Effect of High Specific-Activity Sulfur Colloid Preparations on Sentinel Node Count Rates

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

doi:10.1097/00003072-200202000-00003

Cited by 19 publications

(7 citation statements)

References 5 publications

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“…In addition, larger particles would limit the number of echelon nodes (nodes downstream of the first SN) seen along the lymphatic chain, although it has been suggested that harvesting echelon nodes along with the SN decreases the false-negative rate (12)(13)(14). A high specific activity preparation has been reported to further improve performance (15,16). Tc-99m nanocolloid, which is used outside the United States, has a much smaller average particle range, with almost all particles less than 100 nm in diameter (8).…”

Section: Radiopharmaceutical Preparationmentioning

confidence: 99%

“…A topical anesthetic has worked well for us. EMLA cream alone (lidocaine 2.5% and prilocaine 2.5%; Astra Pharmaceuticals, Wayne, Pa) has proved to be effective in controlling local surface pain during injections for all but areolar-cutaneous junction injections (11,16). The cream needs to be applied to the skin for at least 20 -30 minutes to be fully effective.…”

Section: Pain Controlmentioning

confidence: 99%

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Clinical Breast Lymphoscintigraphy: Optimal Techniques for Performing Studies, Image Atlas, and Analysis of Images

Krynyckyi¹,

Kim²,

Goyenechea³

et al. 2004

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Breast lymphoscintigraphy is increasingly performed before surgery to delineate the drainage to the sentinel node (SN) in the axilla. On the basis of the histologic status of harvested SNs, the disease status of the entire axilla can be predicted. This prediction allows a more limited dissection to be performed while maintaining staging accuracy comparable with that of classic axillary lymph node dissection. Lymphoscintigraphy assists surgeons in harvesting the SN during gamma probe-assisted axillary biopsy or dissection and provides a wide field of view survey, among other benefits. When certain injection protocols are used, lymphoscintigraphy can be performed in the afternoon before surgery the next morning, thus minimizing disruptions of tight surgical schedules. Image acquisition can be optimized and SN activity can be maximized by means of such factors as parameters for preparation of the radiotracer, injection techniques, energy settings for the gamma camera, breast displacement maneuvers, and techniques for marking and outlining the patient's body. The ultimate goals are to delineate the true SN, maximize activity in the node for facilitated removal (even at next-day surgery), and deliver the information to the surgeon without delaying the surgical schedule.

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Section: Radiopharmaceutical Preparationmentioning

confidence: 99%

Section: Pain Controlmentioning

confidence: 99%

Clinical Breast Lymphoscintigraphy: Optimal Techniques for Performing Studies, Image Atlas, and Analysis of Images

Krynyckyi¹,

Kim²,

Goyenechea³

et al. 2004

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“…Effect of specific activity of the Tc99m elute for kit preparation on the success of sentinel node mapping has been evaluated in several studies before. [27][28][29][30] Major results of these studies can be found in Table 2. All four previous studies on this topic showed that increased sentinel node count rate can be achieved by increasing the specific activity of the Tc-99m elute (by using 2-hour elute vs. 24-hour elute, using a proportion of a kit, or using a lower volume of Tc-99m for kit preparation).…”

Section: Discussionmentioning

confidence: 99%

Lymphoscintigraphy in the Time of COVID-19: Effect of Molybdenum-99 Shortage on Feasibility of Sentinel Node Mapping

Sadri

Dabbagh

Forghani

et al. 2021

Lymphatic Research and Biology

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Background: In the current study, we reported our experience on sentinel node mapping of breast cancer patients during the extreme shortage of Mo99-Tc99m generators using Tc-99m phytate. Methods and Results: During the period from March 7, 2019, to April 18, 2020, due to disruption of molybdenum supply chain, we used low specific activity Tc-99m pertechnetate elute (0.5-2 mCi of 99m TcO 4 in 5 mL) for each kit preparation. Two or three intradermal periareolar injections were done for each patient (0.02-0.1 mCi/0.2 mL for each injection). Immediately following injection, dynamic lymphoscintigraphy was done. Surgery was done the same day of injection and the axillary sentinel node was sought using a gamma probe. Overall, 35 patients were included in the study. The specific activity of the Tc-99m elute (in 5 mL) used for kit preparation was 2 mCi/10 mg in four, 1.5 mCi/10 mg in eight, 1.25 mCi/10 mg in eight, 1 mCi/10 mg in three, 0.75 mCi/10 mg in five, and 0.5 mCi/10 mg of 99m Tc-Phytate in seven patients. For the first four groups of patients, we used two 0.2 mL injections, while in the latter two groups, three 0.2 mL injections were used. At least one sentinel node was detected in all patients but three in whom axilla was involved. Conclusion: Sentinel node biopsy can be achieved with low specific activity of Tc-99m elute at the time of Mo99-Tc-99m generator shortage. If special personal protection is used, sentinel node mapping can be done in nuclear medicine departments with excellent results despite the COVID-19 pandemic and disruption of generator shipment.

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“…With time however, such nonspecific trapping will allow the release of particles for subsequent migration to other "downstream" nodes [78]. Krynyckyi et al [80] demonstrated that colloidal preparations with higher specific activity demonstrated higher retention (of radioactivity) within sentinel nodes than preparations with lower specific activity, consistent with the concept of a limited capacity for phagocytic uptake within a single node.…”

Section: Colloids In Lymphaticsmentioning

confidence: 99%

Molecular targeting of the lymphovascular system for imaging and therapy

Schöder

Glass

Pecking

et al. 2006

Cancer Metastasis Rev

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Progress toward targeting cancer cells is a multi-disciplinary endeavor. In addition to the surgical and oncology specialties, radiologists collaborate with mathematicians, computer scientists, and physicists, in a constant effort to incrementally improve upon the current imaging modalities. Recently, radiologists have formed collaborations with molecular biologists and chemists in order to develop molecular agents that target cancer cells via receptor-substrate or specific physiochemical interactions. In this review, we summarize selected efforts toward molecular targeting of the lymphovascular system. Standard imaging modalities, positron emission tomography, single photon emission tomography, and ultrasound, are reviewed as well as, the targeted introduction of substances for endolymphatic therapy. We also review the current status of sentinel lymph node mapping with radiocolloids and the application of molecular targeting for the development of a radiopharmaceutical specifically designed for sentinel lymph node mapping.

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Effect of High Specific-Activity Sulfur Colloid Preparations on Sentinel Node Count Rates

Abstract: These preliminary results suggest higher counts in the sentinel node are possible with a higher SA preparation.

Cited by 19 publications

References 5 publications

Clinical Breast Lymphoscintigraphy: Optimal Techniques for Performing Studies, Image Atlas, and Analysis of Images

Clinical Breast Lymphoscintigraphy: Optimal Techniques for Performing Studies, Image Atlas, and Analysis of Images

Lymphoscintigraphy in the Time of COVID-19: Effect of Molybdenum-99 Shortage on Feasibility of Sentinel Node Mapping

Molecular targeting of the lymphovascular system for imaging and therapy

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