{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:11:26Z","timestamp":1787317886401,"version":"build-2736575974"},"reference-count":10,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T00:00:00Z","timestamp":1746748800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>Invasive lymph node (LN) staging is crucial for survival in penile cancer (PeCa) patients. To lower patient morbidity associated with radical inguinal lymphadenectomy, sentinel node biopsy (SNB) is recommended. Application of conventional radioactive\/fluorescent tracers for sentinel node (SN) labelling is limited to centers with nuclear medicine or lacks pre-operative imaging. We introduce a radiation-free fluorescent magnetic hybrid tracer for bimodal inguinal SN imaging in PeCa patients. In three consecutive PeCa patients, the fluorescent magnetic hybrid tracer (50 \u00b5l indocyanine green, 5 mg\/ml, in 1 ml superparamagnetic iron oxide nanoparticles) was peritumorally injected. SNs were visualized by magnetic resonance imaging (MRI). Intra-operatively, SNs were detected using a handheld magnetometer and a fluorescence camera. Concordance was determined between MRI and magnetometer-guided SNB and between magnetic and fluorescent SN labelling. MRI revealed 29 SNs (median 4.5, range 0\u20138 SNs\/groin). Twenty-five LNs (median 4.5, range 0\u20139 LNs\/groin) were resected, including 16 magnetically active and 17 fluorescent SNs (median 3, range 0\u20136 SNs\/groin, either mode). MRI and magnetometer-guided SNB had 66% concordance, magnetic and fluorescence SN labelling 96%. The diagnostic accuracy of our approach has to be evaluated in larger patient cohorts. Our radiation-free SNB technique is feasible without the need for nuclear medicine, its associated additional effort and regulations.<\/jats:p>","DOI":"10.3389\/fonc.2025.1523038","type":"journal-article","created":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T00:11:05Z","timestamp":1746749465000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Bimodal inguinal sentinel lymph node imaging using a radiation-free fluorescent magnetic hybrid tracer in penile cancer patients"],"prefix":"10.3389","volume":"15","author":[{"given":"Bianca","family":"Michalik","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Svenja","family":"Engels","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian C.","family":"Otterbach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin H.","family":"Maurer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Friedhelm","family":"Wawroschek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Winter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,9]]},"reference":[{"key":"B1","volume-title":"EAU-ASCO guidelines on penile cancer","author":"Brouwer","year":"2024"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2009.02.021","article-title":"Lymphadenectomy in the surgical management of penile cancer","volume":"55","author":"Protzel","year":"2009","journal-title":"Eur Urol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2020.09.007","article-title":"Hybrid indocyanine green-99mTc-nanocolloid for single-photon emission computed tomography and combined radio- and fluorescence-guided sentinel node biopsy in penile cancer: Results of 740 inguinal basins assessed at a single institution","volume":"78","author":"Dell\u2019Oglio","year":"2020","journal-title":"Eur Urol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.euo.2022.09.004","article-title":"Sentinel node identification with hybrid tracer-guided and conventional dynamic sentinel node biopsy in penile cancer: A prospective study in 130 patients from the two national referral centres in Sweden","volume":"5","author":"Torbrand","year":"2022","journal-title":"Eur Urol Oncol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2019.09.007","article-title":"Testing the feasibility of SentiMag\/Sienna+ for detecting inguinal sentinel nodes in penile cancer (SentiPen): An eUROGEN and national cancer research institute trial","volume":"76","author":"Cleaveland","year":"2019","journal-title":"Eur Urol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1159\/000502017","article-title":"Magnetic resonance sentinel lymph node imaging and magnetometer-guided intraoperative detection in penile cancer, using superparamagnetic iron oxide nanoparticles: first results","volume":"104","author":"Winter","year":"2020","journal-title":"Urol Int"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1007\/s11548-021-02458-2","article-title":"Advancing intraoperative magnetic tracing using 3D freehand magnetic particle imaging","volume":"17","author":"Azargoshasb","year":"2022","journal-title":"Int J CARS"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-023-06522-8","article-title":"A new bimodal approach for sentinel lymph node imaging in prostate cancer using a magnetic and fluorescent hybrid tracer","volume":"51","author":"Michalik","year":"2024","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1162\/15353500200505127","article-title":"Organic alternatives to quantum dots for intraoperative near-infrared fluorescent sentinel lymph node mapping","volume":"4","author":"Ohnishi","year":"2005","journal-title":"Mol Imaging"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-023-06191-7","article-title":"A hybrid radioactive and fluorescence approach is more than the sum of its parts; outcome of a phase II randomized sentinel node trial in prostate cancer patients","volume":"50","author":"Wit","year":"2023","journal-title":"Eur J Nucl Med Mol Imaging"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1523038\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T00:11:06Z","timestamp":1746749466000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1523038\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,9]]},"references-count":10,"alternative-id":["10.3389\/fonc.2025.1523038"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2025.1523038","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,9]]},"article-number":"1523038"}}