Cited by 1,971Prostate Cancer Diagnosis and TreatmentMRI in cancer diagnosisMedical Imaging Techniques and Applications

Noninvasive detection of clinically occult lymph-node metastases in prostate cancer

Open access
Harisinghani, Mukesh G., Barentsz, Jelle, Hahn, Peter F., Deserno, Willem M., Tabatabaei, Shahin, van de Kaa, Christine Hulsbergen, de la Rosette, Jean, Weissleder, Ralph·2003·New England Journal of Medicine

Abstract

BACKGROUND: Accurate detection of lymph-node metastases in prostate cancer is an essential component of the approach to treatment. We investigated whether highly lymphotropic superparamagnetic nanoparticles, which gain access to lymph nodes by means of interstitial-lymphatic fluid transport, could be used in conjunction with high-resolution magnetic resonance imaging (MRI) to reveal small nodal metastases. METHODS: Eighty patients with presurgical clinical stage T1, T2, or T3 prostate cancer who underwent surgical lymph-node resection or biopsy were enrolled. All patients were examined by MRI before and 24 hours after the intravenous administration of lymphotropic superparamagnetic nanoparticles (2.6 mg of iron per kilogram of body weight). The imaging results were correlated with histopathological findings. RESULTS: Of the 334 lymph nodes that underwent resection or biopsy, 63 (18.9 percent) from 33 patients (41 percent) had histopathologically detected metastases. Of these 63 nodes, 45 (71.4 percent) did not fulfill the usual imaging criteria for malignancy. MRI with lymphotropic superparamagnetic nanoparticles correctly identified all patients with nodal metastases, and a node-by-node analysis had a significantly higher sensitivity than conventional MRI (90.5 percent vs. 35.4 percent, P<0.001) or nomograms. CONCLUSIONS: High-resolution MRI with magnetic nanoparticles allows the detection of small and otherwise undetectable lymph-node metastases in patients with prostate cancer.

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Crossref · 10.1056/nejmoa022749

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  • Ferumoxtran-enhanced MRI achieves significantly higher sensitivity for lymph node characterization in patients with prostate cancer than non-contrast-enhanced MRI.

    “Significantly higher sensitivity for lymph node characterization in patients with prostate cancer, in which metastases detection with positron emission tomography (PET) is problematic, could be achieved by using ferumoxtran compared to non-contrast-enhanced MR imaging [160, 161].”
  • Ferumoxtran-enhanced MRI achieves significantly higher sensitivity for lymph node characterization in patients with prostate cancer than non-contrast-enhanced MRI.

    “Significantly higher sensitivity for lymph node characterization in patients with prostate cancer, in which metastases detection with positron emission tomography (PET) is problematic, could be achieved by using ferumoxtran compared to non-contrast-enhanced MR imaging [160, 161].”
  • USPIO and contrast-enhanced MRI can distinguish micro-metastatic lymph nodes from healthy and inflammatory nodes more efficiently than standard size-based staging.

    “By using USPIO and contrast-enhanced MRI, micro-metastatic lymph nodes can be distinguished much more efficiently from healthy and inflammatory nodes [161].”

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Authors
Harisinghani, M. G., Barentsz, J., Hahn, P. F., Deserno, W. M., Tabatabaei, S., van de Kaa, C. H., de la Rosette, J., & Weissleder, R.
Affiliations
Harvard University (US)
Venue
New England Journal of Medicine
Published
2003-06-19
Volume
348
Issue
25
Pages
2491-2499
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
OpenAlex
W2116810900
Cited by
1,971
References
42
Citations by year
2026: 13 · 2025: 15 · 2024: 34 · 2023: 42 · 2022: 54 · 2021: 49 · 2020: 59 · 2019: 50 · 2018: 66 · 2017: 82 · 2016: 83 · 2015: 94 · 2014: 95 · 2013: 120 · 2012: 129
FWCI
81.09
Type
journal article
Language
en
Open access
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Radboud Repository (Radboud University) (submittedVersion)
Funders
  • National Institutes of Health (5r01ca059649-07)
  • National Cancer Institute (R01-CA59649)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Prostate Cancer Diagnosis and Treatment
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › MRI in cancer diagnosis
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
Keywords
prostate cancer, lymph node metastasis, superparamagnetic iron oxide nanoparticles, magnetic resonance imaging, non-invasive detection, lymphatic drainage, diagnostic sensitivity
MeSH terms
Aged, Biopsy, Contrast Media, Ferric Compounds, Humans, Image Processing, Computer-Assisted, Lymph Nodes, Lymphatic Metastasis, Magnetic Resonance Imaging, Magnetics, Male, Middle Aged, Neoplasm Staging, Particle Size, Prospective Studies, Prostatic Neoplasms, Sensitivity and Specificity, Nanotechnology

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