Pre-operative sentinel lymph node localization in breast cancer with superparamagnetic iron oxide MRI: the SentiMAG Multicentre Trial imaging subprotocol
Identifieur interne : 000F70 ( Pmc/Checkpoint ); précédent : 000F69; suivant : 000F71Pre-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 HakenSource :
- The British Journal of Radiology [ 0007-1285 ] ; 2015.
Abstract
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.
Patients with breast cancer scheduled to undergo SLNB were recruited for pre-operative LS, single photon emission CT (SPECT)-CT and SPIO MRI.
11 patients were recruited. SPIO MRI successfully identified SLNs in 10 of 11 patients
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.
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:
DOI: 10.1259/bjr.20150634
PubMed: 26492466
PubMed Central: 4984945
Affiliations:
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<author><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>
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<author><name sortKey="Douek, Michael" sort="Douek, Michael" uniqKey="Douek M" first="Michael" last="Douek">Michael Douek</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Pre-operative sentinel lymph node localization in breast cancer with superparamagnetic iron oxide MRI: the SentiMAG Multicentre Trial imaging subprotocol</title>
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<author><name sortKey="Bezooijen, Roland" sort="Bezooijen, Roland" uniqKey="Bezooijen R" first="Roland" last="Bezooijen">Roland Bezooijen</name>
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<author><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>
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<author><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>
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<author><name sortKey="Klaase, Joost M" sort="Klaase, Joost M" uniqKey="Klaase J" first="Joost M" last="Klaase">Joost M. Klaase</name>
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<author><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>
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<author><name sortKey="Douek, Michael" sort="Douek, Michael" uniqKey="Douek M" first="Michael" last="Douek">Michael Douek</name>
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<author><name sortKey="Ten Haken, Bennie" sort="Ten Haken, Bennie" uniqKey="Ten Haken B" first="Bennie" last="Ten Haken">Bennie Ten Haken</name>
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<series><title level="j">The British Journal of Radiology</title>
<idno type="ISSN">0007-1285</idno>
<idno type="eISSN">1748-880X</idno>
<imprint><date when="2015">2015</date>
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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>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Br J Radiol</journal-id>
<journal-id journal-id-type="iso-abbrev">Br J Radiol</journal-id>
<journal-id journal-id-type="publisher-id">bjr</journal-id>
<journal-title-group><journal-title>The British Journal of Radiology</journal-title>
</journal-title-group>
<issn pub-type="ppub">0007-1285</issn>
<issn pub-type="epub">1748-880X</issn>
<publisher><publisher-name>The British Institute of Radiology.</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">26492466</article-id>
<article-id pub-id-type="pmc">4984945</article-id>
<article-id pub-id-type="publisher-manuscript">D15634</article-id>
<article-id pub-id-type="doi">10.1259/bjr.20150634</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Full Paper</subject>
</subj-group>
<subj-group subj-group-type="collection"><subject>Breast</subject>
</subj-group>
</article-categories>
<title-group><article-title>Pre-operative sentinel lymph node localization in breast cancer with superparamagnetic iron oxide MRI: the SentiMAG Multicentre Trial imaging subprotocol</article-title>
<alt-title alt-title-type="left-running-head">Pouw <italic>et al</italic>
</alt-title>
<alt-title alt-title-type="right-running-head">Pre-operative sentinel lymph node localization with SPIO MRI</alt-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">http://orcid.org/0000-0003-4401-5768</contrib-id>
<name><surname>Pouw</surname>
<given-names>Joost J</given-names>
</name>
<degrees>MSc</degrees>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
<email xlink:href="j.j.pouw@utwente.nl">j.j.pouw@utwente.nl</email>
</contrib>
<contrib contrib-type="author"><name><surname>Grootendorst</surname>
<given-names>Maarten R</given-names>
</name>
<degrees>MSc</degrees>
<xref ref-type="aff" rid="aff2"><sup>2</sup>
</xref>
<xref ref-type="aff" rid="aff3"><sup>3</sup>
</xref>
<email xlink:href="maarten.grootendorst@kcl.ac.uk">maarten.grootendorst@kcl.ac.uk</email>
</contrib>
<contrib contrib-type="author"><name><surname>Bezooijen</surname>
<given-names>Roland</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="aff4"><sup>4</sup>
</xref>
<email xlink:href="r.bezooijen@mst.nl">r.bezooijen@mst.nl</email>
</contrib>
<contrib contrib-type="author"><name><surname>Klazen</surname>
<given-names>Caroline A H</given-names>
</name>
<degrees>MD, PhD</degrees>
<xref ref-type="aff" rid="aff4"><sup>4</sup>
</xref>
<email xlink:href="c.klazen@mst.nl">c.klazen@mst.nl</email>
</contrib>
<contrib contrib-type="author"><name><surname>De Bruin</surname>
<given-names>Wieger I</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="aff5"><sup>5</sup>
</xref>
<email xlink:href="w.debruin@mst.nl">w.debruin@mst.nl</email>
</contrib>
<contrib contrib-type="author"><name><surname>Klaase</surname>
<given-names>Joost M</given-names>
</name>
<degrees>MD, PhD</degrees>
<xref ref-type="aff" rid="aff2"><sup>2</sup>
</xref>
<email xlink:href="j.klaase@mst.nl">j.klaase@mst.nl</email>
</contrib>
<contrib contrib-type="author"><name><surname>Hall-Craggs</surname>
<given-names>Margaret A</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="aff6"><sup>6</sup>
</xref>
<email xlink:href="margaret.hall-craggs@uclh.nhs.uk">margaret.hall-craggs@uclh.nhs.uk</email>
</contrib>
<contrib contrib-type="author"><name><surname>Douek</surname>
<given-names>Michael</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="aff3"><sup>3</sup>
</xref>
<email xlink:href="michael.douek@kcl.ac.uk">michael.douek@kcl.ac.uk</email>
</contrib>
<contrib contrib-type="author"><name><surname>ten Haken</surname>
<given-names>Bennie</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
<email xlink:href="b.tenhaken@utwente.nl">b.tenhaken@utwente.nl</email>
</contrib>
<aff id="aff1"><label><sup>1</sup>
</label>
<addr-line>MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, Netherlands</addr-line>
</aff>
<aff id="aff2"><label><sup>2</sup>
</label>
<addr-line>Department of Surgery, Medisch Spectrum Twente, Enschede, Netherlands</addr-line>
</aff>
<aff id="aff3"><label><sup>3</sup>
</label>
<addr-line>Research Oncology, Division of Cancer Studies, King's College London, London, UK</addr-line>
</aff>
<aff id="aff4"><label><sup>4</sup>
</label>
<addr-line>Department of Radiology, Medisch Spectrum Twente, Enschede, Netherlands</addr-line>
</aff>
<aff id="aff5"><label><sup>5</sup>
</label>
<addr-line>Department of Nuclear Medicine, Medisch Spectrum Twente, Enschede, Netherlands</addr-line>
</aff>
<aff id="aff6"><label><sup>6</sup>
</label>
<addr-line>Department of Radiology, University College London Hospital, London, UK</addr-line>
</aff>
</contrib-group>
<author-notes><corresp id="cor1">Address correspondence to: Dr Bennie ten Haken. E-mail: <email xlink:href="B.tenhaken@utwente.nl">B.tenhaken@utwente.nl</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub"><month>12</month>
<year>2015</year>
<string-date>December 2015</string-date>
</pub-date>
<pub-date pub-type="epub"><day>05</day>
<month>11</month>
<year>2015</year>
</pub-date>
<volume>88</volume>
<issue>1056</issue>
<elocation-id>20150634</elocation-id>
<history><date date-type="received"><day>30</day>
<month>7</month>
<year>2015</year>
<string-date>Received on July 30, 2015</string-date>
</date>
<date date-type="rev-recd"><day>28</day>
<month>9</month>
<year>2015</year>
<string-date>Revised on September 28, 2015</string-date>
</date>
<date date-type="accepted"><day>20</day>
<month>10</month>
<year>2015</year>
<string-date>Accepted on October 20, 2015</string-date>
</date>
</history>
<permissions><copyright-statement>© 2015 The Authors. Published by the British Institute of Radiology</copyright-statement>
<copyright-year>2015</copyright-year>
<copyright-holder>The Authors</copyright-holder>
</permissions>
<self-uri content-type="pdf" xlink:href="bjr.20150634.pdf"></self-uri>
<abstract><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>
</abstract>
<counts><fig-count count="3"></fig-count>
<table-count count="1"></table-count>
<ref-count count="35"></ref-count>
<page-count count="8"></page-count>
</counts>
</article-meta>
</front>
</pmc>
<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>
</affiliations>
</record>
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