiuntivo dell’ascella e le pazienti sono state seguite con controlli periodici clinico strumentali. In entrambi i gruppi è stata valutata l’incidenza di eventuali recidive ascellari. All’esame istologico estemporaneo ed al successivo esame istologico definitivo del linfonodo sentinella, in 51 pazienti (6,83%) sono state evidenziate micrometastasi, in 8 pazienti (1,07%) erano presenti cellule tumorali isolate. Quindici di queste pazienti sono state sottoposte a linfadenectomia ascellare totale. Solo in 2 casi (13,33%) sono state ritrovate metastasi a carico dei rimanenti linfonodi ascellari. Quarantaquattro pazienti non hanno ricevuto alcun trattamento aggiuntivo dell’ascella. In queste pazienti nessuna recidiva ascellare è stata registrata durante un follow-up medio di 65,3±9,65 mesi (range 42-78 mesi). Sulla base dei risultati ottenuti in questo studio ed in linea con alcuni recenti trials randomizzati si ci sentiamo di concludere che la linfadenectomia ascellare può essere evitata nei casi con micrometastasi nel linfonodo sentinella. Una sua eventuale indicazione può essere valutata caso per caso considerando come fattori di rischio per la recidiva ascellare alcune caratteristiche biomorfologiche del tumore primitivo.

  1. 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

  2. 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

  3. Pattern formation in oscillatory complex networks consisting of excitable nodes

    NASA Astrophysics Data System (ADS)

    Liao, Xuhong; Xia, Qinzhi; Qian, Yu; Zhang, Lisheng; Hu, Gang; Mi, Yuanyuan

    2011-05-01

    Oscillatory dynamics of complex networks has recently attracted great attention. In this paper we study pattern formation in oscillatory complex networks consisting of excitable nodes. We find that there exist a few center nodes and small skeletons for most oscillations. Complicated and seemingly random oscillatory patterns can be viewed as well-organized target waves propagating from center nodes along the shortest paths, and the shortest loops passing through both the center nodes and their driver nodes play the role of oscillation sources. Analyzing simple skeletons we are able to understand and predict various essential properties of the oscillations and effectively modulate the oscillations. These methods and results will give insights into pattern formation in complex networks and provide suggestive ideas for studying and controlling oscillations in neural networks.

  4. Uncorrelatedness in growing networks with preferential survival of nodes.

    PubMed

    Juher, David; Saldaña, Joan

    2011-01-01

    The emergence of uncorrelated growing networks is proved when nodes are removed either uniformly or under the preferential survival rule recently observed in the World Wide Web evolution. To this aim, the rate equation for the joint probability of degrees is derived, and stationary symmetrical solutions are obtained, by passing to the continuum limit. When a uniformly random removal of extant nodes and linear preferential attachment of new nodes are at work, we prove that the only stationary solution corresponds to uncorrelated networks for any removal rate r∈(0,1). In the more general case of preferential survival of nodes, uncorrelated solutions are also obtained. These results generalize the uncorrelatedness displayed by the (undirected) Barabási-Albert network model to models with uniformly random and selective (against low degrees) removal of nodes.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. 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

  11. 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

  12. 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

  13. 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

  14. 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.

  15. Message-passing multiprocessor simulator

    SciTech Connect

    Dunigan, T.H.

    1986-05-01

    The structure and use of a message-passing multiprocessor simulator are described. The simulator provides a multitasking environment for the development of algorithms for parallel processors using either shared or local memories. The simulator may be used from C or FORTRAN and provides a library of subroutines for task control and message passing. The simulator produces a trace file that can be used for debugging, performance analysis, or graphical display. 9 refs., 7 figs.

  16. Swollen lymph nodes

    MedlinePlus

    ... fingers) include: Groin Armpit Neck (there is a chain of lymph nodes on either side of the front of the neck, both sides of the neck, and down each side of the back of the neck) Under the jaw and chin Behind the ears On the back of the head

  17. 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)

  18. 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

  19. 78 FR 62344 - Sabine Pass Liquefaction Expansion, LLC, Sabine Pass Liquefaction, LLC, and Sabine Pass LNG, L.P...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-18

    ... Energy Regulatory Commission Sabine Pass Liquefaction Expansion, LLC, Sabine Pass Liquefaction, LLC, and... September 30, 2013, Sabine Pass Liquefaction Expansion, LLC, Sabine Pass Liquefaction, LLC, and Sabine Pass... proposed facilities, referred to as the Liquefaction Expansion Project (or Stage 3), would consist of...

  20. [Measles surveillance in Germany. From sentinel to mandatory surveillance].

    PubMed

    Siedler, A; Grüber, A; Mankertz, A

    2013-09-01

    From September 1999 to March 2011, sentinel surveillance of measles was conducted by a self-selected sample of private physicians in Germany. From 2001, when mandatory surveillance for measles was established, two surveillance systems worked in parallel. The aim of this article is to summarize the strengths and limitations of sentinel versus mandatory surveillance. Active monthly reporting included case-based questionnaires on patients with (suspected) measles or zeroreporting. For confirmation of measles, the diagnostic patient specimens were sent to regional laboratories for serological tests or to the National Reference Laboratory (NRC). In the NRC in addition to serological tests measles-virus (MV) detection by PCR in urine, throat swabs, and oral fluid (since 2003) as well as MVgenotyping was offered. From January 2000 to December 2010, 934 out of 1,488 participating sentinel-practices did not see any measles case, while 554 reported 3,573 suspected cases. Measles was confirmed by laboratory testing in 801 cases, excluded in 473 cases, and the diagnosis remained uncertain in 215 cases. Of 3,100 analyzed cases, 2,712 (87 %) were unvaccinated, 217 (7 %) and 32 (1 %) were vaccinated with one or two doses, respectively, and for 139 (4 %) cases the vaccination status was unknown. The main reason for not being vaccinated against measles was refusal (n = 1,383). The confirmation rate was lower in the vaccinated than in the unvaccinated patients (19 % vs. 63 %). Since 2006, sentinel-cases have differed from notified cases by region and age. The proportion of sentinel cases from all NRC-investigated cases decreased from more than  50 % (2002) to less than  5 % (since 2007). Sentinel surveillance allowed for the detection of trends, delivered additional information for measles prevention, and played a major role in measles diagnostics. Since mandatory surveillance was established and sentinel surveillance no longer reflected the epidemiologic

  1. SAIC SENTINEL acoustic counter-sniper system

    NASA Astrophysics Data System (ADS)

    Stoughton, Roland B.

    1997-02-01

    An acoustic surveillance system tailored to the detection and location of sniper fire was designed and a prototype built and tested. The SENTINEL system by Science Applications International Corporation exploits 100 kHz 16- bit digitization of signals from 16 condenser microphones in two volumetric arrays to make robust determinations of bearing, range, bullet trajectory, weapon caliber, and muzzle velocity. Signal processing is accomplished on VME hardware with C40 DSPs. Solutions are displayed within three seconds of a detected event on a ruggedized full-daylight- readable color laptop console. Typical accuracies are 1 degree to 2 degrees in azimuth and 2% to 10% in range, depending on range and environmental conditions. The large bandwidth and dynamic range, and exploitation of shock waveform period and amplitude estimates, give the system good capability even in difficult geometries and highly reverberant environments. In-depth study of the phenomenology of the ballistic shock wave was undertaken during the design phase. Results of this study are summarized.

  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.

  3. 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)

  4. 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.

  5. Are carnivores universally good sentinels of plague?

    PubMed

    Brinkerhoff, R Jory; Collinge, Sharon K; Bai, Ying; Ray, Chris

    2009-10-01

    Sylvatic plague, caused by the bacterium Yersinia pestis, is a flea-borne disease that primarily affects rodents but has been detected in over 200 mammal species worldwide. Mammalian carnivores are routinely surveyed as sentinels of local plague activity, since they can present antibodies to Y. pestis infection but show few clinical signs. In Boulder County, Colorado, USA, plague epizootic events are episodic and occur in black-tailed prairie dogs. Enzootic hosts are unidentified as are plague foci. For three years, we systematically sampled carnivores in two distinct habitat types to determine whether carnivores may play a role in maintenance or transmission of Y. pestis and to identify habitats associated with increased plague prevalence. We sampled 83 individuals representing six carnivore species and found only two that had been exposed to Y. pestis. The low overall rate of plague exposure in carnivores suggests that plague may be ephemeral in this study system, and thus we cannot draw any conclusions regarding habitat-associated plague foci or temporal changes in plague activity. Plague epizootics involving prairie dogs were confirmed in this study system during two of the three years of this study, and we therefore suggest that the targeting carnivores to survey for plague may not be appropriate in all ecological systems.

  6. 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

  7. 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

  8. One node driving synchronisation.

    PubMed

    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.

  9. 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.

  10. 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

  11. 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.

  12. Recent Advance in Lymph Dynamic Analysis in Lymphatics and Lymph Nodes

    PubMed Central

    2012-01-01

    Lymphatics are a unidirectional transport system that carries fluid from the interstitial space and back into the blood stream. Initial lymphatics take up not only fluid but also high-molecular-weight substances, such as plasma proteins and hyaluronan; immune cells, such as lymphocytes, macrophages, and dendritic cells; and colloidal particles, such as carbon particles, bacteria, and tattoo dye. Interstitially injected colloidal particles are known to accumulate in the regional lymph nodes. This phenomenon is applied to find sentinel lymph nodes in cancer patients. Lymph flow rate and composition are influenced by interstitial fluid, lymphatic pump activity, and intra-lymphatic pressure. Lymph composition is changed during its flow downstream. In this review, the main focus is on the mechanisms of lymph formation at the initial lymphatics and lymph transport through the collecting lymphatics and lymph nodes. (*English Translation of J Jpn Coll Angiol, 2008, 48: 113-123.) PMID:23555523

  13. Altered lymphatic drainage after breast-conserving surgery and axillary node dissection: local recurrence with contralateral intramammary nodal metastases.

    PubMed

    Wellner, Rachel; Dave, Jasmine; Kim, Unsup; Menes, Tehillah S

    2007-02-01

    A review of the literature shows that lymphoscintigraphy and sentinel node biopsy are feasible in patients with previous breast and axillary surgery and could be especially warranted because in these patients, lymphatic drainage might not include the axillary basin. We report a case of a woman with recurrent breast cancer after breast-conserving surgery. The patient was found to have metastases in the contralateral intramammary lymph nodes. Demonstrating that such patterns do occur after previous treatment for breast cancer carries implications for the staging and management of these patients. PMID:17386126

  14. 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.

  15. Methylene blue injection into the rectal artery as a simple method to improve lymph node harvest in rectal cancer.

    PubMed

    Märkl, Bruno; Kerwel, Therese G; Wagner, Theodor; Anthuber, Matthias; Arnholdt, Hans M

    2007-07-01

    Adequate lymph node assessment in colorectal cancer is crucial for prognosis estimation and further therapy stratification. However, there is still an ongoing debate on required minimum lymph node numbers and the necessity of advanced techniques such as immunohistochemistry or PCR. It has been proven in several studies that lymph node harvest is often inadequate under routine analysis. Lymph nodes smaller than 5 mm are especially concerning as they can carry the majority of metastases. These small, but affected lymph nodes may escape detection in routine analysis. Therefore, fat-clearing protocols and sentinel techniques have been developed to improve accuracy of lymph node staging. We describe a novel and simple method of ex vivo methylene blue injection into the superior rectal artery of rectal cancer specimens, which highlights lymph nodes and makes them easy to detect during manual dissection. Initially, this method was developed for proving accuracy of total mesorectal excision. We performed a retrospective study comparing lymph node recovery of 12 methylene blue stained and an equal number of unstained cases. Lymph node recovery differed significantly with average lymph node numbers of 27+/-7 and 14+/-4 (P<0.001) for the methylene blue and the unstained group, respectively. The largest difference was found in size groups between 1 and 4 mm causing a shift in size distribution toward smaller nodes. Metastases were confirmed in 21 and 19 lymph nodes occurring in five and four cases, respectively. Hence, we conclude that methylene blue injection technique improves accuracy of lymph node staging by heightening the lymph node harvest in rectal resections. In our experience, it is a very simple time and cost effective method that can be easily established under routine circumstances.

  16. 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

  17. 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.

  18. 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

  19. Identification of sentinel health events as indicators of environmental contamination.

    PubMed Central

    Rothwell, C J; Hamilton, C B; Leaverton, P E

    1991-01-01

    The consensus process was applied to addressing a public health topic; this was a novel endeavor. The following question was addressed: What role, if any, should sentinel health events play in the decision-making process for identifying the effects of environmental exposure? The panel developed three levels of sentinel health events lists: those that are clearly identifiable, those that are potential signs, and those that are indicators of body burdens. Additionally, the panel developed several salient statements regarding the principles of environmental health surveillance and, especially, recommendations for future research. PMID:1683284

  20. 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

  1. BioSentinel: Developing a Space Radiation Biosensor

    NASA Technical Reports Server (NTRS)

    Santa Maria, Sergio R.

    2015-01-01

    BioSentinel is an autonomous fully self-contained science mission that will conduct the first study of the biological response to space radiation outside low Earth orbit (LEO) in over 40 years. The 4-unit (4U) BioSentinel biosensor system, is housed within a 6-Unit (6U) spacecraft, and uses yeast cells in multiple independent microfluidic cards to detect and measure DNA damage that occurs in response to ambient space radiation. Cell growth and metabolic activity will be measured using a 3-color LED detection system and a metabolic indicator dye with a dedicated thermal control system per fluidic card.

  2. 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.

  3. Endosalpingiosis in axillary lymph nodes simulating metastatic breast carcinoma: a potential diagnostic pitfall.

    PubMed

    Salehi, Amir H; Omeroglu, Gulbeyaz; Kanber, Yonca; Omeroglu, Atilla

    2013-12-01

    Intraoperative assessment of sentinel lymph nodes at time of surgical excision of primary breast carcinoma is a crucial step in the determination of cancer extent and the need for further axillary dissection. Benign epithelial inclusions in axillary lymph nodes can mimic metastatic carcinoma and are a well-known pitfall during examination of these nodes in frozen or permanent sections. Most often, these inclusions consists of heterotopic mammary glands and are familiar to the practicing pathologist. Here, however, we present a rare case of endosalpingiosis in the axillary lymph nodes of a breast cancer patient and describe our experience and effort to characterize the lesion. Simulating a metastatic focus of invasive ductal carcinoma, the glandular inclusions lacked myoepithelial cells and failed to stain with myoepithelial markers. However, consistent with a Mullerian origin, the inclusions demonstrated strong staining with PAX-8 and WT-1. Although endosalpingiotic inclusions are not uncommonly encountered in subdiaphragmatic lymph nodes, they are an extremely rare finding above the diaphragm. Pathologists must be aware of these lesions and their ability to imitate metastatic gland-forming carcinoma during frozen section or permanent examination of axillary lymph nodes.

  4. 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

  5. Coarse-node computations with an adaptive node structure

    SciTech Connect

    Tzanos, C.P.

    1988-01-01

    The analysis with COMMIX of liquid metal reactor (LMR) intermediate heat exchanger (IHX) transients that are characterized by low flows, and especially imbalanced low flows, shows that if a coarse-node structure is used the predicted temperatures are significantly different than those given by a fine-node structure. If a fine-node structure is used, for problems that involve a large part of the plant, the computation time becomes excessive. This paper presents an improved version of an adaptive node structure. At this stage this version has been applied only to one-dimensional problems.

  6. 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

  7. 78 FR 67168 - Sixth Annual Sentinel Initiative; Public Workshop

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-08

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Sixth Annual Sentinel Initiative; Public Workshop AGENCY: Food and Drug Administration, HHS. ACTION: Notice of public workshop. The Food and Drug...

  8. 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...

  9. 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

  10. 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.

  11. SAR Wave Mode Processing- Improvements Towards Sentinel-1 Mission

    NASA Astrophysics Data System (ADS)

    Johnsen, Harald; Collard, Fabrice

    2013-03-01

    The Sentinel-1 level-2 (L2) ocean product (OCN) has been designed to deliver geophysical parameters related to the wind, waves and surface velocity to a large panel of end-users. Each L2 OCN product contains up to three geophysical components: the radial velocity (RVL), the ocean surface wind field (OWI) and the ocean swell wave spectra (OSW) components. The Sentinel-1 Level 2 OSW component is the two-dimensional ocean surface wave spectra estimated from a Sentinel-1 Level 1 Single-Look Complex (SLC) SAR image by inversion of the corresponding image cross-spectra. The cross spectra are computed by performing inter-looking in azimuth followed by co- and cross-spectra estimation among the detected individual look images. The image from which a single OSW is computed can be a SLC vignette from the WV mode, or a co-polarized subimage extracted from a SM SLC image. The experiences with ASAR have shown the need to improve the modulation transfer functions (MTF), especially the wind dependency in the RAR MTF. The OSW processing scheme is an upgraded version of the ASAR WM Level 2 processing accounting for these findings. The Sentinel-1 Level 2 OSW processing has been evaluated using ASAR WM and ASAR SM data, and preliminary key results are presented in this paper.

  12. 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…

  13. 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

  14. Evaluation of registration accuracy between Sentinel-2 and Landsat 8

    NASA Astrophysics Data System (ADS)

    Barazzetti, Luigi; Cuca, Branka; Previtali, Mattia

    2016-08-01

    Starting from June 2015, Sentinel-2A is delivering high resolution optical images (ground resolution up to 10 meters) to provide a global coverage of the Earth's land surface every 10 days. The planned launch of Sentinel-2B along with the integration of Landsat images will provide time series with an unprecedented revisit time indispensable for numerous monitoring applications, in which high resolution multi-temporal information is required. They include agriculture, water bodies, natural hazards to name a few. However, the combined use of multi-temporal images requires an accurate geometric registration, i.e. pixel-to-pixel correspondence for terrain-corrected products. This paper presents an analysis of spatial co-registration accuracy for several datasets of Sentinel-2 and Landsat 8 images distributed all around the world. Images were compared with digital correlation techniques for image matching, obtaining an evaluation of registration accuracy with an affine transformation as geometrical model. Results demonstrate that sub-pixel accuracy was achieved between 10 m resolution Sentinel-2 bands (band 3) and 15 m resolution panchromatic Landsat images (band 8).

  15. 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.

  16. 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.

  17. 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.

  18. 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

  19. 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

  20. 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

  1. Oestrogen receptors β1 and βcx have divergent roles in breast cancer survival and lymph node metastasis

    PubMed Central

    Rosin, G; de Boniface, J; Karthik, G M; Frisell, J; Bergh, J; Hartman, J

    2014-01-01

    Background: The expression of oestrogen receptor (ER) α characterises a subset of breast cancers associated with good response to endocrine therapy. However, the clinical significance of the second ER, ERβ1, and its splice variant ERβcx is still unclear. Methods: We here report an assessment of ERα, ERβ1 and ERβcx by immunohistochemistry using quantitative digital image analysis of 340 primary tumours and corresponding sentinel lymph nodes. Results: No differences were seen in ER levels in primary tumours vs lymph node metastases. ERβ1 and ERβcx were equally distributed among age groups and tumour histological grades. Loss of ERβ1 in the primary tumour was strongly associated with poor survival. Its prognostic impact was particularly evident in young patients and in high-grade tumours. The worst outcome was seen in the tumours lacking both ERα and ERβ1. ERβcx expression in the primary tumour correlated with a higher risk of lymph node metastasis, and with poor survival when expressed in sentinel node lymphocytes. Conclusions: Our study reveals highly significant although antagonising roles of ERβ1 and ERβcx in breast cancer. Consequently, we suggest that the histopathological assessment of ERβ1 is of value as a prognostic and potentially predictive biomarker. PMID:25025959

  2. 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.

  3. [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

  4. Microenvironment of Tumor-Draining Lymph Nodes: Opportunities for Liposome-Based Targeted Therapy

    PubMed Central

    Chandrasekaran, Siddarth; King, Michael R.

    2014-01-01

    The World Health Organization (WHO) recently reported that the total number of global cancer cases in 2013 reached 14 million, a 10% rise since 2008, while the total number of cancer deaths reached 8.2 million, a 5.2% increase since 2008. Metastasis is the major cause of death from cancer, accounting for 90% of all cancer related deaths. Tumor-draining lymph nodes (TDLN), the sentinel nodes, are the first organs of metastasis in several types of cancers. The extent of metastasis in the TDLN is often used in disease staging and prognosis evaluation in cancer patients. Here, we describe the microenvironment of the TDLN and review the recent literature on liposome-based therapies directed to immune cells within the TDLN with the intent to target cancer cells. PMID:25380524

  5. PASS spacecraft antenna technology assessment

    NASA Astrophysics Data System (ADS)

    Freeland, R. E.

    1990-09-01

    The purpose was to generate estimates of mechanical performance for the classes of spacecraft antenna under construction for application to the Personal Access Satellite System (PASS). These performance data are needed for the support of trade studies involving antenna system development. The classes of antenna considered included: (1) rigid non-deployable antenna structures; (2) mechanical deployable antenna concepts; (3) inflatable deployable antenna concepts; and (4) mesh deployable antenna concepts. The estimates of mechanical performance are presented in terms of structural weight and cost as a function of the reflector size. Estimates of aperture surface precision are presented for a few discrete antenna sizes. The range of reflector size is 1 to 4 meters for non-deployable structures and 2 to 8 meters for deployable structures. The range of reflector surface precision is lambda/30 to lambda/50 for 20 and 30 GHz, respectively.

  6. 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.

  7. 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

  8. Sentinel Event Notification System for Occupational Risks (SENSOR): the concept.

    PubMed

    Baker, E L

    1989-12-01

    Although many states have laws that require health providers to report cases of occupational illness and injury, most states do not maintain a comprehensive system that actively identifies and targets potential sources of case reports and then responds to such reports. NIOSH has developed a Sentinel Event Notification System for Occupational Risks (SENSOR) that uses targeted sources of sentinel providers to recognize and report selected occupational disorders to a state surveillance center. SENSOR is a cooperative state-federal effort designed to develop local capability for preventing selected occupational disorders. To demonstrate the feasibility of this approach, NIOSH initially funded seven SENSOR projects in 1987 and three additional projects in early 1988 (Table 1). Currently, these projects are in the preliminary stages of organization and start-up, with some having begun to receive case reports. As funds become available, NIOSH intends to gradually expand the scope of the program to include additional states over the next several years.

  9. 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

  10. 27 CFR 9.88 - Pacheco Pass.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... THE TREASURY ALCOHOL AMERICAN VITICULTURAL AREAS Approved American Viticultural Areas § 9.88 Pacheco Pass. (a) Name. The name of the viticultural area described in this section is “Pacheco Pass.” (b) Approved maps. The appropriate maps for determining the boundaries of Pacheco Pass viticultural area...

  11. 27 CFR 9.88 - Pacheco Pass.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... THE TREASURY LIQUORS AMERICAN VITICULTURAL AREAS Approved American Viticultural Areas § 9.88 Pacheco Pass. (a) Name. The name of the viticultural area described in this section is “Pacheco Pass.” (b) Approved maps. The appropriate maps for determining the boundaries of Pacheco Pass viticultural area...

  12. 27 CFR 9.88 - Pacheco Pass.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... THE TREASURY LIQUORS AMERICAN VITICULTURAL AREAS Approved American Viticultural Areas § 9.88 Pacheco Pass. (a) Name. The name of the viticultural area described in this section is “Pacheco Pass.” (b) Approved maps. The appropriate maps for determining the boundaries of Pacheco Pass viticultural area...

  13. 27 CFR 9.88 - Pacheco Pass.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... THE TREASURY LIQUORS AMERICAN VITICULTURAL AREAS Approved American Viticultural Areas § 9.88 Pacheco Pass. (a) Name. The name of the viticultural area described in this section is “Pacheco Pass.” (b) Approved maps. The appropriate maps for determining the boundaries of Pacheco Pass viticultural area...

  14. 27 CFR 9.88 - Pacheco Pass.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... THE TREASURY ALCOHOL AMERICAN VITICULTURAL AREAS Approved American Viticultural Areas § 9.88 Pacheco Pass. (a) Name. The name of the viticultural area described in this section is “Pacheco Pass.” (b) Approved maps. The appropriate maps for determining the boundaries of Pacheco Pass viticultural area...

  15. 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

  16. 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.

  17. 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.

  18. Methods of Investigating Metastatic Lymph Nodes in Head and Neck Cancer

    PubMed Central

    POPESCU, Bogdan; ENE, Patricia; BERTESTEANU, Serban Vifor Gabriel; ENE, Razvan; CIRSTOIU, Catalin; POPESCU, Cristian Radu

    2013-01-01

    ABSTRACT When dealing with patients who have head and neck cancer - squamous cell carcinoma and have clinically N0 neck disease it is very difficult to assess the real extension of the malignant proccess. This is why several techniques are curently in use to determine the actual TNM clasiffication for each patient in order to apply best suited therapy management. Up until today the staging of the neck has been done by using a combination of the physical exam and conventional imaging studies. Recent studies and research have tried to determine weather the use of sentinel lymph node biopsy is a more reliable tool in predicting occult metastasis in cancer patients with clinically N0 neck disease. There are no guidelines in this matter and as such the use of the sentinel lymph node detection technique is yet to be used on a routine basis. The authors are trying to assess the benefits of different paraclinical investigation regarding the improvement of overall survival rates in patients with T1/T2 squamous cell carcinoma of the head and neck and N0 neck disease. PMID:24790674

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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

  4. Potential of Sentinel-1a for Grounding Line Measurements

    NASA Astrophysics Data System (ADS)

    Scheuchl, B.; Mouginot, J.; Rignot, E. J.

    2015-12-01

    The grounding line, the boundary between grounded and floating ice plays a crucial role for mass balance assessment, ice sheet modeling and the analysis of ice shelf melting. Interferometric Synthetic Aperture Radar data are the most accurate means to data to determine the grounding line on a large scale. The analysis of InSAR data from 1996 and 2011 shows a significant retreat of the grounding line in the Amundsen Sea Sector of West Antarctica along a retrograde bed. A new generation of spaceborne SAR sensors (Sentinel-1a, ALOS2) was launched in 2014 and has begun operational data collection since. Sentinel-1a collects data over ice sheets in a novel TOPSAR mode to provide large area coverage at relatively high resolution. Working closely with the ice sheet science community, ESA has implemented a data acquisition plan that ensures at least one ice sheet wide coverage per year and ongoing coverage in key coastal regions. The new mode, however does lead to some challenges in data processing. With focus on glaciers in West Antarctica (in particular we look at Smith, Pope and Kohler Glaciers), we show the potential of Sentinel-1a for grounding line mapping. Combining data from several currently available missions, we provide a 2015 update for the grounding line in the region.

  5. 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.

  6. Sensitivity analysis of a bio-optical model for Italian lakes focused on Landsat-8, Sentinel-2 and Sentinel-3

    NASA Astrophysics Data System (ADS)

    Manzo, Ciro; Bresciani, Mariano; Giardino, Claudia; Braga, Federica; Bassani, Cristiana

    2015-04-01

    In this work, a variance-based procedure was applied to study the sensitivity of a Case-2 bio-optical model which simulates the water reflectance of three Italian lakes - Garda, Mantua and Trasimeno - with different trophic conditions by analysing the main effect of single WQPs and their interactions. The water reflectance was simulated according to a four-components model [Brando and Dekker 2003] considering the SIOPs typical of each lake and the spectral characteristics of three optical sensors, on-board of Landsat-8, Sentinel-2 and Sentinel-3, which can be potentially applied for lakes. Lakes Garda, Mantua and Trasimeno were selected as representative of different trophic levels; for these lakes long-term data of in situ measurements on water quality characteristics were also available. The bio-optical analytical model simulated the subsurface irradiance reflectance R(0-, λ) as a function of absorption and backscattering coefficients (a(λ), bb(λ)) given as a sum of the contribution of water and the water quality parameters. The sensitivity indices of water reflectance for three water types/trophic conditions were calculated decomposing output variance (V) in partial variances which represent the share of V that is explained by the bio-optical model inputs [Saltelli et al., 2010]. The results provide important information relating the sensitivity of the new generation sensors to different trophic statuses, and in particular confirmed that Sentinel-3 water reflectance is sensitive to WQPs in all the trophic conditions investigated.

  7. Metropolitan all-pass and inter-city quantum communication network.

    PubMed

    Chen, Teng-Yun; Wang, Jian; Liang, Hao; Liu, Wei-Yue; Liu, Yang; Jiang, Xiao; Wang, Yuan; Wan, Xu; Cai, Wei-Qi; Ju, Lei; Chen, Luo-Kan; Wang, Liu-Jun; Gao, Yuan; Chen, Kai; Peng, Cheng-Zhi; Chen, Zeng-Bing; Pan, Jian-Wei

    2010-12-20

    We have demonstrated a metropolitan all-pass quantum communication network in field fiber for four nodes. Any two nodes of them can be connected in the network to perform quantum key distribution (QKD). An optical switching module is presented that enables arbitrary 2-connectivity among output ports. Integrated QKD terminals are worked out, which can operate either as a transmitter, a receiver, or even both at the same time. Furthermore, an additional link in another city of 60 km fiber (up to 130 km) is seamless integrated into this network based on a trusted relay architecture. On all the links, we have implemented protocol of decoy state scheme. All of necessary electrical hardware, synchronization, feedback control, network software, execution of QKD protocols are made by tailored designing, which allow a completely automatical and stable running. Our system has been put into operation in Hefei in August 2009, and publicly demonstrated during an evaluation conference on quantum network organized by the Chinese Academy of Sciences on August 29, 2009. Real-time voice telephone with one-time pad encoding between any two of the five nodes (four all-pass nodes plus one additional node through relay) is successfully established in the network within 60 km. PMID:21196999

  8. Node weighted network upgrade problems

    SciTech Connect

    Krumke, S.O.; Noltemeier, H.; Marathe, M.V.; Ravi, S.S.

    1996-09-01

    Consider a network where nodes represent processors and edges represent bidirectional communication links. The processor at a node v can be upgraded at an expense of cost(v). Such an upgrade reduces the delay of each link emanating from v by a fixed factor x, where 0 < x < 1. The goal is to find a minimum cost set of nodes to be upgraded so that the resulting network has a spanning tree in which edge is of delay at most a given value {delta}. The authors provide both hardness and approximation results for the problem. They show that the problem is NP-hard and cannot be approximated within any factor {beta} < ln n, unless NP {improper_subset} DTIME(n{sup log log n}), where n is the number of nodes in the network. They then present the first polynomial time approximation algorithms for the problem. For the general case, the approximation algorithm comes within a factor of 2 ln n of the minimum upgrading cost. When the cost of upgrading each node is 1, they present an approximation algorithm with a performance guarantee of 4(2 + ln {Delta}), where {Delta} is the maximum node degree. Finally, they present a polynomial time algorithm for the class of treewidth-bounded graphs.

  9. Comparison of molecular analysis and histopathology for axillary lymph node staging in primary breast cancer: results of the B-CLOSER-I study.

    PubMed

    Vegué, Laia Bernet; Rojo, Federico; Hardisson, David; Iturriagagoitia, Alicia Córdoba; Panadés, Maria José; Velasco, Ana; Bonet, Eugeni López; Muñoz, Rafael Cano; Polo, Luis

    2012-06-01

    In breast cancer, the number of lymph node metastases is the strongest predictor of outcome. However, histopathology may underestimate the frequency of metastasis. Here we compare automated molecular detection of cytokeratin 19 mRNA by one-step nucleic acid amplification (OSNA) with histopathology of single tissue sections for the staging of axillary lymph nodes in patients with breast cancer. Axillary lymph nodes were collected from 55 patients with primary breast cancer and sentinel lymph node (SLN) metastases. The central 1-mm portion of each node was processed for hematoxylin-eosin staining, and the remaining tissue was analyzed by OSNA. According to OSNA, histopathology misclassified 41.8% of patients as negative for axillary node metastasis (P=0.007). Of the individual nodes considered negative by histopathology, 4.5% contained micrometastases and 2.5% contained macrometastases according to OSNA. Furthermore, 80% of micrometastases identified by histopathology were reclassified as macrometastases by OSNA. Histopathology failed to identify 81.1% of nodes shown to contain metastasis by OSNA. However, OSNA yielded no false-negative results. On the basis of OSNA results, 3 patients were reclassified to a higher pathologic stage. The number of SLN and non-SLN metastases was unrelated according to OSNA (P=0.891). These results show that, compared with molecular detection, histopathology of single tissue sections significantly underestimates the frequency of axillary node metastases. We discuss the implications of these findings in light of current recommendations on the staging of breast cancer.

  10. 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.

  11. 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

  12. Node, Node-Link, and Node-Link-Group Diagrams: An Evaluation.

    PubMed

    Saket, Bahador; Simonetto, Paolo; Kobourov, Stephen; Börner, Katy

    2014-12-01

    Effectively showing the relationships between objects in a dataset is one of the main tasks in information visualization. Typically there is a well-defined notion of distance between pairs of objects, and traditional approaches such as principal component analysis or multi-dimensional scaling are used to place the objects as points in 2D space, so that similar objects are close to each other. In another typical setting, the dataset is visualized as a network graph, where related nodes are connected by links. More recently, datasets are also visualized as maps, where in addition to nodes and links, there is an explicit representation of groups and clusters. We consider these three Techniques, characterized by a progressive increase of the amount of encoded information: node diagrams, node-link diagrams and node-link-group diagrams. We assess these three types of diagrams with a controlled experiment that covers nine different tasks falling broadly in three categories: node-based tasks, network-based tasks and group-based tasks. Our findings indicate that adding links, or links and group representations, does not negatively impact performance (time and accuracy) of node-based tasks. Similarly, adding group representations does not negatively impact the performance of network-based tasks. Node-link-group diagrams outperform the others on group-based tasks. These conclusions contradict results in other studies, in similar but subtly different settings. Taken together, however, such results can have significant implications for the design of standard and domain snecific visualizations tools. PMID:26356937

  13. Anatomy and histology of Virchow's node.

    PubMed

    Mizutani, Masaomi; Nawata, Shin-ichi; Hirai, Ichiro; Murakami, Gen; Kimura, Wataru

    2005-12-01

    A regional lymphatic system is composed of the first, second, third and even fourth or much more intercalated nodes along the lymptatic route from the periphery to the venous angle or the thoracic duct. The third or fourth node is usually termed the last-intercalated node or end node along the route. Similarly, one of the supraclavicular nodes is known to correspond to the end node along the thoracic duct. It is generally called 'Virchow's node', in which the famous 'Virchow's metastasis' of advanced gastric cancer occurs. The histology of this node has not been investigated, although region-specific differences in histology are evident in human lymph nodes. We found macroscopically the end node in five of 30 donated cadavers. Serial sections were prepared for these five nodes and sections stained with hematoxylin and eosin. Histological investigation revealed that, on the inferior or distal side of the end node, the thoracic duct divided into three to 10 collateral ducts and these ducts surrounded the node. The node communicated with the thoracic duct and its collaterals at multiple sites in two to three hilus-like portions, as well as along the subcapsular sinus. Thus, the end node was aligned parallel to the thoracic duct. Moreover, the superficial and deep cortex areas of the end node were fragmented to make an island-like arrangement, which may cause the short-cut intranodal shunt. Consequenly, the filtration function of most of Virchow's node seemed to be quite limited.

  14. 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.

  15. 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.

  16. 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

  17. 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.

  18. 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.

  19. 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

  20. 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

  1. 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.

  2. 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.

  3. Swiss EMBnet node web server.

    PubMed

    Falquet, Laurent; Bordoli, Lorenza; Ioannidis, Vassilios; Pagni, Marco; Jongeneel, C Victor

    2003-07-01

    EMBnet is a consortium of collaborating bioinformatics groups located mainly within Europe (http://www.embnet.org). Each member country is represented by a 'node', a group responsible for the maintenance of local services for their users (e.g. education, training, software, database distribution, technical support, helpdesk). Among these services a web portal with links and access to locally developed and maintained software is essential and different for each node. Our web portal targets biomedical scientists in Switzerland and elsewhere, offering them access to a collection of important sequence analysis tools mirrored from other sites or developed locally. We describe here the Swiss EMBnet node web site (http://www.ch.embnet.org), which presents a number of original services not available anywhere else.

  4. 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.

  5. 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

  6. 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.

  7. 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.

  8. On sampling band-pass signals

    NASA Technical Reports Server (NTRS)

    Sadr, R.; Shahshahani, M.

    1989-01-01

    Four techniques for uniform sampling of band-bass signals are examined. The in-phase and quadrature components of the band-pass signal are computed in terms of the samples of the original band-pass signal. The relative implementation merits of these techniques are discussed with reference to the Deep Space Network (DSN).

  9. 33 CFR 117.311 - New Pass.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false New Pass. 117.311 Section 117.311 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES DRAWBRIDGE OPERATION REGULATIONS Specific Requirements Florida § 117.311 New Pass. The drawspan for the State Road 789...

  10. 33 CFR 117.311 - New Pass.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false New Pass. 117.311 Section 117.311 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES DRAWBRIDGE OPERATION REGULATIONS Specific Requirements Florida § 117.311 New Pass. The drawspan for the State Road 789...

  11. A new routing enhancement scheme based on node blocking state advertisement in wavelength-routed WDM networks

    NASA Astrophysics Data System (ADS)

    Hu, Peigang; Jin, Yaohui; Zhang, Chunlei; He, Hao; Hu, WeiSheng

    2005-02-01

    The increasing switching capacity brings the optical node with considerable complexity. Due to the limitation in cost and technology, an optical node is often designed with partial switching capability and partial resource sharing. It means that the node is of blocking to some extent, for example multi-granularity switching node, which in fact is a structure using pass wavelength to reduce the dimension of OXC, and partial sharing wavelength converter (WC) OXC. It is conceivable that these blocking nodes will have great effects on the problem of routing and wavelength assignment. Some previous works studied the blocking case, partial WC OXC, using complicated wavelength assignment algorithm. But the complexities of these schemes decide them to be not in practice in real networks. In this paper, we propose a new scheme based on the node blocking state advertisement to reduce the retry or rerouting probability and improve the efficiency of routing in the networks with blocking nodes. In the scheme, node blocking state are advertised to the other nodes in networks, which will be used for subsequent route calculation to find a path with lowest blocking probability. The performance of the scheme is evaluated using discrete event model in 14-node NSFNET, all the nodes of which employ a kind of partial sharing WC OXC structure. In the simulation, a simple First-Fit wavelength assignment algorithm is used. The simulation results demonstrate that the new scheme considerably reduces the retry or rerouting probability in routing process.

  12. 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.

  13. Sentinel-5 Precursor: Preparing the first Copernicus Atmospheric Mission

    NASA Astrophysics Data System (ADS)

    Nett, Herbert; McMullan, Kevin; Ingmann, Paul; Fehr, Thorsten

    2015-06-01

    Sentinel-5 Precursor (S-5P) will be the first of a series of atmospheric missions to be launched within the European Commission’s Copernicus (former GMES) Programme. With a planned launch in 2016 and a nominal lifetime of 7 years S-5P is expected to provide continuity in the availability of global atmospheric data products between its predecessor missions SCIAMACHY (Envisat) and OMI (AURA) and the future Sentinel-4 and -5 series. The latter will comprise payload instruments on board the operational satellites MTG-S (S-4, geostationary component) and MetOp Second Generation (S-5, polar orbiting component), the first units of which will be launched in the 2020-2021 timeframe. The S-5P satellite will carry a single payload, TROPOMI (TROPO spheric M onitoring I nstrument) which is jointly developed by The Netherlands and ESA. Covering spectral channels in the UV, visible, near- and short-wave infrared it will measure various key species including tropospheric/stratospheric ozone, NO2 , SO2 , CO, CH4 , CH2 O as well as cloud and aerosol parameters.

  14. 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).

  15. 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.

  16. SensorNet Node Suite

    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. A Distributed and Cooperative Algorithm for the Detection and Elimination of Multiple Black Hole Nodes in Ad Hoc Networks

    NASA Astrophysics Data System (ADS)

    Yu, Chang Wu; Wu, Tung-Kuang; Cheng, Rei-Heng; Yu, Kun-Ming; Chang, Shun Chao

    A mobile node in ad hoc networks may move arbitrarily and act as a router and a host simultaneously. Such a characteristic makes nodes in MANET vulnerable to potential attacks. The black hole problem, in which some malicious nodes pretend to be intermediate nodes of a route to some given destinations and drop packets that pass through it, is one of the major types of attack. In this paper, we propose a distributed and cooperative mechanism to tackle the black hole problem. The mechanism is distributed so that it suits the ad hoc nature of network, and nodes in the protocol cooperate so that they can analyze, detect, and eliminate possible multiple black-hole nodes in a more reliable fashion. Simulation results show that our method achieves a high black hole detection rate and good packet delivery rate, while the overhead is comparatively lower as the network traffic increases.

  18. 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

  19. 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

  20. Response of foraging group members to sentinel calls in suricates, Suricata suricatta

    PubMed Central

    Manser, M. B.

    1999-01-01

    In the suricate (Suricata suricatta), a cooperatively breeding mongoose, one individual typically watches out for predators while the rest of the group is foraging. Most of the time these sentinels announce their guarding duty with special vocalizations. The response of foraging group members to these calls was investigated by analysing observational data, and by performing playback experiments. The use of special calls by sentinels, and the responses of the foraging group members to them, suggest that the coordination of vigilance is strongly influenced by vocal communication. Sentinel calls decreased the time spent alert by the foraging group members. Other group members were less likely to go on guard when a sentinel was vocalizing. Both the proportion of time during which guards overlapped, and the proportion of time the group was unprotected without a guard, decreased when sentinels announced their duty, due to better coordination of the rotation of sentinels. Suricates, however, do not appear to use sentinel calls to mediate a strict rotation of guarding duty.

  1. A New Look at Reweighted Message Passing.

    PubMed

    Kolmogorov, Vladimir

    2015-05-01

    We propose a new family of message passing techniques for MAP estimation in graphical models which we call Sequential Reweighted Message Passing (SRMP). Special cases include well-known techniques such as Min-Sum Diffusion (MSD) and a faster Sequential Tree-Reweighted Message Passing (TRW-S). Importantly, our derivation is simpler than the original derivation of TRW-S, and does not involve a decomposition into trees. This allows easy generalizations. The new family of algorithms can be viewed as a generalization of TRW-S from pairwise to higher-order graphical models. We test SRMP on several real-world problems with promising results.

  2. Decellularized Lymph Nodes as Scaffolds for Tissue Engineered Lymph Nodes

    PubMed Central

    Cuzzone, Daniel A.; Albano, Nicholas J.; Aschen, Seth Z.; Ghanta, Swapna

    2015-01-01

    Abstract Background: The lymphatic system is commonly injured during cancer treatment. However, despite the morbidity of these injuries, there are currently no options for replacing damaged lymphatics. The purpose of this study was to optimize methods for decellularization of murine lymph nodes (LN) and to determine if these scaffolds can be used to tissue engineer lymph node-like structures. Methods and Results: LNs were harvested from adult mice and subjected to various decellularization protocols. The degree of decellularization and removal of nuclear material was analyzed histologically and quantitatively using DNA isolation. In addition, we analyzed histological architecture by staining for matrix proteins. After the optimal method of decellularization was identified, decellularized constructs were implanted in the renal capsule of syngeneic or allogeneic recipient mice and analyzed for antigenicity. Finally, to determine if decellularized constructs could deliver lymphocytes to recipient animals, the matrices were repopulated with splenocytes, implanted in submuscular pockets, and harvested 14 days later. Decellularization was best accomplished with the detergent sodium dodecyl sulfate (SDS), resulting in negligible residual cellular material but maintenance of LN architecture. Implantation of decellularized LNs into syngeneic or allogeneic mice did not elicit a significant antigenic response. In addition, repopulation of decellularized LNs with splenocytes resulted in successful in vivo cellular delivery. Conclusions: We show, for the first time, that LNs can be successfully decellularized and that these matrices have preserved extracellular matrix architecture and the potential to deliver leukocytes in vivo. Future studies are needed to determine if tissue engineered lymph nodes maintain immunologic function. PMID:25144673

  3. Lymph node staging in prostate cancer.

    PubMed

    Sankineni, Sandeep; Brown, Anna M; Fascelli, Michele; Law, Yan Mee; Pinto, Peter A; Choyke, Peter L; Turkbey, Baris

    2015-05-01

    Nodal staging is important in prostate cancer treatment. While surgical lymph node dissection is the classic method of determining whether lymph nodes harbor malignancy, this is a very invasive technique. Current noninvasive approaches to identifying malignant lymph nodes are limited. Conventional imaging methods rely on size and morphology of lymph nodes and have notoriously low sensitivity for detecting malignant nodes. New imaging techniques such as targeted positron emission tomography (PET) imaging and magnetic resonance lymphography (MRL) with iron oxide particles are promising for nodal staging of prostate cancer. In this review, the strengths and limitations of imaging techniques for lymph node staging of prostate cancer are discussed.

  4. Identifying node importance in complex networks

    NASA Astrophysics Data System (ADS)

    Hu, Ping; Fan, Wenli; Mei, Shengwei

    2015-07-01

    In this paper, we propose a novel node importance evaluation method from the perspective of the existence of mutual dependence among nodes. The node importance comprises its initial importance and the importance contributions from both the adjacent and non-adjacent nodes according to the dependence strength between them. From the simulation analyses on an example network and the ARPA network, we observe that our method can well identify the node importance. Then, the cascading failures on the Netscience and E-mail networks demonstrate that the networks are more vulnerable when continuously removing the important nodes identified by our method, which further proves the accuracy of our method.

  5. Controlling data transfers from an origin compute node to a target compute node

    DOEpatents

    Archer, Charles J.; Blocksome, Michael A.; Ratterman, Joseph D.; Smith, Brian E.

    2011-06-21

    Methods, apparatus, and products are disclosed for controlling data transfers from an origin compute node to a target compute node that include: receiving, by an application messaging module on the target compute node, an indication of a data transfer from an origin compute node to the target compute node; and administering, by the application messaging module on the target compute node, the data transfer using one or more messaging primitives of a system messaging module in dependence upon the indication.

  6. 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

  7. Message passing for quantified Boolean formulas

    NASA Astrophysics Data System (ADS)

    Zhang, Pan; Ramezanpour, Abolfazl; Zdeborová, Lenka; Zecchina, Riccardo

    2012-05-01

    We introduce two types of message passing algorithms for quantified Boolean formulas (QBF). The first type is a message passing based heuristics that can prove unsatisfiability of the QBF by assigning the universal variables in such a way that the remaining formula is unsatisfiable. In the second type, we use message passing to guide branching heuristics of a Davis-Putnam-Logemann-Loveland (DPLL) complete solver. Numerical experiments show that on random QBFs our branching heuristics give robust exponential efficiency gain with respect to state-of-the-art solvers. We also manage to solve some previously unsolved benchmarks from the QBFLIB library. Apart from this, our study sheds light on using message passing in small systems and as subroutines in complete solvers.

  8. Hurricane Sandy -- Pass 1, Oct. 29, 2012

    NASA Video Gallery

    Hurricane Sandy was viewed Monday morning from the International Space Station as it orbited 260 miles above the Atlantic Ocean. Sandy had sustained winds of 90 miles an hour as the station passed ...

  9. Hurricane Sandy -- Pass 2, Oct. 29, 2012

    NASA Video Gallery

    Hurricane Sandy was viewed Monday morning from the International Space Station as it orbited 260 miles above the Atlantic Ocean. Sandy had sustained winds of 90 miles an hour as the station passed ...

  10. 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.

  11. 33 CFR 117.487 - Pierre Pass.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Pierre Pass. 117.487 Section 117... OPERATION REGULATIONS Specific Requirements Louisiana § 117.487 Pierre Pass. The draw of the S70 bridge, mile 1.0 at Pierre Part, shall open on signal; except that, from 10 p.m. to 6 a.m., the draw shall...

  12. Message Passing Framework for Globally Interconnected Clusters

    NASA Astrophysics Data System (ADS)

    Hafeez, M.; Asghar, S.; Malik, U. A.; Rehman, A.; Riaz, N.

    2011-12-01

    In prevailing technology trends it is apparent that the network requirements and technologies will advance in future. Therefore the need of High Performance Computing (HPC) based implementation for interconnecting clusters is comprehensible for scalability of clusters. Grid computing provides global infrastructure of interconnecting clusters consisting of dispersed computing resources over Internet. On the other hand the leading model for HPC programming is Message Passing Interface (MPI). As compared to Grid computing, MPI is better suited for solving most of the complex computational problems. MPI itself is restricted to a single cluster. It does not support message passing over the internet to use the computing resources of different clusters in an optimal way. We propose a model that provides message passing capabilities between parallel applications over the internet. The proposed model is based on Architecture for Java Universal Message Passing (A-JUMP) framework and Enterprise Service Bus (ESB) named as High Performance Computing Bus. The HPC Bus is built using ActiveMQ. HPC Bus is responsible for communication and message passing in an asynchronous manner. Asynchronous mode of communication offers an assurance for message delivery as well as a fault tolerance mechanism for message passing. The idea presented in this paper effectively utilizes wide-area intercluster networks. It also provides scheduling, dynamic resource discovery and allocation, and sub-clustering of resources for different jobs. Performance analysis and comparison study of the proposed framework with P2P-MPI are also presented in this paper.

  13. Sinus Node and Atrial Arrhythmias.

    PubMed

    John, Roy M; Kumar, Saurabh

    2016-05-10

    Although sinus node dysfunction (SND) and atrial arrhythmias frequently coexist and interact, the putative mechanism linking the 2 remain unclear. Although SND is accompanied by atrial myocardial structural changes in the right atrium, atrial fibrillation (AF) is a disease of variable interactions between left atrial triggers and substrate most commonly of left atrial origin. Significant advances have been made in our understanding of the genetic and pathophysiologic mechanism underlying the development and progression of SND and AF. Although some patients manifest SND as a result of electric remodeling induced by periods of AF, others develop progressive atrial structural remodeling that gives rise to both conditions together. The treatment strategy will thus vary according to the predominant disease phenotype. Although catheter ablation will benefit patients with predominantly AF and secondary SND, cardiac pacing may be the mainstay of therapy for patients with predominant fibrotic atrial cardiomyopathy. This contemporary review summarizes current knowledge on sinus node pathophysiology with the broader goal of yielding insights into the complex relationship between sinus node disease and atrial arrhythmias.

  14. Underwater Sensor Nodes and Networks

    PubMed Central

    Lloret, Jaime

    2013-01-01

    Sensor technology has matured enough to be used in any type of environment. The appearance of new physical sensors has increased the range of environmental parameters for gathering data. Because of the huge amount of unexploited resources in the ocean environment, there is a need of new research in the field of sensors and sensor networks. This special issue is focused on collecting recent advances on underwater sensors and underwater sensor networks in order to measure, monitor, surveillance of and control of underwater environments. On the one hand, from the sensor node perspective, we will see works related with the deployment of physical sensors, development of sensor nodes and transceivers for sensor nodes, sensor measurement analysis and several issues such as layer 1 and 2 protocols for underwater communication and sensor localization and positioning systems. On the other hand, from the sensor network perspective, we will see several architectures and protocols for underwater environments and analysis concerning sensor network measurements. Both sides will provide us a complete view of last scientific advances in this research field. PMID:24013489

  15. Trafficking of a Dual-Modality Magnetic Resonance and Fluorescence Imaging Superparamagnetic Iron Oxide-Based Nanoprobe to Lymph Nodes

    PubMed Central

    Bumb, Ambika; Regino, Celeste A. S.; Egen, Jackson G.; Bernardo, Marcelino; Dobson, Peter J.; Germain, Ronald N.; Choyke, Peter L.; Brechbiel, Martin W.

    2010-01-01

    Purpose To develop and characterize the trafficking of a dual-modal agent that identifies primary draining or sentinel lymph node (LN). Procedure Herein, a dual-reporting silica-coated iron oxide nanoparticle (SCION) is developed. Nude mice were imaged by magnetic resonance (MR) and optical imaging and axillary LNs were harvested for histological analysis. Trafficking through lymphatics was observed with intravital and ex vivo confocal microscopy of popliteal LNs in B6-albino, CD11c-EYFP, and lys-EGFP transgenic mice. Results In vivo, SCION allows visualization of LNs. The particle’s size and surface functionality play a role in its passive migration from the intradermal injection site and its minimal uptake by CD11c+ dendritic cells and CD169+ and lys+ macrophages. Conclusions After injection, SCION passively migrates to LNs without macrophage uptake and then can be used to image LN(s) by MRI and fluorescence. Thus, SCION can potentially be developed for use in sentinel node resections or for intralymphatic drug delivery. PMID:21080233

  16. Intramammary lymph nodes: a question seeking for an answer or an answer seeking for a question?

    PubMed

    Troupis, T; Michalinos, A; Skandalakis, P

    2012-10-01

    Intramammary lymph nodes have not received for a long time enough attention from the medical literature and thus many of their characteristics are not sufficiently explored. Their incidence at various studies ranges between 0, 7 and 48%. They may be found in all breast quadrants but usually at the Upper Outer Quadrant (UOQ). Their radiological image at mammography is that of a well circumscribed density with an area of lower density at centre representing the hilum and at ultrasonography of a hypoechoic, circumscribed mass with an echogenic hilum. Their role in lymphatic drainage of breast regions is important although it is not known if they represent true sentinel nodes or if lymphatic drainage to them comes from ectopic, independently developed pathways. Intramammary Lymph Nodes are involved in a variety of clinical situations including benign situations, tumor metastasis, breast lymphoma and breast cancer. Their importance over breast cancer is not fully defined but there is evidence that they worsen prognosis and they may change therapeutic decisions. Breast cancer and Breast lymphoma can coexist and interfere.

  17. A Nomogram for Predicting the Pathological Response of Axillary Lymph Node Metastasis in Breast Cancer Patients.

    PubMed

    Jin, Xi; Jiang, Yi-Zhou; Chen, Sheng; Shao, Zhi-Ming; Di, Gen-Hong

    2016-01-01

    The value of sentinel lymph node biopsy (SLNB) in post-neoadjuvant chemotherapy (NCT) patients is still controversial. We aimed to identify predictors and construct a nomogram for predicting the pathologically complete response (pCR) of axillary lymph nodes (ALNs) after NCT in node positive breast cancer patients. In total, 426 patients with pathologically proven ALN metastasis before NCT were enrolled, randomized 1:1 and divided into a training set and a validation set. We developed a nomogram based on independent predictors for ALN pCR identified by multivariate logistic regression as well as clinical significant predictors. The multivariate logistic regression analysis showed that hormone receptor (HR) status, human epidermal growth factor 2 (HER2) status and Ki67 index were independent predictors. The nomogram was thereby constructed by those independent predictors as well as tumor size and NCT regimens. The areas under the receiver operating characteristic curve of the training set and the validation set were 0.804 and 0.749, respectively. We constructed a nomogram for predicting ALN pCR in patients who received NCT. Our nomogram can improve risk stratification, accurately predict post-NCT ALN status and avoid unnecessary ALN dissection. PMID:27576704

  18. A Nomogram for Predicting the Pathological Response of Axillary Lymph Node Metastasis in Breast Cancer Patients

    PubMed Central

    Jin, Xi; Jiang, Yi-Zhou; Chen, Sheng; Shao, Zhi-Ming; Di, Gen-Hong

    2016-01-01

    The value of sentinel lymph node biopsy (SLNB) in post-neoadjuvant chemotherapy (NCT) patients is still controversial. We aimed to identify predictors and construct a nomogram for predicting the pathologically complete response (pCR) of axillary lymph nodes (ALNs) after NCT in node positive breast cancer patients. In total, 426 patients with pathologically proven ALN metastasis before NCT were enrolled, randomized 1:1 and divided into a training set and a validation set. We developed a nomogram based on independent predictors for ALN pCR identified by multivariate logistic regression as well as clinical significant predictors. The multivariate logistic regression analysis showed that hormone receptor (HR) status, human epidermal growth factor 2 (HER2) status and Ki67 index were independent predictors. The nomogram was thereby constructed by those independent predictors as well as tumor size and NCT regimens. The areas under the receiver operating characteristic curve of the training set and the validation set were 0.804 and 0.749, respectively. We constructed a nomogram for predicting ALN pCR in patients who received NCT. Our nomogram can improve risk stratification, accurately predict post-NCT ALN status and avoid unnecessary ALN dissection. PMID:27576704

  19. Message passing with queues and channels

    DOEpatents

    Dozsa, Gabor J; Heidelberger, Philip; Kumar, Sameer; Ratterman, Joseph D; Steinmacher-Burrow, Burkhard

    2013-02-19

    In an embodiment, a reception thread receives a source node identifier, a type, and a data pointer from an application and, in response, creates a receive request. If the source node identifier specifies a source node, the reception thread adds the receive request to a fast-post queue. If a message received from a network does not match a receive request on a posted queue, a polling thread adds a receive request that represents the message to an unexpected queue. If the fast-post queue contains the receive request, the polling thread removes the receive request from the fast-post queue. If the receive request that was removed from the fast-post queue does not match the receive request on the unexpected queue, the polling thread adds the receive request that was removed from the fast-post queue to the posted queue. The reception thread and the polling thread execute asynchronously from each other.

  20. Detecting and Preventing Sybil Attacks in Wireless Sensor Networks Usin