TY - JOUR
T1 - Sentinel lymph node mapping with superparamagnetic iron oxide for melanoma
T2 - a pilot study in healthy participants to establish an optimal MRI workflow protocol
AU - Aldenhoven, Loeki
AU - Frotscher, Caroline
AU - Körver-Steeman, Rachelle
AU - Martens, Milou H
AU - Kuburic, Damir
AU - Janssen, Alfred
AU - Beets, Geerard L
AU - van Bastelaar, James
N1 - © 2022. The Author(s).
PY - 2022/10/14
Y1 - 2022/10/14
N2 - 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.
AB - 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.
KW - Humans
KW - Ferric Compounds
KW - Healthy Volunteers
KW - Lymph Nodes/pathology
KW - Magnetic Iron Oxide Nanoparticles
KW - Magnetic Resonance Imaging
KW - Melanoma/diagnostic imaging
KW - Pilot Projects
KW - Prospective Studies
KW - Sentinel Lymph Node/diagnostic imaging
KW - Sentinel Lymph Node Biopsy/methods
KW - Workflow
U2 - 10.1186/s12885-022-10146-w
DO - 10.1186/s12885-022-10146-w
M3 - Article
C2 - 36241982
SN - 1471-2407
VL - 22
JO - BMC Cancer
JF - BMC Cancer
IS - 1
M1 - 1062
ER -