Background Tissue with Native Target Expression Can Determine Presence of Nodal Metastasis in Head and Neck Squamous Cell Carcinoma Patients Infused with Targeted Fluorescent Tracers
- Open Access
- 18-03-2025
- Metastasis
- Research Article
Published in:
- Authors
- Nicole Meeks
- Sherin James
- Giri Krishnan
- Akhilesh Wodeyar
- Hidenori Tanaka
- Benjamin B. Kasten
- Yu-Jin Lee
- Marisa E. Hom
- Eben L. Rosenthal
- Jason M. Warram
- Published in
- Molecular Imaging and Biology | Issue 3/2025
Abstract
Purpose
Survival and treatment intensity in patients with head and neck squamous cell carcinoma (HNSCC) is determined by the presence of lymph node (LN) metastasis, and as a result surgical removal of potentially affected LN remains a mainstay practice. Fluorescence guided surgery (FGS) using targeted optical agents is an expanding field that shows great potential for aiding diagnosis of metastatic LN. Given variations in fluorescence background, a reference standard for regions of interest is necessary for cross patient comparison. The present study aims to determine whether tissue with native target expression can be used as a background to determine metastatic LN in patients with HNSCC infused with anti-epidermal growth factor receptor (EGFR) targeted imaging agents.
Procedures
Twenty-two patients infused with panitumumab-IRDye800 or cetuximab-IRDye800 prior to surgery were included. Fluorescence imaging and analysis was performed on resected LNs (N = 843) using the submandibular glands (SMG) and skin as reference standard tissue with known EGFR antigen expression.
Results
Sixteen patients (72.7%) had at least one positive LN on final pathology. The LN to SMG (LN/SMG) and LN to skin (LN/skin) ratios were significantly higher in metastatic LN compared to benign LN (p < 0.0001 for both). Using patient-specific ratios to determine an optimal LN/skin cutoff was the most sensitive (95.2%) and directly comparing the LN/skin ratio of all patients to determine a cutoff was the most specific (86.3%).
Conclusions
In HNSCC patients infused with a molecularly targeted fluorescent tracer, endogenous expression of the target antigen can be used as a reference standard to detect LN metastasis. Additionally, the performance of the background in determining metastatic LN can be improved by utilizing patient-specific reference standards.
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- Title
- Background Tissue with Native Target Expression Can Determine Presence of Nodal Metastasis in Head and Neck Squamous Cell Carcinoma Patients Infused with Targeted Fluorescent Tracers
- Authors
-
Nicole Meeks
Sherin James
Giri Krishnan
Akhilesh Wodeyar
Hidenori Tanaka
Benjamin B. Kasten
Yu-Jin Lee
Marisa E. Hom
Eben L. Rosenthal
Jason M. Warram
- Publication date
- 18-03-2025
- Publisher
- Springer International Publishing
- Keywords
-
Metastasis
Panitumumab - Published in
-
Molecular Imaging and Biology / Issue 3/2025
Print ISSN: 1536-1632
Electronic ISSN: 1860-2002 - DOI
- https://doi.org/10.1007/s11307-025-01996-4
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