Sentinel lymph node detection in oral cancer: a within-patient comparison between [99mTc]Tc-tilmanocept and [99mTc]Tc-nanocolloid
| Autor: | Gerard C. Krijger, Bernard M. Tijink, Rutger Mahieu, Robert J.J. van Es, Rob van Rooij, Inne J den Toom, Bart de Keizer, Remco de Bree, Monique G.G. Hobbelink |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Sentinel lymph node
Lymphatic metastasis 030218 nuclear medicine & medical imaging Isotopes of technetium Mannans 03 medical and health sciences 0302 clinical medicine Technetium-99 Biopsy medicine Humans Radiology Nuclear Medicine and imaging [99mTc]Tc-tilmanocept Prospective Studies Stage (cooking) medicine.diagnostic_test business.industry Sentinel Lymph Node Biopsy Oral cancer Significant difference Cancer Dextrans General Medicine medicine.disease Lymphatic system 030220 oncology & carcinogenesis Carcinoma Squamous Cell Technetium Tc 99m Pentetate Original Article Mouth Neoplasms Lymph Nodes Radiopharmaceuticals Sentinel Lymph Node Nuclear medicine business Sentinel lymph nodes Lymphoscintigraphy |
| Zdroj: | European Journal of Nuclear Medicine and Molecular Imaging |
| ISSN: | 1619-7089 1619-7070 |
| Popis: | Purpose Sentinel lymph node (SLN) biopsy has proven to reliably stage the clinically negative neck in early-stage oral squamous cell carcinoma (OSCC). [99mTc]Tc-tilmanocept may be of benefit in OSCC with complex lymphatic drainage patterns and close spatial relation to SLNs. Methods A prospective within-patient evaluation study was designed to compare [99mTc]Tc-tilmanocept with [99mTc]Tc-nanocolloid for SLN detection. A total of 20 patients with early-stage OSCC were included, who underwent lymphoscintigraphy with both tracers. Both lymphoscintigraphic images of each patient were evaluated for SLN detection and radiotracer distribution at 2–4 h post-injection. Results The injection site’s remaining radioactivity was significantly lower for [99mTc]Tc-tilmanocept (29.9%), compared with [99mTc]Tc-nanocolloid (60.9%; p 99mTc]Tc-tilmanocept (1.95%) compared with [99mTc]Tc-nanocolloid (3.16%; p = 0.010). No significant difference was seen in SLN to injection site ratio in radioactivity between [99mTc]Tc-tilmanocept (0.066) and [99mTc]Tc-nanocolloid (0.054; p = 0.232). A median of 3.0 and 2.5 SLNs were identified with [99mTc]Tc-tilmanocept and [99mTc]Tc-nanocolloid, respectively (p = 0.297). Radioactive uptake in higher echelon nodes was not significantly different between [99mTc]Tc-tilmanocept (0.57%) and [99mTc]Tc-nanocolloid (0.86%) (p = 0.052). A median of 2.0 and 2.5 higher echelon nodes was identified with [99mTc]Tc-tilmanocept and [99mTc]Tc-nanocolloid, respectively (p = 0.083). Conclusion [99mTc]Tc-tilmanocept had a higher injection site clearance, but at the same time a lower uptake in the SLN, resulting in an SLN to injection site ratio, which was not significantly different from [99mTc]Tc-nanocolloid. The relatively low-radioactive uptake in SLNs of [99mTc]Tc-tilmanocept may limit intraoperative detection of SLNs, but can be overcome by a higher injection dose. |
| Databáze: | OpenAIRE |
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