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 language | English |
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Pages (from-to) | 851-858 |
Number of pages | 8 |
Journal | European Journal of Nuclear Medicine and Molecular Imaging |
Volume | 48 |
Issue number | 3 |
Early online date | 25 Aug 2020 |
DOIs | |
Publication status | Published - Mar 2021 |
Keywords
- Lymphatic metastasis
- Lymphoscintigraphy
- Oral cancer
- Sentinel lymph nodes
- [ Tc]Tc-tilmanocept
- [Tc-99m]Tc-tilmanocept