Meta-analysis of sentinel lymph node biopsy in breast cancer using the magnetic technique

Zada, Ali; Peek, Mirjam; Ahmed, Muneer; Anninga, Bauke; Baker, Rose; Kusakabe, Moriaki; Sekino, Masaki; Klaase, Joost M.; Haken, Bennie ten; Douek, Michael

doi:10.1002/bjs.10283

Cited by 55 publications

(50 citation statements)

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“…One of the possible approaches to replace the method based on a radioactive tracer is the use of magnetic nanoparticles with a magnetic probe detection system, which has been compared in various clinical studies that have shown promising results . A meta‐analysis of SLNB clinical trials using the magnetic detection system demonstrated that the SLN identification rate was not inferior to that of simultaneous administration of radioactive colloids +/− dye (conventional method vs magnetic method: 96.8% vs 97.1%) . In Europe, Sienna+ has obtained CE mark approval as magnetic nanoparticles, while Sentimag has obtained CE mark approval as a magnetic probe.…”

Section: Introductionmentioning

confidence: 99%

Multicenter clinical trial on sentinel lymph node biopsy using superparamagnetic iron oxide nanoparticles and a novel handheld magnetic probe

Taruno

Kurita

Kuwahata

et al. 2019

Journal of Surgical Oncology

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Background Sentinel lymph node biopsy is a standard staging procedure for early axillary lymph node‐negative breast cancer. As an alternative to the currently used radioactive tracers for sentinel lymph node (SLN) detection during the surgical procedure, a number of studies have shown promising results using superparamagnetic iron oxide (SPIO) nanoparticles. Here, we developed a new handheld, cordless, and lightweight magnetic probe for SPIO detection. Methods Resovist (SPIO nanoparticles) were detected by the newly developed handheld probe, and the SLN detection rate was compared to that of the standard radioisotope (RI) method using radioactive colloids (99mTc) and a blue dye (indigo carmine). This was a multicenter prospective clinical trial that included 220 patients with breast cancer scheduled for sentinel node biopsy after a clinical diagnosis of negative axillary lymph node from three facilities in Japan. Results Of the 210 patients analyzed, SLN was detected in 94.8% (199/210 cases, 90% confidence interval [CI]) with our magnetic method and in 98.1% (206/210 cases, 90% CI) with the RI method. The magnetic method exceeded the threshold identification rate of 90%. Conclusion This was the first clinical study to use a novel handheld magnetometer to detect SLN, which we demonstrate to be not inferior to the RI method.

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Section: Introductionmentioning

confidence: 99%

Multicenter clinical trial on sentinel lymph node biopsy using superparamagnetic iron oxide nanoparticles and a novel handheld magnetic probe

Taruno

Kurita

Kuwahata

et al. 2019

Journal of Surgical Oncology

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“…The magnetic technique has now been evaluated in a number of studies and confirmed on meta-analysis to be noninferior to the radioisotope-dependent technique in breast cancer -with sentinel node identification rates of 97.1 and 96.8%, respectively [3] -and demonstrated technical benefits over other novel techniques [4]. The noninferiority of the magnetic technique has also been demonstrated in the staging of malignant melanoma [5] and has been applied to a range of solid cancers in small cohort series, which has demonstrated its feasibility in the staging of these malignancies [6][7][8].…”

Section: Magnetic Technique For Snbmentioning

confidence: 99%

“…Blue dye is also associated with prolonged skin staining and reports of anaphylaxis in 0.9% of patients [2]. These limitations have resulted in the on-going development of alternative techniques for SNB [3,4]. …”

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How Can Nanoparticles be used in Sentinel Node Detection?

Ahmed

Peek

Douek

2017

Nanomedicine (Lond.)

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Sentinel node biopsy (SNB) is the standard of care for axillary staging in breast cancer patients with a clinically and radiologically normal axilla. The concept is based upon the exclusion of metastases in the first draining lymph node(s) from the primary tumor. The current practice utilizes a radiolabeled tracer and blue dye (combined technique) with reported sentinel node identification rates of 96.4%, and a false negative rate of 7.3% in a large meta-analysis [1]. Although successful, this technique is limited by its dependence upon radioisotopes -with their inherent strict requirements for handling, transport, disposal and close access to nuclear medicine facilities. Blue dye is also associated with prolonged skin staining and reports of anaphylaxis in 0.9% of patients [2]. These limitations have resulted in the on-going development of alternative techniques for SNB [3,4]. Magnetic technique for SNBOne of the most promising radioisotopeindependent techniques for SNB comprises an interstitial injection of superparamagnetic iron oxide (SPIO) nanoparticles, which are identified intraoperatively with a handheld magnetometer and through visual brownblack staining of nodes. The magnetic technique has now been evaluated in a number of studies and confirmed on meta-analysis to be noninferior to the radioisotope-dependent technique in breast cancer -with sentinel node identification rates of 97.1 and 96.8%, respectively [3] -and demonstrated technical benefits over other novel techniques [4]. The noninferiority of the magnetic technique has also been demonstrated in the staging of malignant melanoma [5] and has been applied to a range of solid cancers in small cohort series, which has demonstrated its feasibility in the staging of these malignancies [6][7][8]. What is still lacking is randomized controlled trial evidence, before the magnetic technique can be considered as an alternative to the standard technique. Selective axillary surgeryThe current trend within axillary management in breast cancer is toward quantification of the axillary metastatic burden. The identification of low axillary burden has been shown to allow avoidance of formal axillary node clearance, without compromising overall and disease-free survival at long-term follow-up [9]. This evidence is leading to the concept of 'selective axillary surgery', which would allow targeted excision of only metastatically involved nodes. This relies upon improved preoperative imaging combined with novel techniques to guide surgeons intraoperatively, to involved nodes. Multimodal MRI for assessing nodal involvementMagnetic nanoparticles have been used for axillary staging noninvasively with MRI and demonstrated a sensitivity and specificity for

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“…Риск лимфогенной диссеминации опухоли при РШМ IA стадии в регионарные лимфати-ческие узлы составляет 2,8 -4,8 %, при IB -13,6 -15,9 %, тактика лечения может быть основана на результатах экспресс-морфологического, или послеоперационного исследования удаленных лимфатических узлов [5]. Мно-гие авторы справедливо подчеркивают, что удаление лимфатических узлов не приносит пользу большинству пациенток с начальными стадиями рака шейки матки.…”

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Оптимизация Современных Подходов В Лечении Гинекологического Рака Основных Локализаций

et al. 2017

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Meta-analysis of sentinel lymph node biopsy in breast cancer using the magnetic technique

Abstract: The magnetic technique for SLNB is non-inferior to the standard technique, with a high identification rate but with a significantly higher lymph node retrieval rate.

Cited by 55 publications

References 30 publications

Multicenter clinical trial on sentinel lymph node biopsy using superparamagnetic iron oxide nanoparticles and a novel handheld magnetic probe

Multicenter clinical trial on sentinel lymph node biopsy using superparamagnetic iron oxide nanoparticles and a novel handheld magnetic probe

How Can Nanoparticles be used in Sentinel Node Detection?

Оптимизация Современных Подходов В Лечении Гинекологического Рака Основных Локализаций

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