Detection of Papillary Thyroid Cancer Nodal Metastasis after Intravenous Administration of a Fluorescent Tracer Targeting MET

Background: Prophylactic central compartment lymph node dissection (PCLND) or watchful waiting are two currently used strategies in papillary thyroid cancer (PTC) treatment. Choosing between these two strategies for an individual patient is difficult due to low specificity of preoperative imaging modalities for central compartment nodal metastases. PCLND reduces recurrence rates but exposes pN0 patients to undesirable morbidity. Reoperation for local recurrence after watchful waiting is challenging and causes even higher morbidity rates. Since MET is overexpressed in PTC compared to normal thyroid tissue, we tested the feasibility of intraoperative molecular fluorescence guided imaging (MFGI) of EMI-137 (targeting MET) to improve detection of PTC nodal metastasis. MFGI may improve patient selection for CLND, ultimately reducing recurrence rates and morbidity in PTC.