scholarly journals Optimizing Dose and Timing in Magnetic Tracer Techniques for Sentinel Lymph Node Detection in Early Breast Cancers: The Prospective Multicenter SentiDose Trial

Cancers ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 693
Author(s):  
Abdi-Fatah Hersi ◽  
Lida Pistiolis ◽  
Carlos Dussan Luberth ◽  
Eva Vikhe-Patil ◽  
Fredrik Nilsson ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Gamma Probe ◽  
Comparable Efficacy ◽  
Blue Dye ◽  
Breast Cancers ◽  
Detection Rates ◽  
Individual Patient Level ◽  
Patient Level ◽  
Tracer Techniques

Superparamagnetic iron oxide nanoparticles (SPIO) are non-inferior to radioisotope and blue dye (RI + BD) for sentinel lymph node (SLN) detection. Previously, 2 mL SPIO (Sienna+®) in 3 mL NaCl was used. In this dose-optimizing study, lower doses of a new refined SPIO solution (Magtrace®) (1.5 vs. 1.0 mL) were tested in different timeframes (0–24 h perioperative vs. 1–7 days preoperative) and injections sites (subareolar vs. peritumoral). Two consecutive breast cancer cohorts (n = 328) scheduled for SLN-biopsy were included from 2017 to 2019. All patients received isotope ± blue dye as back-up. SLNs were identified primarily with the SentiMag® probe and thereafter a gamma-probe. The primary endpoint was SLN detection rate with SPIO. Analyses were performed as a one-step individual patient-level meta-analysis using patient-level data from the previously published Nordic Trial (n = 206) as a third, reference cohort. In 534 patients, the SPIO SLN detection rates were similar (97.5% vs. 100% vs. 97.6%, p = 0.11) and non-inferior to the dual technique. Significantly more SLNs were retrieved in the preoperative 1.0 mL cohort compared with 1.5 and the 2.0 mL cohorts (2.18 vs. 1.85 vs. 1.83, p = 0.003). Lower SPIO volumes injected up to 7 days before the operation have comparable efficacy to standard SPIO dose and RI + BD for SLN detection.

First experiences with a new radiopharmaceutical for sentinel lymph node detection in malignant melanoma

2004 ◽  
Vol 43 (01) ◽  
pp. 10-15 ◽  
Author(s):  
R. A. Schmid ◽  
C. Kunte ◽  
B. Konz ◽  
K. Hahn ◽  
M. Weiss
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Malignant Melanoma ◽  
Sentinel Node ◽  
Gamma Probe ◽  
Blue Dye ◽  
Sentinel Nodes ◽  
Technetium 99M ◽  
Positive Rate ◽  
Metastatic Involvement

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.

Mapping Sentinel Lymph Node in Breast Cancer by Combined Lymphoscintigraphy, Blue-Dye, and Intraoperative Gamma-Probe

2000 ◽  
Vol 15 (3) ◽  
pp. 245-252 ◽  
Author(s):  
Giuliano Mariani ◽  
Giuseppe Villa ◽  
Marco Gipponi ◽  
Pietro Bianchi ◽  
Ferdinando Buffoni ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Gamma Probe ◽  
Blue Dye ◽  
Intraoperative Gamma Probe

Triple tracer (blue dye, indocyanine green, and Tc99) compared to double tracer (indocyanine green and Tc99) for sentinel lymph node detection in endometrial cancer: a prospective study with random assignment

2019 ◽  
Vol 29 (7) ◽  
pp. 1121-1125 ◽  
Author(s):  
Roy Kessous ◽  
Jeffrey How ◽  
Jeremie Abitbol ◽  
Sanam Puzhakkal ◽  
Liron Kogan ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Indocyanine Green ◽  
Prospective Study ◽  
Early Stage ◽  
Blue Dye ◽  
Detection Rates ◽  
A Prospective Study ◽  
Early Stage Endometrial Cancer

ObjectiveSentinel lymph node (SLN) mapping is increasingly being used in the treatment of apparent early-stage endometrial cancer. The aim of this study was to evaluate whether three tracers (blue dye, indocyanine green (ICG), and technetium-99 (Tc99)) performed better than two (ICG and Tc99).Study DesignProspective study of all consecutive patients (n=163) diagnosed with clinical early-stage endometrial cancer from 2015 to 2017. All patients were randomly assigned to receive a mixture of ICG and Tc99 with or without blue dye. Subgroup analysis for detection rates was performed for each group (double versus triple tracer).ResultsOne hundred and fifty-seven patients met the inclusion criteria. Eighty patients received ICG and Tc99 with unilateral and bilateral SLN detection rates of 97.5% and 81.3%, respectively. Seventy-seven patients received all three tracers with unilateral and bilateral detection rates of 93.5% and 80.5%, respectively. Only one patient in the triple tracer group was detected by blue dye alone. No significant differences were noticed in unilateral or bilateral detection rates between the two groups, nor in the detection of lymph node metastasis.ConclusionThe addition of blue dye to ICG and Tc99 did not demonstrate any improvement in SLN detection.

Dye- and gamma probe-guided sentinel lymph node biopsy in breast cancer patients: using patent blue dye and technetium-99m-labeled human serum albumin

Breast Cancer ◽  
2000 ◽  
Vol 7 (1) ◽  
pp. 87-94 ◽  
Author(s):  
Koichiro Tsugawa ◽  
Masakuni Noguchi ◽  
Koichi Miwa ◽  
Etsuro Bando ◽  
Kunihiko Yokoyama ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Gamma Probe ◽  
Lymph Node Biopsy ◽  
Blue Dye ◽  
Breast Cancer Patients ◽  
Patent Blue ◽  
Node Biopsy ◽  
Patent Blue Dye

Prospective Multicentric Randomized Study Comparing Periareolar and Peritumoral Injection of Radiotracer and Blue Dye for the Detection of Sentinel Lymph Node in Breast Sparing Procedures: FRANSENODE Trial

2007 ◽  
Vol 25 (24) ◽  
pp. 3664-3669 ◽  
Author(s):  
Jean-François Rodier ◽  
Michel Velten ◽  
Marc Wilt ◽  
Pierre Martel ◽  
Gwanaël Ferron ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Detection Rate ◽  
Ex Vivo ◽  
Gamma Probe ◽  
Randomized Study ◽  
Injection Technique ◽  
Blue Dye ◽  
High Detection Rate ◽  
Multicentric Study

Purpose To determine the optimal injection path for blue dye and radiocolloid for sentinel lymph node (SLN) biopsy in early breast cancer. Patients and Methods A prospective randomized multicentric study was initiated to compare the peritumoral (PT) injection site to the periareolar (PA) site in 449 patients. Results The detection rate of axillary SLN by lymphoscintigraphy was significantly higher (P = .03) in the PA group (85.2%) than in the PT group (73.2%). Intraoperative detection rate by blue dye and/or gamma probe was similar (99.11%) in both groups. The rate of SLN detection was somewhat higher in the PA group than in the PT group: 95.6% versus 93.8% with blue dye (P = .24) and 98.2% versus 96.0% by probe (P = .16), respectively. The number of SLNs detected by lymphoscintigraphy and by probe was significantly higher in the PA group than in the PT group, 1.5 versus 1.2 (P = .001) and 1.9 versus 1.7 (P = .02). The blue and hot concordance was 95.6% in the PA group and 91.5% in the PT group (P = .08). The mean ex vivo count of the SLN was significantly higher in the PA group than in the PT group (P < .0001). Conclusion This study strongly validates the PA injection technique given the high detection rate (99.1%) of SLN and the high concordance (95.6%) between blue dye and the radiotracer, as well as higher significant ex and in vivo counts, improving SLN probe detection.

scholarly journals Sentinel lymph node identification in early stage ovarian cancer: is it still possible after prior tumor resection?

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Pim Laven ◽  
Roy Kruitwagen ◽  
Petra Zusterzeel ◽  
Brigitte Slangen ◽  
Toon van Gorp ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Node ◽  
Early Stage ◽  
Frozen Section ◽  
Gamma Probe ◽  
Tumor Resection ◽  
Blue Dye ◽  
Sentinel Nodes

Abstract Objective Sentinel lymph node (SLN) detection in ovarian cancer is feasible when tracers are injected before the pathological ovary is resected. This study aims to investigate whether the SLN identification is also feasible in patients whose ovarian tumor has already been resected with injection of the tracer into the ovarian ligaments stumps, i.e. in the event that a frozen section confirms malignancy. Methods Patients who underwent laparotomy with frozen section confirming an ovarian malignancy, and those who underwent a second staging laparotomy after prior resection of a malignant ovarian mass, were included. Blue dye and a radioactive isotope were injected in the stumps of the ligamentum ovarium proprium and the ligamentum infundibulo-pelvicum. After an interval of at least 15-min, the sentinel node(s) were identified using either the gamma-probe and / or blue dye. Results A total of 11 patients were included in the study, the sentinel node (SLN) procedure was completed in all 11 patients. At least one SLN was identified in 3 patients, resulting in a rather low detection rate of 27,3%. Conclusion In this study we showed that SLN procedure after (previous) resection of the tumor seems inferior to detect sentinel nodes when compared to injection of the tracer in the ovarian ligaments before tumor resection. Trial registration NCT02540551

Intraoperative Radiochromoguided Mapping of Sentinel Lymph Node in Colon Cancer

2002 ◽  
Vol 88 (4) ◽  
pp. 352-353 ◽  
Author(s):  
P Nastro ◽  
M Sodo ◽  
CA Dodaro ◽  
S Gargiulo ◽  
W Acampa ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Regional Lymph Node ◽  
Gamma Probe ◽  
False Negative ◽  
Lymph Node Status ◽  
Blue Dye ◽  
Immunohistochemical Examination ◽  
Hematoxylin Eosin

Aims and Background The aim of our study was to assess the feasiblility of sentinel lymph node (SLN) detection in colon cancer using a radiochromoguided technique. The regional lymph node status is crucial for colorectal cancer staging and the stage of disease at the time of diagnosis is the main factor influencing therapeutic decision-making and patient survival. Methods and Study Design Between April and June 2001 eight patients with colon cancer were studied by radiochromoguided sentinel lymph node mapping. At the time of surgery 2 ml of patent blue dye was injected around the tumor, followed after 10 minutes by 2 ml of 99mTc-labeled albumin. After 30 minutes the SLN was identified by a gamma probe. Surgery was completed by standard resection. The SLN was processed for permanent hematoxylin and eosin staining and for immunohistochemical examination with anti-CEA and anti-cytokeratin antibodies. Results SLNs were identified in six patients; two were negative for metastasis by hematoxylin-eosin and immunohistochemical examination, two were positive for metastasis by both methods, and two were negative for metastasis by hematoxylin-eosin but positive by immunohistochemical examination. There were no false negative SLNs and no complications occurred. Conclusion The actual utility of SLN detection for prognostic purposes is still unknown, but intraoperative radiochromoguided SLN mapping is technically feasible in colon cancer, although it is associated with more technical difficulties than in breast cancer and malignant melanoma.

scholarly journals Characterizing an ideal experimental canine model for penile sentinel lymph node identification

2018 ◽  
Vol 58 (2) ◽  
pp. 25
Author(s):  
Bruno Tigre de Arruda Leitão ◽  
Willy Okoba ◽  
Diego Aragão Bezerra ◽  
Jose Wilson Benevides de Mesquita Neto ◽  
Diego Alves Cruz ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Ex Vivo ◽  
Statistical Significance ◽  
Gamma Probe ◽  
Canine Model ◽  
Blue Dye ◽  
Kappa Index ◽  
Experimental Canine ◽  
The Right

Objective: Develop and evaluate a canine experimental model of penile sentinel lymph node (SLN) detection using a combination of patent blue dye (PB) and technetium99m phytate (99mTc). Methods: The experiment sampled healthy adult male mongrel dogs (N=19; 10-20 kg). After approval by the local ethics committee, we injected99mTc in the glans penis along the midline raphe. After 10 min, PB was injected in the same region. Ten minutes later, we identified hot spots within the inguinals and iliac artery areausing a gamma probe. We dissected identified sites to quantify the radiation at the SLN in vivo and ex vivo and accounted for the stained and unstained nodes. We analyzed the results for statistical significance and determined the level of agreement between the two methods. Results: SLNs were detected in 94.76% of the cases using PB and 99mTc. There was no difference (p>0.05) between the SLNs-count on the left and the right side. However, PB and 99mTc correlated well on the right side (kappa index: 0.642) and perfectly on the left side (kappa index: 1), indicating a high level of consistency. Conclusion: The experimental canine model of penile SLN, in our study, was shown to be feasible.

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