Dual-Modality Imaging Study
Cervical lymph node staging if of great prognostic value for patients with head and neck cancer. Currently, to identify the presence of metastatic lymph nodes during the surgical resection of head and neck cancer, patients undergo a neck dissection or sentinel node biopsy procedure whereby some or all of the lymph nodes are taken out of the neck and sent for pathological evaluation.
We hope to show that the combined use (i.e. dual-modality) of 89Zr‑panitumumab and panitumumab‑IRDye800 can help surgeons to identify metastatic lymph nodes prior to and during the surgical procedure with equal or better accuracy than the current methods.
Panitumumab‑IRDye800 is an investigational imaging agent that contains a dye molecule that surgeons and researchers can image using light waves both during surgery and after the surgery on removed tissues. Recently we have shown that using this drug, we can identify metastatic lymph nodes from benign, normal lymph nodes based on the fluorescent signal that comes from the panitumumab‑IRDye800. However, because of the limited penetration depth of the fluorescence signal, it is challenging to detect these lymph node(s) in the body.
89Zr‑panitumumab is an investigational imaging agent that contains a small amount of radiation, which makes it visible in positron emission tomography (PET) scans. We hypothesize that by using 89Zr‑panitumumab we can identify metastatic lymph nodes on preoperatively acquired (non-invasive) PET scans. If so, this information we can then use to guide us during the surgery. Because for the dual-modality study we will intravenously infuse both panitumumab-IRDye800 and 89Zr‑panitumumab, we can use the fluorescent signal coming from panitumumab-IRDye800 to precisely localize the metastatic lymph node(s).