Sentinel lymph node detection in oral cancer: a within-patient comparison between [<sup>99m</sup>Tc]Tc-tilmanocept and [<sup>99m</sup>Tc]Tc-nanocolloid.
prospective_cohort · Level II
Where this comes from
- Record sourced from PubMed, PMID 32839855.
- Also identified by DOI 10.1007/s00259-020-04984-8 and PMC identifier 8036184.
- Licence recorded as CC BY.
- The licence permits redistribution, so the abstract is shown in full and the full text is available from the publisher.
Abstract
Sentinel lymph node (SLN) biopsy has proven to reliably stage the clinically negative neck in early-stage oral squamous cell carcinoma (OSCC). [<sup>99m</sup>Tc]Tc-tilmanocept may be of benefit in OSCC with complex lymphatic drainage patterns and close spatial relation to SLNs. A prospective within-patient evaluation study was designed to compare [<sup>99m</sup>Tc]Tc-tilmanocept with [<sup>99m</sup>Tc]Tc-nanocolloid for SLN detection. A total of 20 patients with early-stage OSCC were included, who underwent lymphoscintigraphy with both tracers. Both lymphoscintigraphic images of each patient were evaluated for SLN detection and radiotracer distribution at 2-4 h post-injection. The injection site's remaining radioactivity was significantly lower for [<sup>99m</sup>Tc]Tc-tilmanocept (29.9%), compared with [<sup>99m</sup>Tc]Tc-nanocolloid (60.9%; p < 0.001). Radioactive uptake in SLNs was significantly lower for [<sup>99m</sup>Tc]Tc-tilmanocept (1.95%) compared with [<sup>99m</sup>Tc]Tc-nanocolloid (3.16%; p = 0.010). No significant difference was seen in SLN to injection site ratio in radioactivity between [<sup>99m</sup>Tc]Tc-tilmanocept (0.066) and [<sup>99m</sup>Tc]Tc-nanocolloid (0.054; p = 0.232). A median of 3.0 and 2.5 SLNs were identified with [<sup>99m</sup>Tc]Tc-tilmanocept and [<sup>99m</sup>Tc]Tc-nanocolloid, respectively (p = 0.297). Radioactive uptake in higher echelon nodes was not significantly different between [<sup>99m</sup>Tc]Tc-tilmanocept (0.57%) and [<sup>99m</sup>Tc]Tc-nanocolloid (0.86%) (p = 0.052). A median of 2.0 and 2.5 higher echelon nodes was identified with [<sup>99m</sup>Tc]Tc-tilmanocept and [<sup>99m</sup>Tc]Tc-nanocolloid, respectively (p = 0.083). [<sup>99m</sup>Tc]Tc-tilmanocept had a higher injection site clearance, but at the same time a lower uptake in the SLN, resulting in an SLN to injection site ratio, which was not significantly different from [<sup>99m</sup>Tc]Tc-nanocolloid. The relatively low-radioactive uptake in SLNs of [<sup>99m</sup>Tc]Tc-tilmanocept may limit intraoperative detection of SLNs, but can be overcome by a higher injection dose.
Medical subject headings
- Carcinoma, Squamous Cell
- Mouth Neoplasms
- Sentinel Lymph Node