Sentinel lymph node mapping with superparamagnetic iron oxide for melanoma: a pilot study in healthy participants to establish an optimal MRI workflow protocol

Loeki Aldenhoven*, Caroline Frotscher, Rachelle Körver-Steeman, Milou H Martens, Damir Kuburic, Alfred Janssen, Geerard L Beets, James van Bastelaar

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: Current pre-operative Sentinel Lymph Node (SLN) mapping using dual tracing is associated with drawbacks (radiation exposure, logistic challenges). Superparamagnetic iron oxide (SPIO) is a non-inferior alternative for SLN mapping in breast cancer patients. Limited research has been performed on SPIO use and pre-operative MRI in melanoma patients to identify SLNs. METHODS: Healthy participants underwent MRI-scanning pre- and post SPIO-injection during 20 min. Workflow protocols varied in dosage, massage duration, route of administration and injection sites. The first lymph node showing a susceptibility artefact caused by SPIO accumulation was considered as SLN.

RESULTS: Artefacts were identified in 5/6 participants. Two participants received a 0.5 ml subcutaneous injection and 30-s massage, of which one showed an artefact after one hour. Four participants received a 1.0 ml intracutaneous injection and two-minute massage, leading to artefacts in all participants. All SLNs were observed within five minutes, except after lower limb injection (30 min).

CONCLUSION: SPIO and pre-operative MRI-scanning seems to be a promising alternative for SLN visualization in melanoma patients. An intracutaneous injection of 1.0 ml SPIO tracer, followed by a two-minute massage seems to be the most effective technique, simplifying the pre-operative pathway. Result will be used in a larger prospective study with melanoma patients.

TRIAL REGISTRATION: ClinicalTrials.gov (NCT05054062) - September 9, 2021.

Original languageEnglish
Article number1062
JournalBMC Cancer
Volume22
Issue number1
DOIs
Publication statusPublished - 14 Oct 2022

Keywords

  • Humans
  • Ferric Compounds
  • Healthy Volunteers
  • Lymph Nodes/pathology
  • Magnetic Iron Oxide Nanoparticles
  • Magnetic Resonance Imaging
  • Melanoma/diagnostic imaging
  • Pilot Projects
  • Prospective Studies
  • Sentinel Lymph Node/diagnostic imaging
  • Sentinel Lymph Node Biopsy/methods
  • Workflow

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