Brim, S. (Sherin) (2025) "Lighting the Path: Intraoperative Fluorescence Imaging in sentinel lymph node detection" "Evaluating the diagnostic performance and feasibility of bevacizumab-IRDye800CW in sentinel lymph node detection in Breast Cancer". thesis, Medicine.
Full text available on request.Abstract
Objective: Intraoperative assessment of sentinel lymph nodes (SLNs) remains a challenge in breast-conserving surgery (BCS) for early-stage breast cancer. Standard histopathology analysis is time-consuming and may delay treatment decisions. Fluorescence imaging (FI) with bevacizumab-IRDye800CW, targeting vascular endothelial growth factor α (VEGFα), may enable real-time visualization of tumor-positive lymph nodes (LNs), offering a potential tool for intraoperative decision-making. This is the first study to evaluate the diagnostic accuracy and clinical applicability of intraoperative FI using bevacizumab-IRDye800CW for detecting tumor-positive SLNs in early-stage breast cancer patients. Methods: This retrospective analysis included 53 patients from the MARGIN-2 fluorescence imaging study, all of whom underwent BCS and sentinel node biopsy (SNB) between March 1, 2024, and January 31, 2025. All patients received an intravenous dose of 10 mg bevacizumab-IRDye800CW prior to surgery. Fluorescence images were captured fresh during surgery, after formalin fixation and from formalin-fixed, paraffin-embedded (FFPE) LNs. Both white light and near-infrared fluorescence images were acquired and analyzed to quantify fluorescence intensity across several parameters and then correlated with histopathology findings. Results: Both median and mean fluorescence intensity were significantly higher in fresh tumor-positive LNs (median: 0.004 vs. 0.003, p=0.014; mean: 0.00493 vs. 0.00404, p=0.031), with a moderate diagnostic accuracy (area under the curve ≈ 0.65). Subgroup analysis showed no differences by metastasis or node type. No statistically significant differences were found in the fixed and FFPE LNs. Conclusion: This study, FI with bevacizumab-IRDye800CW demonstrated significantly higher signal in fresh tumor-positive LNs, supporting its potential as a feasible adjunct tool for intraoperative lymph node assessment in breast cancer surgery. Keywords: bevacizumab-IRDye800CW, breast cancer, sentinel lymph node, fluorescence imaging, fluorescence-guided surgery, tumor, vascular endothelial growth factor α.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Kelder, W. |
| Faculty: | Medical Sciences |
| Date Deposited: | 01 May 2026 13:01 |
| Last Modified: | 01 May 2026 13:01 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3938 |
Actions (login required)
 |
View Item |