Comment on: The EANM and SNMMI practice guideline for lymphoscintigraphy and sentinel node localization in breast cancer

Aprile, C.; Buroni, Federica Eleonora; Lodola, Lorenzo; Persico, Marco Giovanni

doi:10.1007/s00259-014-2747-1

Cited by 1 publication

(2 citation statements)

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“…Clinical experience suggests that high SA may be desirable. SA must be considered differently if the tracer is used in SLN biopsy detection or in the lymphoscintigraphy of extremities too, in order to choose the best radioactivity in NC‐HSA labelling …”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, only few data on radiopharmaceuticals characterization are available in literature, as radioactivity distribution related to nanocolloidal HSA (NC‐HSA) particle size distribution, with frequently conflicting results. Recently published guidelines on breast SLN are exhaustive about SLN identification, but the topic regarding the SA of the administered radiocolloid has not been elucidated at all . In theory, the saturable clearing capacity of a lymph node is due to the limited number of macrophages lining sinusoid spaces, regardless of the amount of colloid administered, so a maximum labelling SA could increase SLN count rate, as demonstrated by Gommans et al labelling only a portion of the kit contents, while Krynyckyi et al assessed a similar effect with 99m Tc sulfide colloid.…”

Section: Introductionmentioning

confidence: 99%

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^99mTc‐human serum albumin nanocolloids: particle sizing and radioactivity distribution

Persico

Lodola

Buroni

et al. 2015

Labelled Comp Radiopharmac

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Several parameters affect the biodistribution of administered nanocolloids (NC) for Sentinel Lymph Node (SLN) detection: particle size distribution, number of Tc atoms per particle and specific activity (SA). Relatively few data are available with frequently conflicting results. (99m)Tc-NC-human serum albumin (HSA) Nanocoll®, Nanoalbumon® and Nanotop® were analysed for particles' dimensional and radioactivity distribution, and a mathematical model was elaborated to estimate the number of particles involved. Commercially available kits were reconstituted at maximal SA of 11 MBq/µg HSA. Particles size distribution was evaluated by Dynamic Light Scattering. These data were related to the radioactivity distribution analysis passing labelled NC through three polycarbonate filters (15-30-50-nm pore size) under vacuum. Highest radioactivity was carried by 30-50 nm particles. The smallest ones, even though most numerous, carried only the 10% of (99m)Tc atoms. Nanocoll and Nanotop are not significantly different, while Nanoalbumon is characterized by largest particles (>30 nm) that carried the most of radioactivity (80%). Smallest particles could saturate the clearing capacity of macrophages; therefore, if the tracer is used for SLN detection, more node tiers could be visualized, reducing accuracy of SLN mapping. Manufacturers could implement technical leaflets with particle size distribution and could improve the labelling protocol to provide clinicians useful information.

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Section: Discussionmentioning

confidence: 99%