Areolar-Cutaneous “Junction” Injections to Augment Sentinel Node Count Activity

Krynyckyi, Borys R.; Kim, Chun K.; Mosci, Karina; Fedorciw, Boris J.; Zhang, Zhuang-Yu; Lipszyc, Helena; Macháč, Josef

doi:10.1097/01.rlu.0000048942.43732.1f

Cited by 19 publications

(36 citation statements)

References 29 publications

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“…We also postulated that elimination of the radiolabeled colloid might also reduce the pain associated with the injection of a colloid pre-operatively [12,13].…”

Section: Introductionmentioning

confidence: 99%

Development of ¹²⁵I‐methylene blue for sentinel lymph node biopsy

Stafford

Wright

Schwimer

et al. 2006

Journal of Surgical Oncology

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“…We also postulated that elimination of the radiolabeled colloid might also reduce the pain associated with the injection of a colloid pre-operatively [12,13].…”

Section: Introductionmentioning

confidence: 99%

Development of ¹²⁵I‐methylene blue for sentinel lymph node biopsy

Stafford

Wright

Schwimer

et al. 2006

Journal of Surgical Oncology

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“…5) Yet, finally, an even better solution to the complexities of upper outer quadrant lesions, is to shift part or all of the injected dose to the areolar region [3-5]. This will largely or completely resolve the issues of injected activity/diffusion/scatter hiding a closely approximated SN in the axilla [3-5].…”

Section: Introductionmentioning

confidence: 99%

“…This will largely or completely resolve the issues of injected activity/diffusion/scatter hiding a closely approximated SN in the axilla [3-5]. In addition, An Adaptive Injection Technique (AIT) can be employed to allow a limited control over the number of echelon nodes realized, and improve overall SN intensity.…”

Section: Introductionmentioning

confidence: 99%

“…This is because these very shallow LB injections are extremely efficient at delivering activity to the SN compared to perilesional intra-parenchymal injections, and even intradermal over the lesion injections [3-7]. Compared to concurrently administered perilesional and intradermal over the lesion injections, LB areolar injections, and other areolar type injections in general, delineate essentially the same primary nodes (excluding internal mammary nodes [3,5,6]) in the vast majority of patients, and do so with several times the efficiency of getting activity into the SN [3-7]. The LB areolar injections occasionally depict additional nodes closer to the injection site, the " reverse echelon node " (REN), a feature of areolar type injections in general related to injection location [3,5,8].…”

Section: Introductionmentioning

confidence: 99%

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Preoperative lymphoscintigraphy and triangulated patient body marking are important parts of the sentinel node process in breast cancer

Krynyckyi

Kim

2005

World J Surg Onc

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“…Periareolar injections are made just outside the areolar border at four equally spaced sites. The injections are subdermal though a single subareolar injection lined up with the tumour can also be used [26,27,49] . This technique militates against extra-axillary node identification but is easy and efficient [50][51][52] .…”

Section: Site Of Injectionmentioning

confidence: 99%

What the clinician wants to know: radiation oncology perspective

Leer

2005

Cancer Imaging

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The delineation of the target volume, i.e. the volume which should be irradiated with a therapeutic dose of irradiation, is of utmost importance in radiotherapy. Modern imaging techniques cannot be missed in this process. Diagnosticians and radiation oncologists therefore should understand each other's needs and potential. Keywords: Radiotherapy; treatment planning; target volumes; biological target volume. Staging for radiotherapyRadiotherapy like surgery is a treatment for locoregional tumour growth. So, imaging modalities are extremely important for staging. Computerized tomography (CT), ultrasonography and magnetic resonance imaging (MRI) are used in the work-up of many tumours, e.g. in cervical cancer and head and neck tumours to detect lymph nodes, in rectal cancer to judge whether a free margin can be obtained to make the patient a suitable candidate for short term irradiation followed by surgery. New imaging modalities are also being introduced for staging such as fluorodeoxy glucose positron emission tomography (FDG-PET) scanning in lung cancer and MR lymphography with nanoparticles in prostate cancer. Image guided radiotherapy volumesWhereas surgery is tumour eradication under direct vision, radiotherapy is tumour eradication under indirect vision. So, imaging is of extreme importance for radiotherapy planning. In radiation oncology the target volume is that part of the body where a therapeutic dose of irradiation should be applied. This target volume is subdivided into several subsets: the gross tumour target volume (GTV), the clinical target volume (CTV) and the planning target volume (PTV). The GTV and CTV have a biological background. The GTV is what you can see, measure or palpate. The CTV is the suspected microscopic extension of the disease, and as in surgery, radiation oncologists also take a margin around the visible tumour. The GTV can include regional lymph nodes when microscopic spread to lymph nodes is expected; and when they should be treated electively, one could consider this as a nodal CTV. The PTV is a geometric and not a biological concept. This volume by two margins takes into account organ movement (internal margin) and positioning in accuracies and inaccuracies of the irradiation delivering equipment (set-up margin). The PTV is created to ensure that the therapeutic dose is indeed delivered to the CTV.Although one could imagine that the delineation of the GTV is most simple, we have to realise that different imaging modalities 'see' tumours or organs differently, e.g. the size of the prostate is different on MRI than CT. What is the truth? Often radiation oncologists use both. Consequently image registration or image fusion has become of paramount importance. Like surgery, in radiotherapy we also do some harm to normal tissues. Healthy tissue is unavoidably irradiated. However, the radiation dose in these tissues should be kept below tolerance which means below the dose which creates clinically manifest severe damage. For this reason a fourth volume in the irradiated part ...

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Areolar-Cutaneous “Junction” Injections to Augment Sentinel Node Count Activity

Cited by 19 publications

References 29 publications

Development of ¹²⁵I‐methylene blue for sentinel lymph node biopsy

Development of ¹²⁵I‐methylene blue for sentinel lymph node biopsy

Preoperative lymphoscintigraphy and triangulated patient body marking are important parts of the sentinel node process in breast cancer

What the clinician wants to know: radiation oncology perspective

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Areolar-Cutaneous “Junction” Injections to Augment Sentinel Node Count Activity

Cited by 19 publications

References 29 publications

Development of 125I‐methylene blue for sentinel lymph node biopsy

Development of 125I‐methylene blue for sentinel lymph node biopsy

Preoperative lymphoscintigraphy and triangulated patient body marking are important parts of the sentinel node process in breast cancer

What the clinician wants to know: radiation oncology perspective

Contact Info

Product

Resources

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Development of ¹²⁵I‐methylene blue for sentinel lymph node biopsy

Development of ¹²⁵I‐methylene blue for sentinel lymph node biopsy