Magnetic Technique for Sentinel Lymph Node Biopsy in Melanoma: The MELAMAG Trial

Anninga, Bauke; White, Samantha; Moncrieff, Marc; Dziewulski, Peter; Geh, Jenny; Klaase, Joost M.; Garmo, Hans; Castro, Fernando; Pinder, Sarah; Pankhurst, Quentin A.; Hall‐Craggs, Margaret A; Douek, Michael

doi:10.1245/s10434-016-5113-7

Cited by 22 publications

(21 citation statements)

References 19 publications

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“…Another concern with the magnetic technique is the maximum depth at which the magnetic signal can be detected, both transcutaneously and after incision. The magnetometer does not reach the same depth as a γ probe, which can have consequences for the identification of deeper nodes, as demonstrated in the recently published MELAMAG Trial. Patients with melanoma who required SLNB in the axillary basin had a lower SLN identification rate than those who underwent SLNB in the groin basin, seemingly owing to SLNs being located deeper in the axilla compared with the groin.…”

Section: Discussionmentioning

confidence: 99%

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

Zada

Peek

Ahmed

et al. 2016

Journal of British Surgery

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Section: Discussionmentioning

confidence: 99%

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

Zada

Peek

Ahmed

et al. 2016

Journal of British Surgery

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“…Currently available handheld magnetometers do not reach the same depth as a gamma probe (e.g., SentiMag:~20 mm; TAKUMI ® magnetic probe: 10 mm), which can have consequences for the identification of deeper nodes [22,23]. In the MELAMAG Trial, patients with melanoma who underwent SentiMag-guided SLN biopsy in the axillary basin had a lower SLN identification rate than those who required SLN biopsy in the groin basin, seemingly owing to SLNs being located deeper in the axilla compared with the groin [23]. In principle, it must be taken into account that unlike radioactive marking or the use of a gamma probe, contact of the magnetometer with the tissue is mandatory.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of Magnetometer-Guided Sentinel Lymphadenectomy after Intraprostatic Injection of Superparamagnetic Iron Oxide Nanoparticles in Prostate Cancer: The SentiMag Pro II Study

Winter

Engels

Goos

et al. 2019

Cancers

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Radioisotope-guided sentinel lymph node dissection (sLND) has shown high diagnostic reliability in prostate (PCa) and other cancers. To overcome the limitations of the radioactive tracers, magnetometer-guided sLND using superparamagnetic iron oxide nanoparticles (SPIONs) has been successfully used in PCa. This prospective study (SentiMag Pro II, DRKS00007671) determined the diagnostic accuracy of magnetometer-guided sLND in intermediate-and high-risk PCa. Fifty intermediate-or high-risk PCa patients (prostate-specific antigen (PSA) ≥ 10 ng/mL and/or Gleason score ≥ 7; median PSA 10.8 ng/mL, IQR 7.4-19.2 ng/mL) were enrolled. After the intraprostatic SPIONs injection a day earlier, patients underwent magnetometer-guided sLND and extended lymph node dissection (eLND, followed by radical prostatectomy. SLNs were detected in in vivo and in ex vivo samples. Diagnostic accuracy of sLND was assessed using eLND as the reference. SLNs were detected in all patients (detection rate 100%), with 447 sentinel lymph nodes SLNs (median 9, IQR 6-12) being identified and 966 LNs (median 18, IQR 15-23) being removed. Thirty-six percent (18/50) of patients had LN metastases (median 2, IQR 1-3). Magnetometer-guided sLND had 100% sensitivity, 97.0% specificity, 94.4% positive predictive value, 100% negative predictive value, 0.0% false negative rate, and 3.0% additional diagnostic value (LN metastases only in SLNs outside the eLND template). In vivo, one positive SLN/LN-positive patient was missed, resulting in a sensitivity of 94.4%. In conclusion, this new magnetic sentinel procedure has high accuracy for nodal staging in intermediate-and high-risk PCa. The reliability of intraoperative SLN detection using this magnetometer system requires verification in further multicentric studies.

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“…The highest identification was proven for inguinal and axillary lymph nodes, while the lowest detection rates were registered for the cervical region. From 129 recruited patients, the study reported 95.3% rate of sentinel node identification using this MNPs-based technique (60).…”

Section: Nanomedicine For Melanoma Detection and Treatmentmentioning

confidence: 97%

“…Magnetic nanoparticles (MNPs) were successfully used in MRI (60). In the recent MELAMAG clinical trial, SLNB detection based on MNPs was compared to the standard technique.…”

Section: Nanomedicine For Melanoma Detection and Treatmentmentioning

confidence: 99%

Nanomedicine in Melanoma: Current Trends and Future Perspectives

El-Kenawy

Constantin

Hassan

et al. 2017

Cutaneous Melanoma: Etiology and Therapy

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Abstract:As cutaneous melanoma is a highly aggressive and drug-resistant cancer, there is intense research focusing on developing new, efficient drugs. Nanomedicine focuses on developing different groups of nanomaterials for both diagnosis and therapy, and this combination of specific diagnosis and therapy is called theranostics. Nanomaterials tailored as delivery vehicles can be nanocapsules, nanorods, nanotubes, nanoshells, and nanocages. All these structures protect the intended drug against degradation and enhance its stability. The development and characterization of polymeric nanoparticles, polymeric micelles, liposomes, nanohydrogel, dendrimers, inorganic nanoparticles, and hybrid nanocarriers are among the delivery vehicles that transport different anticancer agents. Functionalization of nanocarriers with specific molecules, such as antibodies, can generate different smart nanodrugs for application in cancer therapy and/or diagnosis. Nanotherapeutic strategies deal with several shortcomings that comprise of tumor characteristics, biological barriers, biocompatibility, and so on. As nanostructures interact with various host biomolecules, comprehensive in vitro cellular models call for evaluation of physicochemical properties, dose, and time of action of nanomaterials, while in vivo assessments would provide valuable data regarding the level of absorption, tissue/organ distribution, and metabolism. The future perspectives in nanotechnology applied to cancer overcomes the translational barrier from the laboratory to the clinical application to potentially improve conventional theranostic techniques.

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Magnetic Technique for Sentinel Lymph Node Biopsy in Melanoma: The MELAMAG Trial

Abstract: The magnetic technique is feasible for SLNB in melanoma with a high SLN identification rate, but is associated with skin staining. When compared with the standard dual technique, it did not reach our predefined non-inferiority margin.

Cited by 22 publications

References 19 publications

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

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

Accuracy of Magnetometer-Guided Sentinel Lymphadenectomy after Intraprostatic Injection of Superparamagnetic Iron Oxide Nanoparticles in Prostate Cancer: The SentiMag Pro II Study

Nanomedicine in Melanoma: Current Trends and Future Perspectives

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