New approaches to lymphatic imaging.
lymphedemapeople
Lymphat Res Biol. 2009 Dec
Lucarelli RT, Ogawa M, Kosaka N, Turkbey B, Kobayashi H, Choyke PL.
Molecular Imaging Program, National Cancer Institute, Bethesda,
Maryland.
Address correspondence to:
Peter L. Choyke, M.D.
Molecular Imaging Program
National Cancer Institute
Building 10, Room B3B69F
Bethesda, MD 20892
Molecular Imaging Program, National Cancer Institute, Bethesda,
Maryland 20892, USA.
Accurate imaging of the lymphatic system can aid in cancer staging,
optimize surgical procedures to reduce lymphedema, and may one day be
a means of delivering intralymphatic therapy. The Sentinel Lymph Node
(SLN) concept has been pivotal in driving new imaging techniques.
Metastasis to a SLN is a critical indicator of advanced disease.
However, presently, few tools are available for imaging the
lymphatics, and even fewer are available for locating the SLN for
biopsy. Recently, new macromolecular agents, including gadolinium-
labeled dendrimers, fluorescent quantum dots, and fluorescently-
labeled immunoglobins, have been used to image the lymphatics and SLN
with MRI and optical techniques, and new fluorescent nanoparticles
such as upconverting nanocrystals are potential future agents.
Additionally, multi-modality probes combining two modalities such as
optical/MR dendrimers have been designed to provide both preoperative
imaging, and intraoperative guidance during lymph node resections.
These probes can map the lymphatic system for maximal therapeutic
benefit while minimizing complications such as lymphedema. Advances in
the understanding of the molecular mechanisms of lymphangiogenesis and
lymphatic spread of tumors offer the opportunity for more targeted
imaging of the lymphatic system. Additionally, these imaging agents
could be used as powerful research tools for tracking immunological
cells and monitoring the immune response as well as providing the
means to deliver lymphatic-targeted therapies. The future holds great
promise for the translation of these methods to the clinic.