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Author Notes:

Corresponding Author: Hyunsuk Shim, PhD, Department of Radiology and Imaging Sciences, 1701 Uppergate Drive, C5018, Atlanta, GA 30322, Email: hshim@emory.edu

The authors thank Ms. Amber Feng for assistance in proofreading the manuscript.

Disclosure: Mohs AM, Mancini MC, and Nie S are inventors of instrumentation related to this manuscript.

Conflict of Interest: None reported.


Research Funding:

This work was supported by grants from the National Cancer Institute (R01CA165306 to H.S., R01CA163256 to S.N., and K99CA153916 to A.M.).


  • RGD
  • head and neck cancer
  • infiltrative
  • intraoperative guidance
  • lymph nodes
  • metastatic
  • near-infrared
  • tumor margins

Combination of an Integrin-Targeting NIR Tracer and an Ultrasensitive Spectroscopic Device for Intraoperative Detection of Head and Neck Tumor Margins and Metastatic Lymph Nodes.


Journal Title:

Tomography : a journal for imaging research


Volume 2, Number 3


, Pages 215-222

Type of Work:

Article | Final Publisher PDF


Despite major advances in targeted drug therapy and radiation therapy, surgery remains the most effective treatment for most solid tumors. The single most important predictor of patient survival is a complete surgical resection of the primary tumor, draining lymph nodes, and metastatic lesions. Presently, however, 20%-30% of patients with head and neck cancer who undergo surgery still leave the operating room without complete resection because of missed lesions. Thus, major opportunities exist to develop advanced imaging tracers and intraoperative instrumentation that would allow surgeons to visualize microscopic tumors during surgery. The cell adhesion molecule integrin αvβ3 is specifically expressed by tumor neovasculature and invading tumor cells, but not by quiescent vessels or normal cells. Here we report the combined use of an integrin-targeting near-infrared tracer (RGD-IRDye800CW) and a handheld spectroscopic device, an integrated point spectroscopy with wide-field imaging system, for highly sensitive detection of integrin overexpression on infiltrating cancer cells. By using an orthotopic head and neck cancer animal model, we show that this tracer-device combination allows intraoperative detection of not only invasive tumor margins but also metastatic lymph nodes. Correlated histological analysis further reveals that microscopic clusters of 50-100 tumor cells can be detected intraoperatively with high sensitivity and specificity, raising new possibilities in guiding surgical resection of microscopic tumors and metastatic lymph nodes.

Copyright information:

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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