Sentinel lymph node detection in oral cancer: a within-patient comparison between [99mTc]Tc-tilmanocept and [99mTc]Tc-nanocolloid

Inne J den Toom, Rutger Mahieu, Rob van Rooij, Robert J J van Es, Monique G G Hobbelink, Gerard C Krijger, Bernard M Tijink, Bart de Keizer, Remco de Bree

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Purpose: Sentinel lymph node (SLN) biopsy has proven to reliably stage the clinically negative neck in early-stage oral squamous cell carcinoma (OSCC). [ 99mTc]Tc-tilmanocept may be of benefit in OSCC with complex lymphatic drainage patterns and close spatial relation to SLNs. Methods: A prospective within-patient evaluation study was designed to compare [ 99mTc]Tc-tilmanocept with [ 99mTc]Tc-nanocolloid for SLN detection. A total of 20 patients with early-stage OSCC were included, who underwent lymphoscintigraphy with both tracers. Both lymphoscintigraphic images of each patient were evaluated for SLN detection and radiotracer distribution at 2–4 h post-injection. Results: The injection site’s remaining radioactivity was significantly lower for [ 99mTc]Tc-tilmanocept (29.9%), compared with [ 99mTc]Tc-nanocolloid (60.9%; p < 0.001). Radioactive uptake in SLNs was significantly lower for [ 99mTc]Tc-tilmanocept (1.95%) compared with [ 99mTc]Tc-nanocolloid (3.16%; p = 0.010). No significant difference was seen in SLN to injection site ratio in radioactivity between [ 99mTc]Tc-tilmanocept (0.066) and [ 99mTc]Tc-nanocolloid (0.054; p = 0.232). A median of 3.0 and 2.5 SLNs were identified with [ 99mTc]Tc-tilmanocept and [ 99mTc]Tc-nanocolloid, respectively (p = 0.297). Radioactive uptake in higher echelon nodes was not significantly different between [ 99mTc]Tc-tilmanocept (0.57%) and [ 99mTc]Tc-nanocolloid (0.86%) (p = 0.052). A median of 2.0 and 2.5 higher echelon nodes was identified with [ 99mTc]Tc-tilmanocept and [ 99mTc]Tc-nanocolloid, respectively (p = 0.083). Conclusion: [ 99mTc]Tc-tilmanocept had a higher injection site clearance, but at the same time a lower uptake in the SLN, resulting in an SLN to injection site ratio, which was not significantly different from [ 99mTc]Tc-nanocolloid. The relatively low-radioactive uptake in SLNs of [ 99mTc]Tc-tilmanocept may limit intraoperative detection of SLNs, but can be overcome by a higher injection dose.

Original languageEnglish
Pages (from-to)851-858
Number of pages8
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume48
Issue number3
Early online date25 Aug 2020
DOIs
Publication statusPublished - Mar 2021

Keywords

  • Lymphatic metastasis
  • Lymphoscintigraphy
  • Oral cancer
  • Sentinel lymph nodes
  • [ Tc]Tc-tilmanocept
  • [Tc-99m]Tc-tilmanocept

Fingerprint

Dive into the research topics of 'Sentinel lymph node detection in oral cancer: a within-patient comparison between [99mTc]Tc-tilmanocept and [99mTc]Tc-nanocolloid'. Together they form a unique fingerprint.

Cite this