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European Journal of Nuclear Medicine and Molecular Imaging

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Open Access 01-03-2021 | Oral Cancer | Original Article

Sentinel lymph node detection in oral cancer: a within-patient comparison between [^99mTc]Tc-tilmanocept and [^99mTc]Tc-nanocolloid

Authors: Inne J. den Toom, Rutger Mahieu, Rob van Rooij, Robert J. J. van Es, Monique G. G. Hobbelink, Gerard C. Krijger, Bernard M. Tijink, Bart de Keizer, Remco de Bree

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 3/2021

Abstract

Purpose

Sentinel lymph node (SLN) biopsy has proven to reliably stage the clinically negative neck in early-stage oral squamous cell carcinoma (OSCC). [^99mTc]Tc-tilmanocept may be of benefit in OSCC with complex lymphatic drainage patterns and close spatial relation to SLNs.

Methods

A prospective within-patient evaluation study was designed to compare [^99mTc]Tc-tilmanocept with [^99mTc]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.

Results

The injection site’s remaining radioactivity was significantly lower for [^99mTc]Tc-tilmanocept (29.9%), compared with [^99mTc]Tc-nanocolloid (60.9%; p < 0.001). Radioactive uptake in SLNs was significantly lower for [^99mTc]Tc-tilmanocept (1.95%) compared with [^99mTc]Tc-nanocolloid (3.16%; p = 0.010). No significant difference was seen in SLN to injection site ratio in radioactivity between [^99mTc]Tc-tilmanocept (0.066) and [^99mTc]Tc-nanocolloid (0.054; p = 0.232). A median of 3.0 and 2.5 SLNs were identified with [^99mTc]Tc-tilmanocept and [^99mTc]Tc-nanocolloid, respectively (p = 0.297). Radioactive uptake in higher echelon nodes was not significantly different between [^99mTc]Tc-tilmanocept (0.57%) and [^99mTc]Tc-nanocolloid (0.86%) (p = 0.052). A median of 2.0 and 2.5 higher echelon nodes was identified with [^99mTc]Tc-tilmanocept and [^99mTc]Tc-nanocolloid, respectively (p = 0.083).

Conclusion

[^99mTc]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 [^99mTc]Tc-nanocolloid. The relatively low-radioactive uptake in SLNs of [^99mTc]Tc-tilmanocept may limit intraoperative detection of SLNs, but can be overcome by a higher injection dose.

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Title: Sentinel lymph node detection in oral cancer: a within-patient comparison between [99mTc]Tc-tilmanocept and [99mTc]Tc-nanocolloid
Authors: Inne J. den Toom
Rutger Mahieu
Rob van Rooij
Robert J. J. van Es
Monique G. G. Hobbelink
Gerard C. Krijger
Bernard M. Tijink
Bart de Keizer
Remco de Bree
Publication date: 01-03-2021
Publisher: Springer Berlin Heidelberg
Keywords: Oral Cancer
Metastasis
Oral Cavity Carcinoma
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 3/2021
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-020-04984-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Sentinel lymph node detection in oral cancer: a within-patient comparison between [^99mTc]Tc-tilmanocept and [^99mTc]Tc-nanocolloid

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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