Consecutive Case Series of Melanoma Sentinel Node Biopsy for Lymphoseek Compared to Sulfur Colloids

Abstract

Introduction: Sentinel lymph node biopsy (SLNB) is an important adjunct in the staging of patients with melanoma. Preoperative lymphoscintigraphy (LS) with radiolabeled isotopes is essential to localize sentinel nodes for removal. Our study compared the effectiveness ofLymphoseek  to standard sulfur colloids (SC) in patients with melanoma undergoing SLNB. Methods:We queried our IRB-approved melanoma database to identify 370 consecutive patients who underwent SLNB from 2012-2016 with at least one year of follow up. There were 185 patients in each group. Data points included characteristics of the primary melanoma lymphoscintigraphy, and SLNB. Student's t-test and Chi-Square were used to analyze the data with a p-value of <0.05 being considered significant. Results:Patients were equally matched in regard to age, sex, and primary characteristics of their melanoma. In comparison to SC, Lymphoseek  required lower radiation dosages (p<0.001), shorter mapping times (p=0.008), and decreased number of sentinel nodes removed (p=0.03).There was no difference in the number of patients with positive nodes (p=0.5). Additionally, there were no statistical differences between the two radioactive tracers in regard to the number of patients with false negative SLNB. Conclusion:Lymphoseek  has the potential to decrease radioactivity and mapping time in patients who need SLNB. With a decrease in the number of nodes removed without loss of sensitivity, there is a potential to avoid unnecessary node removal and thus complications such as lymphedema. Longer follow-up will help to determine if there is any increase in false negative rates despite fewer nodes removed.

Metal-Polymer Complexes of Gallium/Gallium-68 with Copolymers of N-Vinylpyrrolidonewith N-Vinylformamideand N-Vinyliminodiacetic Acid: A Hint for Radiolabeling of Water-Soluble Synthetic Flexible Chain Macromolecules

“…Нerewith, flexible chain synthetic water-soluble polymers can be considered as promising objects for targeted radionuclide transport [15,16]. For example, mannosylateddextrans decorated with diethylenetriaminepentaacetic acid (DTPA) chelation units and labeled with 99m Tc are adopted in clinical practice for visualization of defeated lymph nodes under the trade name "Lymphoseek" TM [17].…”

Sentinel Lymph Node Biopsy in Early Stages of Oral Squamous Cell Carcinoma Using the Receptor-Targeted Radiotracer 99mTc-Tilmanocept

“…This study could not find any differences between these tracers. In a case series of melanoma, no significant differences could be found between 99m Tc-sulfur colloid and 99m Tc-tilmanocept [ 23 ]. However, significantly lower radiation dosages, shorter mapping times and decreased numbers of sentinel nodes were removed in patients treated with 99m Tc-tilmanocept as compared to 99m Tc-sulfur colloids [ 23 ].…”

Sentinel Node Identification in Melanoma: Current Clinical Impact, New Emerging SPECT Radiotracers and Technological Advancements. An Update of the Last Decade

“…This radiotracer presents quick clearance from the injection site, higher retention in the SLN, negligible accumulation in second-echelon nodes compared to radiocolloids and acceptable biodistribution [ 5 , 68 ]. Importantly, these characteristics determine decreased radiation exposure and mapping time for the patients with an equivalent sensitivity in detecting the SLN [ 69 ]. Wallace, first, demonstrated in a small group of 24 melanoma patients equivalent SLN uptake for Lymphoseek ® and 99m Tc-sulfur colloid, but a faster mean clearance half-time for Lymphoseek ® (2.17 ± 0.96 h vs. 14.7 ± 6.3 h) [ 70 ].…”