Prof. Dr. Van Leeuwen and Prof. Dr. Steenbergen have a minor interest in PA Imaging BV, which however did not finance the research in any way.
Article first published online: 6 AUG 2012
Copyright © 2012 Wiley Periodicals, Inc.
Lasers in Surgery and Medicine
Volume 44, Issue 7, pages 541–549, September 2012
How to Cite
Grootendorst, D.J., Jose, J., Wouters, M.W., van Boven, H., Van der Hage, J., Van Leeuwen, T.G., Steenbergen, W., Manohar, S. and Ruers, T.J.M. (2012), First experiences of photoacoustic imaging for detection of melanoma metastases in resected human lymph nodes. Lasers Surg. Med., 44: 541–549. doi: 10.1002/lsm.22058
Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.
- Issue published online: 21 AUG 2012
- Article first published online: 6 AUG 2012
- Manuscript Accepted: 11 JUL 2012
- PRESMITT Project of the AgentschapNL Program IOP Photonic Devices. Grant Number: IPD067771
- Mira Institute for Biomedical Technology and Technical Medicine
- lymph node;
- nodal metastases
Background and Objective
Excision and histological assessment of the first draining node (sentinel lymph node) is a frequently used method to assess metastatic lymph node involvement related to cutaneous melanoma. Due to the time required for accurate histological assessment, nodal status is not immediately available to the surgeon. Hence, in case histological examination shows metastases, the patient has to be recalled to perform additional lymphadenectomy. To overcome these drawbacks we studied the applicability of photoacoustic tomographic imaging as an intra-operative modality for examining the status of resected lymph nodes.
Materials and Methods
In melanoma patients undergoing lymphadectomy for metastatic disease, six suspect lymph nodes were photoacoustically (PA) imaged using multiple wavelengths. Histopathologal examination showed three nodes without tumor cells (benign nodes) and three nodes with melanoma cells (malignant nodes). PA images were compared with histology and anatomical features were analyzed. In addition, PA spectral analysis was performed on areas of increased signal intensity.
After correlation with histopathology, multiple areas containing melanoma cells could be identified in the PA images due to their increased response. Malignant nodes showed a higher PA response and responded differently to an increase in excitation wavelength than benign nodes. In addition, differences in anatomical features between the two groups were detected.
Photoacoustic detection of melanoma metastases based on their melanin content proves to be possible in resected human lymph nodes. The amount of PA signal and several specific anatomical features seem to provide additional characteristics for nodal analysis. However, it is as yet preliminary to designate a highly accurate parameter to distinguish between malignant and benign nodes. We expect to improve the specificity of the technique with a future implementation of an adjusted illumination scheme and depth correction for photon fluence. Lasers Surg. Med. 44: 541–549, 2012. © Wiley Periodicals, Inc.