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Optimising magnetic sentinel lymph node biopsy in an in vivo porcine model

Ahmed, M; Anninga, B; Pouw, JJ; Vreemann, S; Peek, M; Van Hemelrijck, M; Pinder, S; ... Douek, M; + view all (2015) Optimising magnetic sentinel lymph node biopsy in an in vivo porcine model. Nanomedicine: Nanotechnology Biology and Medicine , 11 (4) pp. 993-1002. 10.1016/j.nano.2015.01.010. Green open access

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Abstract

The magnetic technique for sentinel lymph node biopsy (SLNB) has been evaluated in several clinical trials. An in vivo porcine model was developed to optimise the magnetic technique by evaluating the effect of differing volume, concentration and time of injection of magnetic tracer. A total of 60 sentinel node procedures were undertaken. There was a significant correlation between magnetometer counts and iron content of excised sentinel lymph nodes (SLNs) (r = 0.82; P < 0.001). Total number of SLNs increased with increasing volumes of magnetic tracer (P < 0.001). Transcutaneous magnetometer counts increased with increasing time from injection of magnetic tracer (P < 0.0001), plateauing within 60 min. Increasing concentration resulted in higher iron content of SLNs (P = 0.006). Increasing magnetic tracer volume and injecting prior to surgery improve transcutaneous ‘hotspot’ identification but very high volumes, increase the number of nodes excised. From the Clinical Editor Sentinel lymph node biopsy (SLNB) is the standard of care for axillary staging of breast cancer patients. Although the current gold standard technique is the combined injection of technetium-labelled nanocolloid and blue dye into the breast, the magnetic technique, using superparamagnetic carboxydextran-coated iron oxide (SPIO), has also been demonstrated as a feasible alternative. In this article, the authors set up to study factors in order to optimize the magnetic tracers. Graphical abstract Variable volumes and concentrations of a magnetic tracer were injected into the third inguinal mammary gland bilaterally in an in vivo porcine model (1) allowing the performance of magnetic sentinel lymph node biopsy of draining inguinal nodes (2). The harvested nodes were ‘darkly stained’ for iron uptake and ‘hot’ for magnetometer counts (3). The iron was deposited within the cortex and subcapsular space – visible as blue using PERL’s staining – on histopathology (4) and was quantified using quantitative magnetometry and a validated iron-grading scale.

Type: Article
Title: Optimising magnetic sentinel lymph node biopsy in an in vivo porcine model
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.nano.2015.01.010
Publisher version: https://doi.org/10.1016/j.nano.2015.01.010
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Superparamagnetic iron oxide, SPIO, Sentinel lymph node biopsy, SLNB:magnetic technique, Sentinel lymph node biopsy, Magnetic tracer
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Med Phys and Biomedical Eng
URI: https://discovery.ucl.ac.uk/id/eprint/10051083
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