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Non-invasive molecular imaging for precision diagnosis of metastatic lymph nodes: opportunities from preclinical to clinical applications

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Abstract

Lymph node metastasis is an indicator of the invasiveness and aggressiveness of cancer. It is a vital prognostic factor in clinical staging of the disease and therapeutic decision-making. Patients with positive metastatic lymph nodes are likely to develop recurrent disease, distant metastasis, and succumb to death in the coming few years. Lymph node dissection and histological analysis are needed to detect whether regional lymph nodes have been infiltrated by cancer cells and determine the likely outcome of treatment and the patient’s chances of survival. However, these procedures are invasive, and tissue biopsies are prone to sampling error. In recent years, advanced molecular imaging with novel imaging probes has provided new technologies that are contributing to comprehensive management of cancer, including non-invasive investigation of lymphatic drainage from tumors, identifying metastatic lymph nodes, and guiding surgeons to operate efficiently in patients with complex lesions. In this review, first, we outline the current status of different molecular imaging modalities applied for lymph node metastasis management. Second, we summarize the multi-functional imaging probes applied with the different imaging modalities as well as applications of cancer lymph node metastasis from preclinical studies to clinical translations. Third, we describe the limitations that must be considered in the field of molecular imaging for improved detection of lymph node metastasis. Finally, we propose future directions for molecular imaging technology that will allow more personalized treatment plans for patients with lymph node metastasis.

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Funding

This work has received funding from Beijing Natural Science Foundation under grant No. 7212207 and National Natural Science Foundation of China under grant No. 62027901, 81871514, and 81227901.

Author information

Author notes

  1. Zhongquan Cheng and Jiaojiao Ma contributed equally to this manuscript.

Authors and Affiliations

  1. Department of General Surgery, Capital Medical University, Beijing Friendship Hospital, Beijing, 100050, China

    Zhongquan Cheng, Leyi Yu & Zhu Yuan

  2. CAS Key Laboratory of Molecular Imaging, Beijing Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China

    Zhongquan Cheng, Lin Yin, Jie Tian & Yang Du

  3. Department of Medical Ultrasonics, China-Japan Friendship Hospital, Yinghua East Road 2#, ChaoYang Dist., Beijing, 100029, China

    Jiaojiao Ma & Bo Zhang

  4. University of Chinese Academy of Sciences, Beijing, 100080, China

    Lin Yin & Yang Du

  5. Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, School of Medicine Science and Engineering, Beihang University, Beijing, 100191, China

    Jie Tian

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  2. Jiaojiao Ma
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  3. Lin Yin
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  4. Leyi Yu
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  5. Zhu Yuan
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  6. Bo Zhang
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  7. Jie Tian
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  8. Yang Du
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Contributions

YD and ZQC conceived the manuscript; ZQC, JJM, LY, and LYY wrote the manuscript; YD, JT, BZ, and ZY supervised and edited the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Zhu Yuan, Bo Zhang, Jie Tian or Yang Du.

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Cheng, Z., Ma, J., Yin, L. et al. Non-invasive molecular imaging for precision diagnosis of metastatic lymph nodes: opportunities from preclinical to clinical applications. Eur J Nucl Med Mol Imaging 50, 1111–1133 (2023). https://doi.org/10.1007/s00259-022-06056-5

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