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Noninvasive Detection of Clinically Occult Lymph-Node Metastases in Prostate Cancer
Open accessAbstract
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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“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].”
From Iron oxide nanoparticles: Diagnostic, therapeutic and theranostic applications (2019) · cites this paper as [161]
In the citing paper
“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].”
From Iron oxide nanoparticles: Diagnostic, therapeutic and theranostic applications (2019) · cites this paper as [160]
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“By using USPIO and contrast-enhanced MRI, micro-metastatic lymph nodes can be distinguished much more efficiently from healthy and inflammatory nodes [161].”
From Iron oxide nanoparticles: Diagnostic, therapeutic and theranostic applications (2019) · cites this paper as [161]
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Metadata
- 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
- Publisher
- Massachusetts Medical Society
- 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
- bronze
- doi.org
- 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 › Urology › 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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