TY - JOUR
T1 - Magnetic Sentinel Lymph Node Biopsy in Early Breast Cancer Patients
T2 - An Individual Patient Data Meta-analysis of Tracer Uptake
AU - Christenhusz, Anke
AU - Mirzaei, Nushin
AU - Karakatsanis, Andreas
AU - Eriksson, Staffan
AU - Wärnberg, Fredrik
AU - Olofsson Bagge, Roger
AU - van der Palen, Job
AU - Simanowski, Julia
AU - Salamzadeh, Sadaf
AU - ten Haken, Bennie
AU - Dassen, Anneriet E.
AU - Alic, Lejla
N1 - Publisher Copyright:
© Society of Surgical Oncology 2024.
PY - 2024/12/17
Y1 - 2024/12/17
N2 - Background: Superparamagnetic iron oxide nanoparticles (SPIO) are emerging as a viable alternative to technetium and blue dye. Our study was designed to evaluate the correlation between SPIO dose, injection site, and timing with sentinel lymph node (SLN) detection and iron content in retrieved SLNs. Methods: This study combined individual patient data from three Dutch and five Swedish studies. Associations between SLN detection and dose, site, and timeframe of SPIO injection were examined. The iron content for each retrieved SLNs with or without metastases were calculated according to a predefined look up table based on probe counts and sensitivity setting. Analyses were conducted by using multivariable logistic and linear regression models using generalized estimating equation. Results: A total of 908 patients were included. The detection between the magnetic technique (96.6%) and the radioactive technique was comparable (96.6% vs. 96.8%, p = 0.75). The 1.0-mL SPIO dose was associated with the highest, and <0.5 mL of SPIO was associated with the lowest patient-based detection (100.0 and 96.6% respectively). An intratumoural injection was found to be less favourable compared with peritumoural and subareolar, whereas injection >168 hours before surgery demonstrated the highest patient-based detection. Conclusions: The noninferiority of SPIO compared with technetium99m ± BD has been proven by several studies. A dose of 1 mL, around the areola, with a longer exposure time, appears to increase the SPIO uptake in the nodes and SLN detection. Metastatic burden in SLNs did not significantly impact the uptake of SPIO.
AB - Background: Superparamagnetic iron oxide nanoparticles (SPIO) are emerging as a viable alternative to technetium and blue dye. Our study was designed to evaluate the correlation between SPIO dose, injection site, and timing with sentinel lymph node (SLN) detection and iron content in retrieved SLNs. Methods: This study combined individual patient data from three Dutch and five Swedish studies. Associations between SLN detection and dose, site, and timeframe of SPIO injection were examined. The iron content for each retrieved SLNs with or without metastases were calculated according to a predefined look up table based on probe counts and sensitivity setting. Analyses were conducted by using multivariable logistic and linear regression models using generalized estimating equation. Results: A total of 908 patients were included. The detection between the magnetic technique (96.6%) and the radioactive technique was comparable (96.6% vs. 96.8%, p = 0.75). The 1.0-mL SPIO dose was associated with the highest, and <0.5 mL of SPIO was associated with the lowest patient-based detection (100.0 and 96.6% respectively). An intratumoural injection was found to be less favourable compared with peritumoural and subareolar, whereas injection >168 hours before surgery demonstrated the highest patient-based detection. Conclusions: The noninferiority of SPIO compared with technetium99m ± BD has been proven by several studies. A dose of 1 mL, around the areola, with a longer exposure time, appears to increase the SPIO uptake in the nodes and SLN detection. Metastatic burden in SLNs did not significantly impact the uptake of SPIO.
KW - 2025 OA procedure
KW - Magnetic
KW - Sentinel lymph node biopsy
KW - Superparamagnetic iron oxide tracer (SPIO)
KW - Tracer distribution
KW - Breast cancer
UR - http://www.scopus.com/inward/record.url?scp=85212255738&partnerID=8YFLogxK
U2 - 10.1245/s10434-024-16626-6
DO - 10.1245/s10434-024-16626-6
M3 - Article
AN - SCOPUS:85212255738
SN - 1068-9265
JO - Annals of surgical oncology
JF - Annals of surgical oncology
ER -