Detection of the sentinel lymph node with hybrid tracer (ICG-[99mTc]Tc-albumin nanocolloid) in intermediate- and high-risk endometrial cancer: a feasibility study

EJNMMI Research

Federico Migliorelli¹  Sergi Vidal-Sicart²  Francisco Campos²  Pilar Paredes²  Nuria Sánchez-Izquierdo²  Andrés Perissinotti²  Jaume Ordi³  Adela Saco³  Aureli Torné⁴  Berta Diaz-Feijoo⁴  Meritxell Munmany⁴  Martina Aida Angeles⁴  Marta del Pino⁴  Ariel Glickman⁴ 

[1] Department of Gynecology and Obstetrics, Centre Hospitalier Intercommunal des Vallées de l’Ariège;Department of Nuclear Medicine, Hospital Clínic of Barcelona;Department of Pathology, Hospital Clínic of Barcelona;Institute Clinic of Gynecology, Obstetrics, and Neonatology, Hospital Clínic of Barcelona;

关键词: Hybrid tracer (ICG-[99mTc]Tc-albumin nanocolloid);    Sentinel lymph node;    Endometrial cancer;    Lymphatic mapping;    Radiotracer;    ICG;   

DOI  :  10.1186/s13550-021-00863-x

来源: DOAJ

【 摘 要 】

Abstract Purpose Indocyanine green (ICG) is frequently used for the detection of the sentinel lymph node (SLN) in gynecology, but it carries the loss of the presurgical SLN mapping provided by [99mTc]-based colloids. Hybrid tracers such as ICG-[99mTc]Tc-albumin nanocolloid combine the benefits of both components. The aim of this study was to evaluate the feasibility and applicability of this hybrid tracer injected by transvaginal ultrasound-guided myometrial injection of radiotracer (TUMIR) approach in the detection of SLNs in patients with intermediate- and high-risk EC. Methods Fifty-two patients with intermediate- and high-risk EC underwent SLN biopsy after injection of a hybrid tracer using the TUMIR approach, followed by pelvic and paraaortic lymphadenectomy. SLNs were detected preoperatively by lymphoscintigraphic study and intraoperatively by gamma probe and near-infrared (NIR) optical laparoscopic camera. Results Preoperative lymphatic drainage was obtained in 69% and intraoperative detection in 71.4% of patients. A total of 146 SLNs (4.17 SLNs/patient) were biopsied. Pelvic bilateral detection was observed in 57% of the women and paraaortic drainage in 34% of the patients. The radioactive component allowed the detection of SLN in 97.1% of the patients, while the fluorescent component detected 80%. In more than 17% of the patients with intraoperative detection, SLNs were detected only by the radioactive signal. Lymph node metastasis was identified in 14.3% of patients submitted to SLNB. The sensitivity and negative predictive value for metastatic involvement were 100%. Conclusion TUMIR injection of a hybrid tracer in patients with intermediate- and high-risk EC combines the benefits of the radiotracer and the fluorescence methods with a single tracer. The method increases the paraaortic detection rate and allows a potential increase in SLN detection. Notwithstanding, based on our findings, the radioactive component of the hybrid tracer cannot be obviated.

【 授权许可】

Unknown