Magnetic Particle Imaging Lymphography (MPIL): A novel technique for lymph node mapping

Abstract

During metastasis, tumour cells drain to nearby lymph nodes, the first of which are named the sentinel lymph node(s) (SLN). SLN biopsy (SLNB) determines if metastasis has occurred. Traditionally, SLNB involves injecting a Technetium-labeled tracer peritumourally, pre-operative imaging with SPECT to locate the SLN, and surgery guided by a gamma probe to remove them. Limitations include short tracer half-life which can make scheduling the SLNB difficult, and radiation dose to patients and healthcare workers. Alternatively, magnetic localization, with superparamagnetic iron oxide nanoparticles (SPIONs) as the tracer and a magnetometer to detect SPIONs in the SLN during surgery can be used, however, this lacks pre-operative imaging. Magnetic Particle Imaging (MPI) is a new imaging modality that directly detects SPIONs, holding potential for pre-operative imaging in magnetic SLNB. SPIONs for SLNB should have rapid drainage, high SLN accumulation, and high specificity to the SLN. For MPI Lymphography (MPIL), high particle sensitivity is also important. This study assesses the in vivo pharmacokinetics for SLN mapping with MPIL in a murine model, using five commercially available SPIONs of varying iron core sizes and surface coatings. We show that some SPIONs provide higher MPI signal at the SLN and show the potential to detect higher echelon nodes (HENs). PEGylation of SPIONs and mannose targeted SPIONs increase clearance from the injection site and the mannose targeted SPION reduces flow to HENs.