[68Ga]Ga-tilmanocept PET/CT lymphoscintigraphy: a novel technique for sentinel lymph node imaging

Mahieu, Rutger; Krijger, Gerard C.; Ververs, F. F. T.; Roos, Remmert de; Bree, Remco de; Keizer, Bart de

doi:10.1007/s00259-020-05101-5

Cited by 17 publications

(3 citation statements)

References 27 publications

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“…Practice points for lymphoedema diagnostic techniques generated through our NGT involve comparing circumferential or limb volume measurement of affected and unaffected limbs in unilateral limb lymphoedema or undertaking a baseline measurement of the affected body part. While other diagnostic techniques such as lymphoscintigraphy and Indocyanine green (ICG) orescent lymphography are effective, their prohibitive costs and limited availability makes them unsuitable for use in most LMIC [50].…”

Section: Discussionmentioning

confidence: 99%

Developing practice points for healthcare workers to optimise lymphoedema care in low and middle-income countries: a nominal group technique

Torgbenu

Luckett

Buhagiar

et al. 2022

Preprint

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Background: Lymphoedema is a common, distressing, and debilitating condition affecting over 200 million people globally. While the World Health Organization has developed a Wound and Lymphoedema Management guidance document to support lymphoedema care in low- and middle-income countries (LMIC), it mainly focuses on lymphoedema caused by wounds and infectious filariasis and has limited content on lymphoedema diagnosis and assessment. Several lymphoedema clinical practice guidelines have been developed for high-income countries (HIC), but some recommendations are unlikely to be feasible in low-resource settings. Aim: To develop practice points for healthcare workers that optimise lymphoedema care in LMIC. Methods: A nominal group technique (NGT) was undertaken to gain consensus on which content from HIC guidelines are important and feasible to include in practice points for LMIC, plus other important advice or recommendations. Participants included experts, clinicians, and volunteers involved in lymphoedema care in LMIC. The NGT followed five key stages: silent ‘ideas’ generation, round-robin rationale, clarification, refinement and verification. The first, fourth and fifth stages were completed via email, and the second and third during a video meeting. Practice points were divided into prevention, assessment, diagnosis, and management of lymphoedema in LMIC. Results: Of 16 participants invited, 10 members completed stage 1 of the NGT (ideas generation), of whom six contributed to stages 2 (round-robin) and 3 (clarification). All those who completed stage 1 also completed stages 4 (refinement) and 5 (verification). Practice points unanimously agreed on included Complex Decongestive Therapy (CDT) and good skin care, with management to be determined by lymphoedema stage. For podoconiosis-endemic areas, the use of socks and shoes was identified as very important in the prevention of non-filarial lymphoedema and other lymphoedema-causing conditions. Participants indicated that diagnosing lymphoedema using the lymphoscintigraphy and Indocyanine green (ICG) fluorescent lymphography was not possible due to unavailability and cost in LMIC. Surgical procedures for lymphoedema management were unanimously eliminated due to the unavailability of technology, limited workforce, and expensive cost in LMIC. Conclusion: The consensus-based practice points generated by this project provide healthcare workers with guidance on caring for people with lymphoedema in LMIC. Further development of workforce capacity is needed.

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Section: Discussionmentioning

confidence: 99%

Developing practice points for healthcare workers to optimise lymphoedema care in low and middle-income countries: a nominal group technique

Torgbenu

Luckett

Buhagiar

et al. 2022

Preprint

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“…Before conducting new radiotherapy trials, it seems appropriate to firstly validate the reliability of the SLN procedure on ≥T3, N+, and floor‐of‐mouth OC tumors and OPSCC, LC, and HPC. The higher resolution of PET/CT may solve the problem of “shine through phenomenon” for lymphoscintigraphy of floor‐of‐mouth OC tumors 136 …”

Section: Spect/ct‐guided Elective Nodal Irradiationmentioning

confidence: 99%

Unilateral versus bilateral nodal irradiation: Current evidence in the treatment of squamous cell carcinoma of the head and neck

et al. 2021

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Cancers of the head and neck region often present with nodal involvement. There is a long‐standing convention within the community of head and neck radiation oncology to irradiate both sides of the neck electively in almost all cases to include both macroscopic and microscopic disease extension (so called elective nodal volume). International guidelines for the selection and delineation of the elective lymph nodes were published in the early 2000s and were updated recently. However, diagnostic imaging techniques have improved the accuracy and reliability of nodal staging and as a result, small metastases that used to remain undetected and were thus in the past included in the elective nodal volume, will now be included in high‐dose volumes. Furthermore, the elective nodal areas are situated close to the parotid glands, the submandibular glands and the swallowing muscles. Therefore, irradiation of a smaller, more selected volume of the elective nodes could reduce treatment‐related toxicity. Several researchers consider the current bilateral elective neck irradiation strategies an overtreatment and show growing interest in a unilateral nodal irradiation in selected patients. The aim of this article is to give an overview of the current evidence about the indications and benefits of unilateral nodal irradiation and the use of SPECT/CT‐guided nodal irradiation in squamous cell carcinomas of the head and neck.

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“…Several imaging modalities can be used to monitor the superficial suspected LNs, such as ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) ( 4 ). The role of CT is limited for the nodal staging ( 5 ).…”

Section: Introductionmentioning

confidence: 99%

Classification of superficial suspected lymph nodes: non-invasive radiomic model based on multiphase contrast-enhanced ultrasound for therapeutic options of lymphadenopathy

Jiang,

Yuan,

Zhang

et al. 2024

Quant Imaging Med Surg

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Background Accurate determination of the types of lymphadenopathy is of great importance in disease diagnosis and treatment and is usually confirmed by pathological findings. Radiomics is a non-invasive tool that can extract quantitative information from medical images. Our study was designed to develop a non-invasive radiomic approach based on multiphase contrast-enhanced ultrasound (CEUS) images for the classification of different types of lymphadenopathy. Methods A total of 426 patients with superficial suspected lymph nodes (LNs) from three centres were grouped into a training cohort (n=190), an internal testing cohort (n=127), and an external testing cohort (n=109). The radiomic features were extracted from the prevascular phase, vascular phase, and postvascular phase of the CEUS images. Model 1 (the conventional feature model), model 2 (the multiphase radiomics model), and model 3 (the combined feature model) were established for lymphadenopathy classification. The area under the curve (AUC) and confusion matrix were used to evaluate the performance of the three models. The usefulness of the models was assessed in different threshold probabilities by decision curve analysis. Results There were 139 patients (32.6%) with benign LNs, 110 patients (25.8%) with lymphoma, and 177 patients (41.5%) with metastatic LNs in our population. Finally, twenty features were selected to construct the radiomics models for these three types of lymphadenopathy. Model 2 integrating multiphase images of the CEUS yielded the AUCs of 0.838, 0.739, and 0.733 in the training cohort, internal testing cohort, and external testing cohort, respectively. After the combination of conventional features and radiomic features, the AUCs of model 3 improved to 0.943, 0.823 and 0.785 in the training cohort, internal testing cohort, and external testing cohort. Besides, model 3 had an accuracy of 81.05%, sensitivity of 80%, and specificity of 90.43% in the training cohort. Model performance was further confirmed in the internal testing cohort and external testing cohort. Conclusions We constructed a combined feature model using a series of CEUS images for the classification of the lymphadenopathies. For patients with superficial suspected LNs, this model can help clinicians make a decision on the LN type noninvasively and choose appropriate treatments.

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[68Ga]Ga-tilmanocept PET/CT lymphoscintigraphy: a novel technique for sentinel lymph node imaging

Cited by 17 publications

References 27 publications

Developing practice points for healthcare workers to optimise lymphoedema care in low and middle-income countries: a nominal group technique

Developing practice points for healthcare workers to optimise lymphoedema care in low and middle-income countries: a nominal group technique

Unilateral versus bilateral nodal irradiation: Current evidence in the treatment of squamous cell carcinoma of the head and neck

Classification of superficial suspected lymph nodes: non-invasive radiomic model based on multiphase contrast-enhanced ultrasound for therapeutic options of lymphadenopathy

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