Sentinel Node Staging of Early Breast Cancer Using Lymphoscintigraphy and the Intraoperative Gamma Detecting Probe

Alazraki, Naomi P.; Styblo, Toncred M.; Grant, Sandra; Cohen, Cynthia; Larsen, Travis; Waldrop, Sandra M.; Aarsvold, John N.

doi:10.1016/s0033-8389(05)70322-5

Cited by 38 publications

(26 citation statements)

References 30 publications

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“…[1][2][3][4] Various techniques and imaging agents have been developed to map lymphatic drainage from tumors, including the use of blue dye with surgical dissection and injection of radiopharmaceuticals followed by evaluation with a gamma camBarry B. Goldberg, MD, Daniel A. Merton, BS, RDMS, Ji-Bin Liu, MD, Flemming Forsberg, PhD, Kaijun Zhang, PhD, Madhukar Thakur, PhD, Stephanie Schulz, PhD, Robin Schanche, BS, George F. Murphy, MD, Scott A. Waldman, MD, PhD Received October 6, 2010, …”

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confidence: 99%

“…[5][6][7][8][9][10][11] Several radiopharmaceutical agents are used for lymphoscintigraphy, including technetium Tc 99m antinomy trisulfate colloid, Tc 99m nanocolloid, and Tc 99m sulfur colloid. 3,7 Likewise, a number of dyes have been used to localize SLNs, including methylene blue, isosulfin blue, patent blue, and fluorescein. 6 Diagnostic ultrasound imaging (US) has been used to evaluate lymph nodes (LNs) for both benign disease as well as metastases.…”

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confidence: 99%

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Contrast-Enhanced Ultrasound Imaging of Sentinel Lymph Nodes After Peritumoral Administration of Sonazoid in a Melanoma Tumor Animal Model

Goldberg

Merton

Liu

et al. 2011

Journal of Ultrasound in Medicine

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etection and characterization of sentinel lymph nodes (SLNs) are important for the management of patients who have a variety of malignancies, including melanoma, breast, colon, and other cancers. [1][2][3][4] Various techniques and imaging agents have been developed to map lymphatic drainage from tumors, including the use of blue dye with surgical dissection and injection of radiopharmaceuticals followed by evaluation with a gamma camBarry B. Goldberg, MD, Daniel A. Merton, BS, RDMS, Ji-Bin Liu, MD, Flemming Forsberg, PhD, Kaijun Zhang, PhD, Madhukar Thakur, PhD, Stephanie Schulz, PhD, Robin Schanche, BS, George F. Murphy, MD, Scott A. Waldman, MD, PhD Received October 6, 2010, ORIGINAL RESEARCHObjectives-The purpose of this study was to compare lymphosonography (ie, contrast-enhanced ultrasound imaging [US] after interstitial injection of a US contrast agent) for the detection of sentinel lymph nodes (SLNs) in swine with naturally occurring melanoma tumors to lymphoscintigraphy using blue dye-guided surgical dissection as the reference standard. Also, we sought to determine if lymphosonography can be used to characterize SLNs.Methods-Sixty-three swine with 104 melanomas were evaluated. Contrast-specific US was performed after peritumoral injection (1 mL dose) of Sonazoid (GE Healthcare, Oslo, Norway). Lymphoscintigraphy was performed after peritumoral injections of technetium Tc 99m sulfur colloid. Peritumoral injection of 1% Lymphazurin (Ben Venue Labs, Inc, Bedford, OH) was used to guide SLN resection. The accuracy of SLN detection with the two imaging modalities was compared using the McNemar test. The SLNs were qualitatively and quantitatively characterized as benign or malignant based on the lymphosonography results with histopathology and RNA analyses used as the reference standards.Results-Blue dye-guided surgery identified 351 SLNs. Lymphosonography detected 293 SLNs and 11 false-positives, while lymphoscintigraphy detected 231 SLNs and 20 false-positives. The accuracy of SLN detection was 81.8% for lymphosonography, which was significantly higher than the 63.2% achieved with lymphoscintigraphy (P < .0001). The accuracy of lymphosonography for SLN characterization was 80%. When the size of the enhanced SLN was taken into consideration to characterize SLNs, the accuracy was 86%.Conclusions-Lymphosonography is statistically better than lymphoscintigraphy for the detection of SLNs in this animal model. The ability to use lymphosonography as a means to characterize SLNs as benign or malignant is limited.

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Contrast-Enhanced Ultrasound Imaging of Sentinel Lymph Nodes After Peritumoral Administration of Sonazoid in a Melanoma Tumor Animal Model

Goldberg

Merton

Liu

et al. 2011

Journal of Ultrasound in Medicine

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“…-Используя возможности портативного гамма-детек-тора NEO2000 во время операции для идентифика-ции очагов накопления [2,3] радиофармпрепарата «Технефит 99mTc», возможно выполнение прицельной биопсии сторожевых лимфатических узлов. -Удаленные при биопсии сторожевые лимфатические узлы исследуются вне операционного поля для под-тверждения накопления радиофармпрепарата «Технефит 99mTc» и направляются на срочное цитологическое и ги-стологическое исследование.…”

Section: анализ полученных результатовunclassified

Sentinel lymph nodes biopsy in early breast cancer and melanoma patients using “Tehnefit 99mTc” radioactive colloid technetium 99mTc

Ермаков¹,

Зикиряходжаев²,

Лазутина³

et al. 2016

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“…In particular, the internal mammary chains and supraclavicular nodes are commonly seen after intraparenchymal injection but rarely after subareolar or subdermal injections. Peritumoural and subdermal injection of 99m Tc sulphur colloid combined with periareolar injection of isosulphan blue dye is advocated by another group with extensive experience [32,[57][58][59] . Overall, the identification rate, accuracy and predictive value of sentinel node biopsy seem to be unaffected by the site of injection though a difference may become apparent with long-term follow-up that examines the pattern of axillary failure correlated with the injection site [13] .…”

Section: Site Of Injectionmentioning

confidence: 99%

“…Internal mammary nodes identified on preoperative lymphoscintigraphy require histopathological confirmation of disease before therapy is commenced [105] . Internal mammary nodes are best identified when peritumoural, intratumoural or subtumoural injections are made with some reports visualising these nodes in 10%-30% of patients whereas subdermal, intradermal, periareolar or subareolar injections result in much less frequent visualisation of these nodes [47,58] .…”

Section: Internal Mammary and Intramammary Lymph Nodesmentioning

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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Sentinel Node Staging of Early Breast Cancer Using Lymphoscintigraphy and the Intraoperative Gamma Detecting Probe

Cited by 38 publications

References 30 publications

Contrast-Enhanced Ultrasound Imaging of Sentinel Lymph Nodes After Peritumoral Administration of Sonazoid in a Melanoma Tumor Animal Model

Contrast-Enhanced Ultrasound Imaging of Sentinel Lymph Nodes After Peritumoral Administration of Sonazoid in a Melanoma Tumor Animal Model

Sentinel lymph nodes biopsy in early breast cancer and melanoma patients using “Tehnefit 99mTc” radioactive colloid technetium 99mTc

What the clinician wants to know: radiation oncology perspective

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