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Remco De Bree - One of the best experts on this subject based on the ideXlab platform.
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feasibility of intraoperative detection of sentinel lymph nodes with 89 zirconium labelled nanocolloidal albumin pet ct and a handheld high energy gamma probe
EJNMMI research, 2018Co-Authors: Derrek A Heuveling, Otto S. Hoekstra, Hakki K Karagozoglu, Arthur Van Lingen, Guus A M S Van Dongen, Remco De BreeAbstract:PET/CT Lymphoscintigraphy using 89Zr-nanocolloidal albumin has the potential to improve the preoperative identification of sentinel lymph nodes (SLNs), especially if located in the near proximity of the primary tumour. This study aims to demonstrate the feasibility of PET/CT Lymphoscintigraphy followed by intraoperative detection of 89Zr-nanocolloidal albumin containing SLNs with the use of a handheld high-energy gamma probe. PET/CT Lymphoscintigraphy was performed after peritumoural injection of 89Zr-nanocolloidal albumin in five patients with oral cavity carcinoma planned for surgical resection. SLN biopsy procedure was performed 18 h later. SLNs were detected using detailed information of PET/CT and the high-energy gamma probe. In all patients, SLNs were identified on PET/CT Lymphoscintigraphy. Intraoperative detection using the high-energy gamma probe was possible in 10 of 13 SLNs, at a short distance from the SLN. This study demonstrates that intraoperative detection of SLNs containing 89Zr-nanocolloidal albumin using a handheld high-energy gamma probe is feasible, but its clinical use and sensitivity seem to be limited. CCMO NL37222.092.11
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pilot study on the feasibility of pet ct Lymphoscintigraphy with zr 89 nanocolloidal albumin for sentinel node identification in oral cancer patients
The Journal of Nuclear Medicine, 2013Co-Authors: Derrek A Heuveling, Otto S. Hoekstra, Danielle J. Vugts, N.h. Hendrikse, M. Yaqub, K.h. Karagozoglu, C.r. Leemans, A Van Schie, G A M S Van Dongen, Remco De BreeAbstract:With conventional imaging techniques such as planar Lymphoscintigraphy and SPECT/CT, preoperative sentinel node (SN) identification can be difficult when the SN is near the primary tumor, as is the case in floor-of-mouth carcinomas. PET/CT Lymphoscintigraphy may improve the detection and localization of such SNs. Methods: In this study, the clinical feasibility of PET/CT Lymphoscintigraphy using 89Zr-nanocolloidal albumin was evaluated in 5 oral cancer patients. PET/CT Lymphoscintigraphy was performed after peritumoral injection of 89Zr-nanocolloidal albumin. The routine SN procedure, including SPECT/CT using 99mTc-nanocolloidal albumin, was performed on the same patients 7-9 d after the injection of 89Zr-nanocolloidal albumin. Results: Comparison of radiocolloid distribution on PET/CT and SPECT/CT showed identical drainage patterns. Moreover, PET/CT was able to identify additional foci near the primary tumor. Conclusion: This pilot PET/CT study on SN detection indicated that Lymphoscintigraphy using 89Zr-nanocolloidal albumin is feasible.
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Pilot study on the feasibility of PET/CT Lymphoscintigraphy with Zr-89-nanocolloidal albumin for sentinel node identification in oral cancer patients
The Journal of Nuclear Medicine, 2013Co-Authors: Derrek A Heuveling, Otto S. Hoekstra, Guus A M S Van Dongen, A. Van Schie, Danielle J. Vugts, N.h. Hendrikse, M. Yaqub, K.h. Karagozoglu, C.r. Leemans, Remco De BreeAbstract:With conventional imaging techniques such as planar Lymphoscintigraphy and SPECT/CT, preoperative sentinel node (SN) identification can be difficult when the SN is near the primary tumor, as is the case in floor-of-mouth carcinomas. PET/CT Lymphoscintigraphy may improve the detection and localization of such SNs. Methods: In this study, the clinical feasibility of PET/CT Lymphoscintigraphy using 89Zr-nanocolloidal albumin was evaluated in 5 oral cancer patients. PET/CT Lymphoscintigraphy was performed after peritumoral injection of 89Zr-nanocolloidal albumin. The routine SN procedure, including SPECT/CT using 99mTc-nanocolloidal albumin, was performed on the same patients 7-9 d after the injection of 89Zr-nanocolloidal albumin. Results: Comparison of radiocolloid distribution on PET/CT and SPECT/CT showed identical drainage patterns. Moreover, PET/CT was able to identify additional foci near the primary tumor. Conclusion: This pilot PET/CT study on SN detection indicated that Lymphoscintigraphy using 89Zr-nanocolloidal albumin is feasible.
Robert E. Mansel - One of the best experts on this subject based on the ideXlab platform.
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role of routine preoperative Lymphoscintigraphy in sentinel node biopsy for breast cancer
European Journal of Cancer, 2005Co-Authors: Amit Goyal, Robert G. Newcombe, Robert E. ManselAbstract:Sentinel node biopsy (SNB) is rapidly emerging as the preferred technique for nodal staging in breast cancer. When radioactive colloid is used, a preoperative lymphoscintiscan is obtained to ease sentinel lymph node (SN) identification. This study evaluates whether preoperative Lymphoscintigraphy adds diagnostic accuracy to offset the additional time and cost required. 823 breast cancer patients underwent SNB based on Lymphoscintigraphy, intraoperative gamma probe detection, and blue dye mapping using 99 mTc-nanocolloid and Patent Blue V injected peritumourally. The SNB was followed by standard axillary treatment at the same operation. Preoperative Lymphoscintigraphy was performed around 3 h after the radioisotope injection. Preoperative Lymphoscintigraphy revealed SNs in 593 (72%) of the 823 patients imaged. SN visualisation on Lymphoscintigraphy was less successful in large tumours and tumours involving the upper outer quadrant of the breast (P=0.046, P<0.001, respectively). Lymphoscintigraphy showed internal mammary sentinel nodes in 9% (62/707) patients. The SN was identified intraoperatively in 98% (581) patients who had SN visualised on preoperative Lymphoscintigraphy, with a false-negative rate of 7%. In patients who did not have SN visualised on preoperative Lymphoscintigraphy, the SN was identified at operation in 90% (204) patients, with a false-negative rate of 7%. The SN identification rate was significantly higher in patients with SN visualised on preoperative Lymphoscintigraphy (P<0.001). SN identification rate intraoperatively using the gamma probe was significantly higher in the SN visualised group compared with the SN non-visualised group (95% vs. 68%; chi square (1 degrees of freedom (df)) P<0.001. There was no statistically significant difference in the false-negative rate and the operative time between the two groups. A mean of 2.3 (standard deviation (SD) 1.3) SNs per patient were removed in patients with SN visualised on preoperative Lymphoscintigraphy compared with 1.8 (SD 1.2) in patients with no SN visualised on Lymphoscintigraphy (P<0.001). Although SN visualisation on preoperative Lymphoscintigraphy significantly improved the intraoperative SN localisation rate, SN was successfully identified in 90% of patients with no SN visualisation on Lymphoscintigraphy. Given the time and cost required to perform routine preoperative Lymphoscintigraphy, these data suggest that it may not be necessary in all cases. It may be valuable for surgeons in the learning phase to shorten the learning curve and in patients who have increased risk of intraoperative failed localisation (obese or old patients). A negative preoperative lymphoscintiscan predicts the inability to localise with the hand-held gamma probe. Therefore, if the SN is not visualised on Lymphoscintigraphy then the addition of intraoperative blue dye is recommended to increase the likelihood of SN identification.
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sentinel lymph node biopsy in male breast cancer patients
Ejso, 2004Co-Authors: Amit Goyal, Kieran Horgan, Mark W. Kissin, Constantinos Yiangou, Mark Sibbering, Mark Lansdown, Robert G. Newcombe, Robert E. ManselAbstract:The concept of sentinel node biopsy has been validated for female breast cancer patients whereas, ALND remains the standard of care for male breast cancer patients with similar tumours. We evaluated the results of SLN biopsy in male breast cancer patients with clinically negative axillae. This study included all male breast cancer patients who underwent SLN biopsy between February 1998 and October 2003. All patients had negative axillae on clinical examination. All patients underwent pre-operative Lymphoscintigraphy. SLN biopsy was performed using a combination of Patent blue V and 99mTc-radiolabelled colloidal albumin injected peritumourally. Nine patients, 26-79 years of age, were included in the study. Pre-operative lymphoscinitgraphy identified SLNs in all patients. Intraoperatively, SLNs were successfully localised in all patients. The mean number of SLNs encountered was 2.4. Five patients had a positive SLN, four a negative SLN. Five patients (one with a negative SLN, four with a positive SLN) had been elected pre-operatively to undergo ALND regardless of findings on SLN biopsy. ALND confirmed the SLN to be negative in one patient (false-negative rate: 0%) and three of the four patients with positive SLN(s) had additional positive nodes in the axilla. SLN biopsy accurately predicted axillary lymph node status in these five patients. These findings compare favourably with findings reported in the literature regarding SLN biopsy in female breast cancer patients. SLN biopsy accurately staged the axilla in male breast cancer patients and should be considered for axillary staging in male breast cancer patients with clinically negative axillae.
Umberto Veronesi - One of the best experts on this subject based on the ideXlab platform.
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Lymphoscintigraphy and Radioguided Biopsy of the Sentinel Axillary Node in Breast Cancer
The Journal of Nuclear Medicine, 1998Co-Authors: Concetta De Cicco, Chiara Maria Grana, Marta Cremonesi, Alberto Luini, Mirco Bartolomei, Gennaro Prisco, Viviana Galimberti, Paolo Calza, Giuseppe Viale, Umberto VeronesiAbstract:UNLABELLED Lymphoscintigraphy associated with radioguided biopsy of the sentinel node (SN) is well established in clinical practice for melanoma. In breast cancer, the SN concept is similarly valid, and Lymphoscintigraphy is a useful method for localizing the axillary SN. The aim of this study was to optimize the Lymphoscintigraphy technique in association with a gamma ray detecting probe (GDP) for identifying and removing the SN in breast cancer patients. METHODS Two-hundred fifty patients with operable breast tumor underwent Lymphoscintigraphy before surgery. Three different size ranges of 99mTc-labeled colloid particles (
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Lymphoscintigraphy and radioguided biopsy of the sentinel axillary node in breast cancer
The Journal of Nuclear Medicine, 1998Co-Authors: Concetta De Cicco, Chiara Maria Grana, Marta Cremonesi, Alberto Luini, Mirco Bartolomei, Gennaro Prisco, Viviana Galimberti, Paolo Calza, Giuseppe Viale, Umberto VeronesiAbstract:UNLABELLED Lymphoscintigraphy associated with radioguided biopsy of the sentinel node (SN) is well established in clinical practice for melanoma. In breast cancer, the SN concept is similarly valid, and Lymphoscintigraphy is a useful method for localizing the axillary SN. The aim of this study was to optimize the Lymphoscintigraphy technique in association with a gamma ray detecting probe (GDP) for identifying and removing the SN in breast cancer patients. METHODS Two-hundred fifty patients with operable breast tumor underwent Lymphoscintigraphy before surgery. Three different size ranges of 99mTc-labeled colloid particles (<50, <80 and 200-1000 nm) were used, with either subdermal (above tumor) or peritumoral injection. Early and late scintigraphic images were obtained in anterior and oblique projections, and the skin projection of the detected SN was marked. Sentinel nodes were identified and removed with the aid of the GDP during breast surgery; they were tagged separately. Complete axillary dissection followed. In 40 patients, a blue dye was also administered in addition to subdermal radiolabeled colloid to compare blue dye mapping with Lymphoscintigraphy localization. RESULTS Lymphoscintigraphy successfully revealed lymphatic drainage in 245 of 250 patients (98%). The axillary SN was identified in 240 patients (96%). SN biopsy correctly predicted axillary node status in 234 of 240 patients (97.5%). Lymphoscintigraphy and GDP detected the SN most easily and consistently when 200-1000 nm colloid was administered subdermally in an injection volume of 0.4 ml. Blue dye mapping was successful in 30 of 40 patients (75%). In 26 of these patients, the dye and Lymphoscintigraphy identified the same node; in 4 cases different nodes were identified. None of these four patients had axillary disease. CONCLUSION Lymphoscintigraphy is a simple procedure that is well tolerated by patients. Sentinel node identification is more reliable when large-size radiolabeled colloids are injected in a relatively small injection volume (0.4 ml). Use of a GDP greatly facilitates precise pinpointing and rapid removal of the SN.
Amit Goyal - One of the best experts on this subject based on the ideXlab platform.
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role of routine preoperative Lymphoscintigraphy in sentinel node biopsy for breast cancer
European Journal of Cancer, 2005Co-Authors: Amit Goyal, Robert G. Newcombe, Robert E. ManselAbstract:Sentinel node biopsy (SNB) is rapidly emerging as the preferred technique for nodal staging in breast cancer. When radioactive colloid is used, a preoperative lymphoscintiscan is obtained to ease sentinel lymph node (SN) identification. This study evaluates whether preoperative Lymphoscintigraphy adds diagnostic accuracy to offset the additional time and cost required. 823 breast cancer patients underwent SNB based on Lymphoscintigraphy, intraoperative gamma probe detection, and blue dye mapping using 99 mTc-nanocolloid and Patent Blue V injected peritumourally. The SNB was followed by standard axillary treatment at the same operation. Preoperative Lymphoscintigraphy was performed around 3 h after the radioisotope injection. Preoperative Lymphoscintigraphy revealed SNs in 593 (72%) of the 823 patients imaged. SN visualisation on Lymphoscintigraphy was less successful in large tumours and tumours involving the upper outer quadrant of the breast (P=0.046, P<0.001, respectively). Lymphoscintigraphy showed internal mammary sentinel nodes in 9% (62/707) patients. The SN was identified intraoperatively in 98% (581) patients who had SN visualised on preoperative Lymphoscintigraphy, with a false-negative rate of 7%. In patients who did not have SN visualised on preoperative Lymphoscintigraphy, the SN was identified at operation in 90% (204) patients, with a false-negative rate of 7%. The SN identification rate was significantly higher in patients with SN visualised on preoperative Lymphoscintigraphy (P<0.001). SN identification rate intraoperatively using the gamma probe was significantly higher in the SN visualised group compared with the SN non-visualised group (95% vs. 68%; chi square (1 degrees of freedom (df)) P<0.001. There was no statistically significant difference in the false-negative rate and the operative time between the two groups. A mean of 2.3 (standard deviation (SD) 1.3) SNs per patient were removed in patients with SN visualised on preoperative Lymphoscintigraphy compared with 1.8 (SD 1.2) in patients with no SN visualised on Lymphoscintigraphy (P<0.001). Although SN visualisation on preoperative Lymphoscintigraphy significantly improved the intraoperative SN localisation rate, SN was successfully identified in 90% of patients with no SN visualisation on Lymphoscintigraphy. Given the time and cost required to perform routine preoperative Lymphoscintigraphy, these data suggest that it may not be necessary in all cases. It may be valuable for surgeons in the learning phase to shorten the learning curve and in patients who have increased risk of intraoperative failed localisation (obese or old patients). A negative preoperative lymphoscintiscan predicts the inability to localise with the hand-held gamma probe. Therefore, if the SN is not visualised on Lymphoscintigraphy then the addition of intraoperative blue dye is recommended to increase the likelihood of SN identification.
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sentinel lymph node biopsy in male breast cancer patients
Ejso, 2004Co-Authors: Amit Goyal, Kieran Horgan, Mark W. Kissin, Constantinos Yiangou, Mark Sibbering, Mark Lansdown, Robert G. Newcombe, Robert E. ManselAbstract:The concept of sentinel node biopsy has been validated for female breast cancer patients whereas, ALND remains the standard of care for male breast cancer patients with similar tumours. We evaluated the results of SLN biopsy in male breast cancer patients with clinically negative axillae. This study included all male breast cancer patients who underwent SLN biopsy between February 1998 and October 2003. All patients had negative axillae on clinical examination. All patients underwent pre-operative Lymphoscintigraphy. SLN biopsy was performed using a combination of Patent blue V and 99mTc-radiolabelled colloidal albumin injected peritumourally. Nine patients, 26-79 years of age, were included in the study. Pre-operative lymphoscinitgraphy identified SLNs in all patients. Intraoperatively, SLNs were successfully localised in all patients. The mean number of SLNs encountered was 2.4. Five patients had a positive SLN, four a negative SLN. Five patients (one with a negative SLN, four with a positive SLN) had been elected pre-operatively to undergo ALND regardless of findings on SLN biopsy. ALND confirmed the SLN to be negative in one patient (false-negative rate: 0%) and three of the four patients with positive SLN(s) had additional positive nodes in the axilla. SLN biopsy accurately predicted axillary lymph node status in these five patients. These findings compare favourably with findings reported in the literature regarding SLN biopsy in female breast cancer patients. SLN biopsy accurately staged the axilla in male breast cancer patients and should be considered for axillary staging in male breast cancer patients with clinically negative axillae.
Derrek A Heuveling - One of the best experts on this subject based on the ideXlab platform.
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feasibility of intraoperative detection of sentinel lymph nodes with 89 zirconium labelled nanocolloidal albumin pet ct and a handheld high energy gamma probe
EJNMMI research, 2018Co-Authors: Derrek A Heuveling, Otto S. Hoekstra, Hakki K Karagozoglu, Arthur Van Lingen, Guus A M S Van Dongen, Remco De BreeAbstract:PET/CT Lymphoscintigraphy using 89Zr-nanocolloidal albumin has the potential to improve the preoperative identification of sentinel lymph nodes (SLNs), especially if located in the near proximity of the primary tumour. This study aims to demonstrate the feasibility of PET/CT Lymphoscintigraphy followed by intraoperative detection of 89Zr-nanocolloidal albumin containing SLNs with the use of a handheld high-energy gamma probe. PET/CT Lymphoscintigraphy was performed after peritumoural injection of 89Zr-nanocolloidal albumin in five patients with oral cavity carcinoma planned for surgical resection. SLN biopsy procedure was performed 18 h later. SLNs were detected using detailed information of PET/CT and the high-energy gamma probe. In all patients, SLNs were identified on PET/CT Lymphoscintigraphy. Intraoperative detection using the high-energy gamma probe was possible in 10 of 13 SLNs, at a short distance from the SLN. This study demonstrates that intraoperative detection of SLNs containing 89Zr-nanocolloidal albumin using a handheld high-energy gamma probe is feasible, but its clinical use and sensitivity seem to be limited. CCMO NL37222.092.11
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pilot study on the feasibility of pet ct Lymphoscintigraphy with zr 89 nanocolloidal albumin for sentinel node identification in oral cancer patients
The Journal of Nuclear Medicine, 2013Co-Authors: Derrek A Heuveling, Otto S. Hoekstra, Danielle J. Vugts, N.h. Hendrikse, M. Yaqub, K.h. Karagozoglu, C.r. Leemans, A Van Schie, G A M S Van Dongen, Remco De BreeAbstract:With conventional imaging techniques such as planar Lymphoscintigraphy and SPECT/CT, preoperative sentinel node (SN) identification can be difficult when the SN is near the primary tumor, as is the case in floor-of-mouth carcinomas. PET/CT Lymphoscintigraphy may improve the detection and localization of such SNs. Methods: In this study, the clinical feasibility of PET/CT Lymphoscintigraphy using 89Zr-nanocolloidal albumin was evaluated in 5 oral cancer patients. PET/CT Lymphoscintigraphy was performed after peritumoral injection of 89Zr-nanocolloidal albumin. The routine SN procedure, including SPECT/CT using 99mTc-nanocolloidal albumin, was performed on the same patients 7-9 d after the injection of 89Zr-nanocolloidal albumin. Results: Comparison of radiocolloid distribution on PET/CT and SPECT/CT showed identical drainage patterns. Moreover, PET/CT was able to identify additional foci near the primary tumor. Conclusion: This pilot PET/CT study on SN detection indicated that Lymphoscintigraphy using 89Zr-nanocolloidal albumin is feasible.
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Pilot study on the feasibility of PET/CT Lymphoscintigraphy with Zr-89-nanocolloidal albumin for sentinel node identification in oral cancer patients
The Journal of Nuclear Medicine, 2013Co-Authors: Derrek A Heuveling, Otto S. Hoekstra, Guus A M S Van Dongen, A. Van Schie, Danielle J. Vugts, N.h. Hendrikse, M. Yaqub, K.h. Karagozoglu, C.r. Leemans, Remco De BreeAbstract:With conventional imaging techniques such as planar Lymphoscintigraphy and SPECT/CT, preoperative sentinel node (SN) identification can be difficult when the SN is near the primary tumor, as is the case in floor-of-mouth carcinomas. PET/CT Lymphoscintigraphy may improve the detection and localization of such SNs. Methods: In this study, the clinical feasibility of PET/CT Lymphoscintigraphy using 89Zr-nanocolloidal albumin was evaluated in 5 oral cancer patients. PET/CT Lymphoscintigraphy was performed after peritumoral injection of 89Zr-nanocolloidal albumin. The routine SN procedure, including SPECT/CT using 99mTc-nanocolloidal albumin, was performed on the same patients 7-9 d after the injection of 89Zr-nanocolloidal albumin. Results: Comparison of radiocolloid distribution on PET/CT and SPECT/CT showed identical drainage patterns. Moreover, PET/CT was able to identify additional foci near the primary tumor. Conclusion: This pilot PET/CT study on SN detection indicated that Lymphoscintigraphy using 89Zr-nanocolloidal albumin is feasible.
