TY - JOUR
T1 - A complete magnetic sentinel lymph node biopsy procedure in oral cancer patients
T2 - A pilot study
AU - Nieuwenhuis, Eliane R.
AU - Kolenaar, Barry
AU - van Bemmel, Alexander J.M.
AU - Hof, Jurrit J.
AU - van Baarlen, Joop
AU - Christenhusz, Anke
AU - Pouw, Joost J.
AU - ten Haken, Bernard
AU - Alic, Lejla
AU - de Bree, Remco
N1 - Funding Information:
This research was supported by the Dutch Cancer Society and Technology Foundation TTW, as part of their joint strategic research program ‘Technology for Oncology’ (project number: 15194). The funding source had no involvement in any detail of this study.
Publisher Copyright:
© 2021
PY - 2021/10
Y1 - 2021/10
N2 - Objectives: To assess the feasibility and merits of a complete magnetic approach for a sentinel lymph node biopsy (SLNB) procedure in oral cancer patients. Materials and methods: This study included ten oral cancer patients (stage cT1-T2N0M0) scheduled for elective neck dissection (END). Superparamagnetic iron oxide nanoparticles (SPIO) were administered peritumorally prior to surgery. A preoperative MRI was acquired to identify lymph nodes (LNs) with iron uptake. A magnetic detector was used to identify magnetic hotspots prior, during, and after the SLNB procedure. The resected sentinel LNs (SLNs) were evaluated using step-serial sectioning, and the neck dissection specimen was assessed by routine histopathological examination. A postoperative MRI was acquired to observe any residual iron. Results: Of ten primary tumors, eight were located in the tongue, one floor-of-mouth (FOM), and one tongue-FOM transition. SPIO injections were experienced as painful by nine patients, two of whom developed a tongue swelling. In eight patients, magnetic SLNs were successfully detected and excised during the magnetic SLNB procedure. During the END procedure, additional magnetic SLNs were identified in three patients. Histopathology confirmed iron deposits in sinuses of excised SLNs. Three SLNs were harboring metastases, of which one was identified only during the END procedure. The END specimens revealed no further metastases. Conclusion: A complete magnetic SLNB procedure was successfully performed in eight of ten patients (80% success rate), therefore the procedure seems feasible. Recommendations for further investigation are made including: use of anesthetics, magnetic tracer volume, planning preoperative MRI, comparison to conventional technique and follow-up.
AB - Objectives: To assess the feasibility and merits of a complete magnetic approach for a sentinel lymph node biopsy (SLNB) procedure in oral cancer patients. Materials and methods: This study included ten oral cancer patients (stage cT1-T2N0M0) scheduled for elective neck dissection (END). Superparamagnetic iron oxide nanoparticles (SPIO) were administered peritumorally prior to surgery. A preoperative MRI was acquired to identify lymph nodes (LNs) with iron uptake. A magnetic detector was used to identify magnetic hotspots prior, during, and after the SLNB procedure. The resected sentinel LNs (SLNs) were evaluated using step-serial sectioning, and the neck dissection specimen was assessed by routine histopathological examination. A postoperative MRI was acquired to observe any residual iron. Results: Of ten primary tumors, eight were located in the tongue, one floor-of-mouth (FOM), and one tongue-FOM transition. SPIO injections were experienced as painful by nine patients, two of whom developed a tongue swelling. In eight patients, magnetic SLNs were successfully detected and excised during the magnetic SLNB procedure. During the END procedure, additional magnetic SLNs were identified in three patients. Histopathology confirmed iron deposits in sinuses of excised SLNs. Three SLNs were harboring metastases, of which one was identified only during the END procedure. The END specimens revealed no further metastases. Conclusion: A complete magnetic SLNB procedure was successfully performed in eight of ten patients (80% success rate), therefore the procedure seems feasible. Recommendations for further investigation are made including: use of anesthetics, magnetic tracer volume, planning preoperative MRI, comparison to conventional technique and follow-up.
KW - Magnetic handheld probe
KW - Magnetic tracer
KW - Oral cancer
KW - Sentinel lymph node biopsy
KW - SPIO
KW - Superparamagnetic iron oxide
UR - http://www.scopus.com/inward/record.url?scp=85111217429&partnerID=8YFLogxK
U2 - 10.1016/j.oraloncology.2021.105464
DO - 10.1016/j.oraloncology.2021.105464
M3 - Article
AN - SCOPUS:85111217429
SN - 1368-8375
VL - 121
SP - 1
EP - 7
JO - Oral Oncology
JF - Oral Oncology
M1 - 105464
ER -