Sentinel Lymph Node Detection Research Articles

Prospective evaluation of MRI artefacts following breast conserving surgery and sentinel lymph node dissection with the magnetic technique

IntroductionSuperparamagnetic Iron Oxide (SPIO) nanoparticles serve as a promising tracer for sentinel lymph node (SLN) detection in breast cancer. Concerns exist regarding artefacts on postoperative Magnetic Resonance Imaging (MRI), especially following breast conservation (BCS). Materials and methodsIn this prospective observational study, 97 women with DCIS or invasive breast cancer underwent BCS and SLN detection with peritumoral SPIO injection administered up to four weeks before surgery. Postoperatively, patients were followed with MRI and mammograms, and imaging outcomes were evaluated by four, independent breast radiologists, blinded to clinical data, using a predefined, standardized questionnaire. ResultsIn 97 patients included, there was inter-rater discordance in the prevalence of “any artefact” (range: 24.1–74.4 %; weighted average: 32.4 %) and “SPIO specific artefact” (range: 12.0–49.4 %; weighted average: 20.9 %). The median area of “any artefact” was 9.24 cm2 (iqr 4.72, 15.50) and SPIO specific artefact 9.88 (iqr 5.32, 15.5). Likert scores indicated higher difficulty interpreting MRI if artefacts were present (OR: 2.295, 95 % CI 1.028, 5.123; p = 0.043), but this was reduced if intravenous contrast was administered (OR: 0.177, 95 % CI 0.091, 0.342; p < 0.001). Multivariable analysis identified free-hand SPIO administration as a risk factor (OR 8.929, 95 % CI 2.849, 27.778; p < 0.001). All six patients with local recurrence were successfully diagnosed on MRI by all raters. ConclusionThis prospective cohort study suggests that a targeted peritumoral SPIO injection can result in the removal of SPIO during lumpectomy and address the concerns for artefacts on postoperative MRI follow-up, in the selected patients that MRI may be warranted.

Análisis de ganglios coincidentes con SentiMag® y técnica estándar en la BSGC del cáncer de mama

IntroductionIn breast cancer surgery, there are techniques for sentinel lymph node biopsy (SLNB) that do not require nuclear medicine, such as SentiMag®, which uses ferromagnetic particles. The main purpose of this analysis is to study the degree of concordance in SLNB between SentiMag® and the standard method (Tc99 radiotracer). The secondary objective is to identify factors that impact in sentinel node detection rate and matching detection rate between both probes. MethodsObservational and retrospective study performed from January to December 2021 focused on patients undergoing breast surgery and SLNB who were injected with both tracers, the ferromagnetic SentiMag® and Tc99 radiotracer. Once the diagnostic accuracy tests were performed, a further evaluation of the detection rate for each probe and the concordance between probes were accomplished. After those results, a deeper analysis of differences in detection rates for each probe and concordance between probes were assessed for various factors: neoadjuvant therapy, BMI, mitotic index, and triple-negative immunohistochemical profile. ResultsThe clinical study had a sample size of 70 patients. The overall false-negative rate (FNR) was 4.3%. The detection rate was the same for each technique (85.7%). A total of 106 nodes were biopsied, with a concordance rate of 70.75%. Significant differences were found in concordant nodes according to neoadjuvant therapy (p-value 0.012). For the Ki-67 factor (<20 or ≥20), significant differences were found in detected nodes (p-value 0.031 gamma probe; p-value 0.124 SentiMag®). ConclusionsThe detection rates of SentiMag® and the gamma probe are equivalent. The application of the dual technique minimizes the FNR. A high mitotic index affects the detection rate of the gamma probe, and neoadjuvant therapy negatively impacts the concordance rate.

Analysis of Predictive Factors Associated with Unsuccessful Sentinel Lymph Node Mapping in Endometrial Carcinoma.

Sentinel lymph node (SLN) biopsy is recommended over systematic lymphadenectomy in early-stage endometrial cancer due to its lower morbidity and comparable detection rate. The objective of this study was to identify clinical factors associated with unsuccessful mapping. Between April 2020 and June 2024, 120 patients over the age of 18 and diagnosed with early-stage endometrial cancer were enrolled in this prospective study at a single institution. Demographic, clinicopathologic, and treatment data were collected and analyzed using descriptive statistics. Univariate and multiple linear regressions were performed to identify predictors of failed mapping. The mean age of the patient cohort was 62.5 years (range 33 to 83), and the mean body mass index (BMI) was 32 kg/m2 (range 18 to 50). Patients underwent intracervical injections with methylene blue (MB), indocyanine green (ICG), or a combination of both tracers, with 40 patients in each group. A total of 108 patients (90.0%) were diagnosed with endometrioid carcinoma and 12 (10.0%) with non-endometrioid cancers. Additionally, 110 patients (91.7%) were diagnosed in early stages of the disease. The overall SLN detection rate was 73.4%, with bilateral detection at 49.2% and unilateral detection at 24.2%. Univariate analysis showed that older age (p < 0.001), menopause (p = 0.001), the use of MB as the sole tracer (p = 0.006), a shorter tumor-to-serosa distance (p = 0.048), and bulky lymph nodes (p = 0.18) were associated with unsuccessful mapping. Multiple linear regression model analysis identified age (p = 0.007), tracer type (p = 0.013), and enlarged lymph nodes (p = 0.013) as independent predictors of SLN mapping failure. Advanced age, tracer type, and intraoperative detection of enlarged lymph nodes were identified as independent risk factors for unsuccessful mapping in patients undergoing laparoscopic SLN mapping.

Match detection analysis on SentiMag® system and standard technique in SLNB of breast cancer

IntroductionIn breast cancer surgery, there are techniques for sentinel lymph node biopsy (SLNB) that do not require Nuclear Medicine, such SentiMag®, which uses ferromagnetic particles. The main purpose of this analysis is to study the degree of concordance in SLNB between SentiMag® and the standard method (Tc99 radiotracer). The secondary objective is to identify factors that impact in sentinel node detection rate and matching detection rate between both probes. MethodsObservational and retrospective study performed from January to December 2021 focused on patients undergoing breast surgery and SLNB who were injected with both tracers, the ferromagnetic SentiMag® and Tc99 radiotracer. Once the diagnostic accuracy tests were performed, a further evaluation of the detection rate for each probe and the concordance between probes were accomplished. After those results, a deeper analysis of differences in detection rates for each probe and concordance between probes were assessed for various factors: neoadjuvant therapy, BMI, mitotic index, and triple-negative immunohistochemical profile. ResultsThe clinical study had a sample size of 70 patients. The overall false-negative rate (FNR) was 4.3%. The detection rate was the same for each technique (85.7%). A total of 106 nodes were biopsied, with a concordance rate of 70.75%. Significant differences were found in concordant nodes according to neoadjuvant therapy (p-value 0.012). For the Ki-67 factor (<20 or ≥20), significant differences were found in detected nodes (p-value 0.031 gamma probe; p-value 0.124 SentiMag®). ConclusionsThe detection rates of SentiMag® and the gamma probe are equivalent. The application of the dual technique minimizes the FNR. A high mitotic index affects the detection rate of the gamma probe, and neoadjuvant therapy negatively impacts the concordance rate.

Key issues in diagnostic accuracy of sentinel lymph node biopsy in early-stage ovarian cancer: systematic review and meta-analysis

ObjectiveSentinel lymph node (SLN) mapping may reduce the morbidity of lymphadenectomy while maintaining diagnostic accuracy. Nevertheless, SLN mapping in epithelial ovarian cancer is still under investigation. This systematic review and...

Using express cytological method for diagnosis of sentinel lymph nodes in breast cancer patients

Objective: to assess the informativity of the use of the rapid cytological method in the study of sentinel lymph nodes in patients with breast cancer. Material and methods. The study involved 46 patients from 30 to 85 years old with verified breast cancer. On the eve of the operation, about 150-200 MBq of the 99 mTc-Nanotope radiopharma-ceutical was peritumorally injected into the parenchyma of the affected mammary gland. After 1.5-2 hours, lymphos-cintigraphy was performed, followed by SPECT/CT, in which sentinel lymph nodes are zualized. The next day after the administration of the radiopharmaceutical, during surgery, sentinel lymph nodes were found using a g-detector. Further, the surgeon removed the node (or nodes) and sent them for express cytological examination. To check the informativity of this method, a comparison was made with the "gold standard" of morphological diagnostics — with histological examination of postoperative material. Results. An express cytological study revealed the presence of metastases in the sentinel lymph nodes in 12 patients, which significantly influenced the further tactics. It was found that the cytological method of the study is not inferior to the histological one, the sensitivity and specificity of the method is 100%. When comparing the results of rapid cytological and planned histological studies, there were no discrepancies in diagnoses by the state of the lymph nodes. Conclusion. Rapid cytological examination of sentinel limphatic nodes informative method for sentinel lymph node detection in breast cancer patients.

Indocyanine green and methylene blue dye guided sentinel lymph node biopsy in patients with penile cancer (PeCa): results of 50 inguinal basins assessed at a single institution in India.

The primary aim of this study was to validate the reliability, sensitivity and safety profile of novel combination of ICG- methylene blue dye as an SN tracer for PeCa. This is a validation and non-randomised prospective observational study involving 25 patients (50 inguinal basins) who underwent SLNB where in ICG and methylene blue were used for localisation. The patients with clinically node negative groins were recruited in the study. SNs were identified intraoperatively using near infrared fluorescence imaging (NIRF Imaging system, SPY-PHI, Stryker, Sweden) and blue dye. The numbers of SNs identified by each tracer and the rates of complications and nodal recurrence during the followup. Overall 137 SNs were identified intraoperatively. Among the 137 SNs excised fluorescence, blue dye and Combined (blue + green) identified 57(41.6%), 27 (19.7%), and 51 (37.2%), respectively. The average number of SLNs removed per patient was 5 (range, 1-11) with sentinel lymph nodes detection rate at 94% (47/50). Seven patients had malignancy on SLNB and underwent ipsilateral radical inguinal lymphadenectomy. One patient had false negative SN and positive node in modified inguinal lymphadenectomy specimen. No adverse events were observed in all cases. The Novel combination of ICG fluorescence-Methylene blue dye technique is simple, reliable and safe. Moreover, it demonstrates a high SLN detection rate with a low false-negative rate, and it avoids radiation exposure.

Optimizing the Sensitivity of a Pelvic Sentinel Node Algorithm Requires a Hybrid Algorithm Combining Indocyanine Green Based Mapping and the Removal of Non-Mapped Nodes at Defined Anatomic Positions.

to investigate the incidence of non-mapped isolated metastatic pelvic lymph nodes at pre-defined anatomical positions. Between June 2019 and January 2024, women with uterine-confined endometrial cancer (EC) deemed suitable for robotic surgery and the detection of pelvic sentinel nodes (SLNs) were included. An anatomically based, published algorithm utilizing indocyanine green (ICG) as a tracer was adhered to. In women where no ICG mapping occurred in either the proximal obturator and/or the interiliac positions, defined as "typical positions", those nodes were removed and designated as "SLN anatomy". Ultrastaging and immunohistochemistry were applied to all SLNs. The proportion of isolated metastatic "SLN anatomy" was evaluated. A non-mapping of either the obturator or interiliac area occurred in 180 of the 620 women (29%). In total, 114 women (18.4%) were node-positive and five of these women (4.3%) had isolated metastases in an "SLN anatomy", suggesting a similar lower sensitivity of the ICG-only algorithm. In an optimized SLN algorithm for endometrial cancer, to avoid undetected nodal metastases in 4.3% of node-positive women, if mapping fails in either the proximal obturator or interiliac area, nodes should be removed from those defined anatomic positions, despite mapping at other positions.

VNOTES scarless and painless endometrial cancer staging surgery.

Sentinel lymph node dissection is performed in endometrial cancer surgery instead of staging surgery, particularly when the disease is advanced and confined to the uterus. The aim of this study is to share our sentinel lymph node detection rates via the vaginal natural orifice transluminal endoscopic surgery method with the literature and to demonstrate a safer and more comfortable surgical treatment process. The analysis includes the patients who underwent surgery sentinel lymph node dissection for endometrial cancer utilizing indociyanin green in our center between January 2022 and June 2024. In all, of 24 endometrial cancer patients underwent surgery sentinel lymph node dissection, nonendometrioid (serous) pathology was observed in only 1 (4%) patient, our other patients (96%) had endometrioid adenocarcinoma pathology. The rates of our sentinel lymph node dissection bilateral and symmetric are 96% (23/24), 94% (22/24), and 79% (19/24), respectively. We would like to emphasize that we successfully used vaginal natural orifice transluminal endoscopic surgery approach on four of our patients who were unsuitable for laparoscopic and robotic surgery due to pain scores of 2 at the 12th hour after surgery and low lung capacity. Vaginal natural orifice transluminal endoscopic surgery and sentinel lymph node dissection will be considered as surgical options in other gynecological cancers due to the comfort it brings to the patient in endometrial cancer.

ThP1.2 - Management of breast cancer sentinel lymph node macrometastasis in the axilla; audit of current unit practice and evaluation of factors that influence patient management

Abstract Aims Detection of sentinel lymph node (SLN) macrometastasis for breast cancer no longer mandates further axillary surgery. Association of Breast Surgery (ABS) guideline provides recommendation to optimise patient management. It also acknowledges management uncertainties in specific patient groups. We aimed to examine our unit practice against national guideline and evaluate potential factors that influence axillary management. Methods Retrospective analysis of prospectively maintained electronic database determined clinico-pathological characteristics on patients diagnosed with SLN macrometastasis (n=127) at the Leeds Breast Unit (2020-2022). Axillary management was compared against ABS guideline. Results 56 (44.1%) received completion axillary node clearance (cANC), 37 (29.1%) axillary radiotherapy (aRT), and 34 (26.8%) no further axillary treatment. 80.3% had one macrometastasis. As per guideline, all patients who had &amp;gt;3 macrometastasis (n=10) underwent cANC. Type of breast surgery (mastectomy vs. breast conserving surgery; BCS) did not affect further axillary treatment rate (76.7% vs. 70.1%). Type of further axillary treatment varied with cANC commonest for mastectomy patients (78.3%) and aRT commonest for BCS patients (57.4%). In contrast to the guideline, 58% of post-menopausal BCS patients with ER+HER2- T1 tumours (n=12) received further axillary treatment. Where guideline stated management uncertainty, further axillary treatment was frequent; pre-menopausal patients (82%), T2 tumours (73%), lymphovascular invasion (74%), and extranodal spread (77%). Conclusion Our unit’s SLN macrometastasis management is mostly in line with national guideline but further work is required to avoid overtreatment. Where management uncertainty exists, patients commonly received further axillary treatment. Further research is required in these patient groups to optimise axillary management.

SP6.1 - Use of Endomag (Magseed® and Magtrace®): our initial experience at Midyorks trust

Abstract Introduction WLE is a cornerstone in breast surgery post MILAN trail. Breast lesions undergo wire guided localisation. Drawbacks are scheduling, patient dissatisfaction, wire movement and discomfort, SLNB: Combined technique. Radioactive (TcM99m) labelled nanocolloid and 2mls of diluted Patent V blue dye. NEWSTART and ALMANAC, largest UK SLNB datasets- 1% allergy rate Whereas in endomag, Magseed® Marker- Tiny Magnetic seed Less intrusive than guide-wire- flexible and precise. Can be inserted anytime before surgery. Only becomes detectable when Sentimag Probe passes over it. Magtrace® Lymphatic Tracer Non radioactive and non toxic- safer compared to blue-dye Can be injected up to 28 days prior to surgery. Aim Demonstrate the feasibility of Magseed® marker localisation and Magtrace® tracer injection for breast lesions and sentinel lymph nodes in our unit. Methods All patients who underwent breast WLE from 12/21 to 03/22 using endomag. Sample size identified 63 Total number of procedures: 64 Diagnostic excisions 8 WLE 16 WLE and SNB 39 WLE and ANC 1 Technique of magseed insertion: Stereo 41, U/S 22. Eight patients had clear margin after second surgery One patient needed third surger Magseed not retrieved in original specimen but retrieved via intra-operative shave during same surgery: 4/ 64 (6.25%) Magseed not retrieved during surgery: 3/ 64 (4.68%) Two patients required redo surgery and one completion mastectomy.Magtrace Tracer Failed SNB requiring sampling: 7 / 39 (17.9%). Conclusion Endomag is safe and accurate with comparable surgical endpoints (margins) to traditional localisation. With time (learning curve) intra-operative magseed localisation and sentinel node detection will improve.

Impact of Indocyanine Green Dose on Sentinel Lymph Node Mapping in Cervical Cancer: A Systematic Review.

Over the past decade, SLN mapping has become increasingly important in cervical cancer surgery. ICG is the most commonly used tracer due to its high bilateral detection rates, ease of use, and safety. However, there is no consensus on the optimal ICG dose, leading to variability in outcomes. This systematic review aims to evaluate the impact of different ICG doses on SLN detection in early-stage cervical cancer, identifying the most effective and safe dose for clinical practice. A comprehensive search was conducted in MEDLINE/PubMed up to May 2024. Studies included assessed SLN mapping using ICG in stage IA2-IIA/IIB cervical cancer. Exclusions were applied to studies not reporting ICG dose or using multiple tracers without dose-specific results. Twelve studies were included, with ICG concentrations ranging from 0.25 mg/mL to 25 mg/mL and injection volumes from 1 to 10 mL. Overall SLN detection rates ranged from 88% to 100%, while bilateral detection rates varied between 74.1% and 98.5%. The most consistent results were obtained with an ICG concentration of 1.25 mg/mL and a 4 mL injection volume. In conclusion, an ICG concentration of 1.25 mg/mL with a 4 mL injection volume is recommended for effective SLN mapping in cervical cancer, achieving high detection rates with minimal variability. Standardizing this dose in clinical practice is suggested to improve reproducibility and outcomes.

Topography and Lateralization of Nodal Metastases in Muscle-Invasive Bladder Cancer Using Super-Extended Pelvic Lymph Node Dissection with the Sentinel Lymph Node Technique.

Background: This study assessed the topography and lateralization of lymph node (LN) metastases in muscle-invasive bladder cancer (MIBC) patients using super-extended pelvic lymph node dissection (sePLND) with sentinel lymph node dissection (SLND). Methods: We analyzed 54 MIBC patients who underwent cystectomy with sePLND and SLND. Tumor location was classified using cystoscopy. Nanocolloid-Tc-99m was injected peritumorally. Preoperative SPECT/CT lymphoscintigraphy and an intraoperative gamma probe were used for SLN detection. Results: A total of 1414 LNs, including 192 SLNs, were resected from 54 patients. Metastases were found in 72 LNs from 22 patients (41%). The obturator fossa was the primary site for LN metastases (37.5%). SLNs were most common in the external iliac region (34.4%). In 36% of the patients with positive LNs, metastases were identified only through sePLND. In 9% of the patients, metastases were found solely in the pararectal region, identified through SLND. Tumor lateralization correlated with ipsilateral positive LNs, but 20% of the patients had contralateral metastases. Conclusions: The pararectal region may be the exclusive site for positive LNs in MIBC. The obturator fossa is the most prevalent region for LN metastases. Unilateral PLND should be avoided due to the risk of contralateral metastases. Combining sePLND with SLND improves staging.

Survival Impact of Sentinel Lymph Node Biopsy in Patients with Early-Stage Cervical Cancer.

To assess whether there were statistically significant differences in terms of overall survival (OS) and progression-free survival (PFS) between pelvic lymphadenectomy (PL) and sentinel lymph node biopsy (SLNB) alone as a nodal assessment method in patients with early-stage cervical cancer (IA1 with ILV to IB2 or IIA1 of the FIGO 2018 classification). A retrospective study was conducted among patients with early-stage cervical cancer who underwent radical surgery with pelvic lymph node assessment at La Paz University Hospital between 2005 and 2022. For nodal staging, either PL, SLNB + PL, or exclusive SLNB were performed, depending on the time period. Kaplan-Meier survival curves were compared between the PL and SLNB groups. Predictors of bilateral sentinel lymph node (SLN) detection were identified with Cox proportional hazard models. Among the 128 patients included, PL ± SLNB was performed in 79 (61.7%) patients and exclusive SLNB in 49 (38.3%) patients. There was no difference between PL and SLNB in OS (log-rank 0.0730) or PFS (log-rank 0.0189). Lower limb lymphedema (LLL) was significantly lower in the SLNB group (p = 0.001). Pelvic nodal assessment with SLNB alone did not worsen survival rates compared with the standard PL in patients with early-stage cervical cancer, and it is associated with a lower rate of LLL.

Comparison of different tracers in sentinel lymph node detection for endometrial cancer: A systematic review and network meta-analysis.

In the realm of endometrial cancer (EC) therapeutics and prognostic assessments, lymph nodes' status is paramount. The sentinel lymph node (SLN) detection, recognized for its reliability, has been progressively adopted as a standard procedure, posing a compelling alternative to conventional systematic lymphadenectomy. However, there remains a lack of agreement on the most effective choice of tracers for this procedure. This investigation was dedicated to a comparative analysis of various tracers to identify the most effective combination that achieves the highest detection rate. This endeavor sought to enhance the efficacy of SLN biopsy in the surgical management of EC. A systematic review was conducted across multiple databases, including the Cochrane Central Register of Controlled Trials, PubMed, Web of Science, Embase, and clinicaltrials.gov, to analyze studies employing different tracers for SLN biopsy during surgery in EC. Using Bayesian network meta-analysis, we compared the total and bilateral detection rates of various tracers. After screening 1431 articles, 11 studies including 2699 participants were selected in this network meta-analysis. The combination of radioactive isotopes and indocyanine green (ICG) emerged as the most efficacious method in total and bilateral detection rates, with the Surface Under the Cumulative Ranking Curve (SUCRA) scores of 80.00% and 86.36%, respectively. Additionally, carbon nanoparticles (CNPs) demonstrated superior performance in the detection of para-aortic lymph nodes with an SUCRA score of 97.77%. Network meta-analysis shows that the application of radioactive isotopes and ICG is the optimal tracer combination for SLN biopsy during surgery in EC.

Feasibility and Efficacy of Sentinel Lymph Node Mapping in Gastric Cancer.

Lymph node metastasis is a critical prognostic factor for patients with gastric carcinoma (GC). Sentinel lymph node (SLN) mapping has the potential to identify the initial site of draining lymph node metastasis and reduce the extent of surgical lymphadenectomy. This study aimed to evaluate the diagnostic accuracy of SLN mapping in GC. The study enrolled 129 GC patients undergoing total or partial gastrectomy with D2 lymphadenectomy and indocyanine green fluorescence-guided SLN mapping. The primary outcomes were the negative predictive value (NPV) and sensitivity of SLN mapping. The secondary outcomes were clinicopathologic factors associated with SLN mapping accuracy and successful SLN mapping. The SLN detection rate in this study was 86.8 %. The study had an overall NPV of 83.1 % and an overall sensitivity of 65.8 %. The NPV was found to be significantly higher in the patients with no lymphovascular invasion (LVI) than in those with LVI (96.0 % vs 59.3 %; p < 0.001) and in the patients whose pathologic T (pT) stage lower than 3 than in those whose T stage was 3 or higher (92.0 % vs 66.7 %; p = 0.009). The sensitivity of SLN mapping was 50 % in the patients with no LVI and 33 % in the patients with a pT stage lower than 3. The study results showed that for patients with early-stage GC with no LVI, negative SLN findings may represent a potential additive predictor indicating the absence of regional LN metastasis. However, given the low sensitivity rates noted, further research is needed to identify specific patient populations that may benefit from SLN mapping in GC.

Transcutaneous sentinel lymph node detection in skin melanoma with near-infrared fluorescence imaging using indocyanine green.

The aim of the study is to assess whether indocyanine green (ICG) fluorescence can replace technetium in the preoperative detection of sentinel lymph nodes (SLN) from cutaneous melanoma. The current golden standard for SLN detection is the radioisotope technetium. A promising alternative is fluorescence imaging (FLI) using ICG. In this study, we enrolled patients undergoing sentinel lymph node biopsy (SLNB) for skin melanoma at the Erasmus Medical Center between November 2022 and July 2023. The SLNB procedure was performed as a standard of care. After general anesthesia, ICG was injected intradermally around the primary tumor site. Both the patient and the surgeon were not blinded for the location of the SLN. FLI was performed before incision, in vivo after incision, and ex vivo. Fluorescent SLNs were confirmed using the gamma probe in all cases. Thirty-two patients were included in this study, and a total of 39 SLNs were harvested. The transcutaneous detection rate of ICG was 21.9%. The combined ex vivo ICG fluorescence and technetium uptake was 94.9%. One SLN contained only ICG (2.6%) and one SLN contained only technetium-uptake (2.6%). FLI using ICG resulted in a relatively low transcutaneous detection, which means that exclusive use of this technique in its present form is not feasible. However, we did find a high accumulation of ICG in the SLN, indicating the potential of ICG in combination with other imaging techniques.

71288 - Sentinel lymph node detection with an ultra-low dose of superparamagnetic iron oxide nanoparticles in patients with breast cancer

71288 - Sentinel lymph node detection with an ultra-low dose of superparamagnetic iron oxide nanoparticles in patients with breast cancer

The clinical value of carbon nanoparticles in sentinel lymph node biopsy for early vulvar cancer

ObjectiveCarbon nanoparticle (CNP)-guided sentinel lymph node biopsy (SLNB) has been extensively adopted as a cost-effective and highly efficient method for tracing malignant tumors except for those associated with vulvar cancer. The current study aimed to validate the feasibility and efficacy of CNPs in tracking sentinel lymph nodes (SLNs) in patients with early vulvar cancer. MethodsWe retrospectively reviewed patients with vulvar cancer at our institution from January 2016 to April 2022 who were pathologically diagnosed and underwent SLNB or inguinofemoral lymphadenectomy (IFLND). CNPs were the only lymphatic tracer used in SLNB. Patient demographics, perioperative outcomes and follow-up results, including overall survival (OS) and progression-free survival (PFS), were compared between the SLNB and IFLND groups. ResultsData from 52 patients were collected and investigated. Forty groins of 22 patients who underwent SLNB with CNP tracing were included. Black-stained SLNs were detected in 32 groins of 19 patients, and the rates of CNP detection by patient and by groin were 86.4 % and 80 %, respectively. Patients who underwent SLNB had better perioperative outcomes than those who underwent IFLND in certain aspects (groin drainage rate: 41.2 % and 80 %, respectively, p < 0.05; daily drainage volume (ml): 12.49 and 36.4, respectively, p < 0.05; and inguinal wound healing rate: 100 % and 80 %, respectively, p < 0.05). The results of survival analysis indicated similar prognoses for node-negative patients who underwent CNP-guided SLNB or IFLND. ConclusionsSentinel lymph node mapping with CNPs in vulvar cancer is feasible and demonstrates considerable biosecurity. With a satisfactory SLN detection rate achieved expediently, CNPs are a promising lymphatic tracer worthy of further utilization in vulvar cancer and could be an alternative option to canonical tracers.

72197 - Evaluating MRI artefacts and skin discoloration using an intradermal ultra-low dose of superparamagnetic iron oxide for sentinel lymph node detection

72197 - Evaluating MRI artefacts and skin discoloration using an intradermal ultra-low dose of superparamagnetic iron oxide for sentinel lymph node detection