Ultrasmall Core-Shell Fluorescent Silica Nanoparticles for I
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The findings of this JAMA study suggest that ultrabright, optical contrast–conferring particles for Sentinel lymph node (SLN) identification hold promise for overcoming current probe limitations and improving surgical outcomes.

The objective of this study was to evaluate whether an ultrasmall, molecularly targeted core-shell silica nanoparticle (Cornell prime dots) can safely and reliably identify optically avid SLNs in head and neck melanoma during a fluorescence-guided biopsy.

This nonrandomized clinical trial enrolled patients aged 18 years or older with histologically confirmed melanoma in whom SLN mapping was indicated. Exclusion criteria included known pregnancy, breast-feeding, or medical illness unrelated to the tumor.

24 consecutive patients were enrolled. In 24 surgical procedures, 40 SLNs were excised. Preoperative localization of SLNs with technetium Tc 99m sulfur colloid was followed by particle dose-escalation studies, yielding optimized doses and volumes of 2 nmol and 0.4 mL, respectively, and maximum SLN signal-to-background ratios of 40.

No adverse events were observed. The concordance rate of evaluable SLNs by technetium Tc 99m sulfur colloid and cRGDY-PEG-Cy5.5-nanoparticles was 90%, 5 of which were metastatic. Ultrabright nanoparticle fluorescence enabled high-sensitivity SLN visualization, deep tissue imaging, and, in some instances, detection through intact skin, thereby facilitating intraoperative identification without extensive dissection of adjacent normal tissue or nerves.

In conclusion, this study found that nanoparticle-based fluorescence-guided SLN biopsy in head and neck melanoma was feasible and safe. This technology holds promise for improving lymphatic mapping and SLN biopsy procedures, while potentially mitigating procedural risks.

Source: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2777633