Minimal Disease in the Sentinel Lymph Node: How to Best Measure Sentinel Node Micrometastases to Predict Risk of Additional Non-Sentinel Lymph Node Disease

Summary Aim of this study was to localize the sentinel lymph node by lymphoscintigraphy using technetium-99m colloidal rhenium sulphide (Nanocis®), a new commercially available radiopharmaceutical. Due to the manufacturers’ instructions it is licensed for lymphoscintigraphy. Patients, methods: 35 consecutive patients with histologically proved malignant melanoma, but without clinical evidence of metastases, were preoperatively examined by injecting 20-40 MBq Nanocis® with (mean particle size: 100 nm; range: 50-200 nm) intradermally around the lesion. Additionally blue dye was injected intaoperatively. A hand-held gamma probe guided sentinel node biopsy. Results: During surgery, the preoperatively scintigraphically detected sentinel lymph nodes were identified in 34/35 (97%) patients. The number of sentinel nodes per patient ranged from one to four (mean: n = 1.8). Histologically, metastatic involvement of the sentinel lymph node was found in 12/35 (34%) patients; the sentinel lymph node positive-rate (14/63 SLN) was 22%. Thus, it is comparable to the findings of SLN-mapping using other technetium-99m-labeled nanocolloides. Conclusion: 99mTc-bound colloidal rhenium sulphide is also suitable for sentinel node mapping.

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Micrometastasis of the Sentinel Lymph Node: Which factors can predict non-sentinel node involvement?

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2010.08.064 ◽

2010 ◽

Vol 36 (11) ◽

pp. 1122-1123

Author(s):

Jamie Crichton ◽

A. Zeiton

Keyword(s):

Lymph Node ◽

Sentinel Lymph Node ◽

Sentinel Node ◽

Node Involvement

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Failure of Radiotracer Migration: Salvaging Sentinel Lymph Node Biopsy in Melanoma Care With Indocyanine Green

Plastic Surgery Case Studies ◽

10.1177/2513826x211022209 ◽

2021 ◽

Vol 7 ◽

pp. 2513826X2110222

Author(s):

Christine Nicholas ◽

Carmen Webb ◽

Claire Temple-Oberle

Keyword(s):

Lymph Node ◽

Sentinel Lymph Node ◽

Indocyanine Green ◽

Sentinel Node ◽

Head And Neck ◽

Near Infrared ◽

False Negative ◽

Lymph Node Biopsy ◽

Blue Dye ◽

Traditional Methods

Reducing false negative rates for sentinel lymph node biopsies (SLNB) in melanoma is important to accurately prognosticate and to guide treatment. Traditionally, SLNB has been performed with the adjunct of radiotracers and blue dye. Although sentinel node mapping is highly successful in axillary and inguinal node basins, identification of nodes in the head and neck is not as accurate with traditional methods. One reason for this may be failure of radiotracer migration. To augment standard technique using a radiocolloid, indocyanine green (ICG) combined with near infrared spectroscopy (NIRS), has shown promising results. We demonstrate a case of an individual undergoing SLNB in the head and neck region with failure of radiotracer migration. Identification of a sentinel node was accomplished with the use of ICG and NIRS. This technology offers an opportunity to salvage the SLNB when traditional methods fail.

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