LymphedemaV1, Main, Exploration, bibRecord, 001977

Pre-operative sentinel lymph node localization in breast cancer with superparamagnetic iron oxide MRI: the SentiMAG Multicentre Trial imaging subprotocol

Identifieur interne : 001977 ( Main/Exploration ); précédent : 001976; suivant : 001978

Pre-operative sentinel lymph node localization in breast cancer with superparamagnetic iron oxide MRI: the SentiMAG Multicentre Trial imaging subprotocol

Auteurs : Joost J. Pouw ; Maarten R. Grootendorst ; Roland Bezooijen ; Caroline A H. Klazen ; Wieger I. De Bruin ; Joost M. Klaase ; Margaret A. Hall-Craggs ; Michael Douek ; Bennie Ten Haken

Source :

The British Journal of Radiology [ 0007-1285 ] ; 2015.

RBID : PMC:4984945

Abstract

Objective:

Sentinel lymph node biopsy (SLNB) with a superparamagnetic iron oxide (SPIO) tracer was shown to be non-inferior to the standard combined technique in the SentiMAG Multicentre Trial. The MRI subprotocol of this trial aimed to develop a magnetic alternative for pre-operative lymphoscintigraphy (LS). We evaluated the feasibility of using MRI following the administration of magnetic tracer for pre-operative localization of sentinel lymph nodes (SLNs) and its potential for non-invasive identification of lymph node (LN) metastases.

Methods:

Patients with breast cancer scheduled to undergo SLNB were recruited for pre-operative LS, single photon emission CT (SPECT)-CT and SPIO MRI. T₁ weighted turbo spin echo and T₂ weighted gradient echo sequences were used before and after interstitial injection of magnetic tracer into the breast. SLNs on MRI were defined as LNs with signal drop and direct lymphatic drainage from the injection site. LNs showing inhomogeneous SPIO uptake were classified as metastatic. During surgery, a handheld magnetometer was used for SLNB. Blue or radioactive nodes were also excised. The number of SLNs and MR assessment of metastatic involvement were compared with surgical and histological outcomes.

Results:

11 patients were recruited. SPIO MRI successfully identified SLNs in 10 of 11 patients vs 11 of 11 patients with LS/SPECT-CT. One patient had metastatic involvement of four LNs, and this was identified in one node on pre-operative MRI.

Conclusion:

SPIO MRI is a feasible technique for pre-operative localization of SLNs and, in combination with intraoperative use of a handheld magnetometer, provides an entirely radioisotope-free technique for SLNB. Further research is needed for the evaluation of MRI characterization of LN involvement using subcutaneous injection of magnetic tracer.

Advances in knowledge:

This study is the first to demonstrate that an interstitially administered magnetic tracer can be used both for pre-operative imaging and intraoperative SLNB, with equal performance to imaging and localization with radioisotopes.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4984945

DOI: 10.1259/bjr.20150634
PubMed: 26492466
PubMed Central: 4984945

Affiliations:

Le document en format XML

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<front><div type="abstract" xml:lang="en"><sec><title>Objective:</title>
<p>Sentinel lymph node biopsy (SLNB) with a superparamagnetic iron oxide (SPIO) tracer was shown to be non-inferior to the standard combined technique in the SentiMAG Multicentre Trial. The MRI subprotocol of this trial aimed to develop a magnetic alternative for pre-operative lymphoscintigraphy (LS). We evaluated the feasibility of using MRI following the administration of magnetic tracer for pre-operative localization of sentinel lymph nodes (SLNs) and its potential for non-invasive identification of lymph node (LN) metastases.</p>
</sec>
<sec><title>Methods:</title>
<p>Patients with breast cancer scheduled to undergo SLNB were recruited for pre-operative LS, single photon emission CT (SPECT)-CT and SPIO MRI. <italic>T</italic>
<sub>1</sub>
 weighted turbo spin echo and <italic>T</italic>
<sub>2</sub>
 weighted gradient echo sequences were used before and after interstitial injection of magnetic tracer into the breast. SLNs on MRI were defined as LNs with signal drop and direct lymphatic drainage from the injection site. LNs showing inhomogeneous SPIO uptake were classified as metastatic. During surgery, a handheld magnetometer was used for SLNB. Blue or radioactive nodes were also excised. The number of SLNs and MR assessment of metastatic involvement were compared with surgical and histological outcomes.</p>
</sec>
<sec><title>Results:</title>
<p>11 patients were recruited. SPIO MRI successfully identified SLNs in 10 of 11 patients <italic>vs</italic>
 11 of 11 patients with LS/SPECT-CT. One patient had metastatic involvement of four LNs, and this was identified in one node on pre-operative MRI.</p>
</sec>
<sec><title>Conclusion:</title>
<p>SPIO MRI is a feasible technique for pre-operative localization of SLNs and, in combination with intraoperative use of a handheld magnetometer, provides an entirely radioisotope-free technique for SLNB. Further research is needed for the evaluation of MRI characterization of LN involvement using subcutaneous injection of magnetic tracer.</p>
</sec>
<sec><title>Advances in knowledge:</title>
<p>This study is the first to demonstrate that an interstitially administered magnetic tracer can be used both for pre-operative imaging and intraoperative SLNB, with equal performance to imaging and localization with radioisotopes.</p>
</sec>
</div>
</front>
</TEI>
<affiliations><list></list>
<tree><noCountry><name sortKey="Bezooijen, Roland" sort="Bezooijen, Roland" uniqKey="Bezooijen R" first="Roland" last="Bezooijen">Roland Bezooijen</name>
<name sortKey="De Bruin, Wieger I" sort="De Bruin, Wieger I" uniqKey="De Bruin W" first="Wieger I" last="De Bruin">Wieger I. De Bruin</name>
<name sortKey="Douek, Michael" sort="Douek, Michael" uniqKey="Douek M" first="Michael" last="Douek">Michael Douek</name>
<name sortKey="Grootendorst, Maarten R" sort="Grootendorst, Maarten R" uniqKey="Grootendorst M" first="Maarten R" last="Grootendorst">Maarten R. Grootendorst</name>
<name sortKey="Hall Craggs, Margaret A" sort="Hall Craggs, Margaret A" uniqKey="Hall Craggs M" first="Margaret A" last="Hall-Craggs">Margaret A. Hall-Craggs</name>
<name sortKey="Klaase, Joost M" sort="Klaase, Joost M" uniqKey="Klaase J" first="Joost M" last="Klaase">Joost M. Klaase</name>
<name sortKey="Klazen, Caroline A H" sort="Klazen, Caroline A H" uniqKey="Klazen C" first="Caroline A H" last="Klazen">Caroline A H. Klazen</name>
<name sortKey="Pouw, Joost J" sort="Pouw, Joost J" uniqKey="Pouw J" first="Joost J" last="Pouw">Joost J. Pouw</name>
<name sortKey="Ten Haken, Bennie" sort="Ten Haken, Bennie" uniqKey="Ten Haken B" first="Bennie" last="Ten Haken">Bennie Ten Haken</name>
</noCountry>
</tree>
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</record>

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Pre-operative sentinel lymph node localization in breast cancer with superparamagnetic iron oxide MRI: the SentiMAG Multicentre Trial imaging subprotocol

Pre-operative sentinel lymph node localization in breast cancer with superparamagnetic iron oxide MRI: the SentiMAG Multicentre Trial imaging subprotocol

Source :

Abstract

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	Serveur d'exploration sur le lymphœdème
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