The impact of radiopharmaceutical particle size on the visualization and identification of sentinel nodes in breast cancer

Nucl Med Commun. 2004 Mar;25(3):233-8. doi: 10.1097/00006231-200403000-00004.

Abstract

Objectives: The aim of this study was to compare the success rate in lymphatic mapping and sentinel node biopsy in breast cancer using two radiopharmaceuticals.

Methods: The study included 119 breast cancer patients who underwent lymphoscintigraphy after a single intratumoral injection of 99mTc-labelled human albumin colloid with a particle size of 0.2-3 microm (Albu-Res) (large particle group) and 119 pair-matched control patients who underwent lymphoscintigraphy using 99mTc-labelled albumin colloid with a particle size of < 80 nm (Nanocoll) (small particle group). The dose of the tracer was used as the matching factor.

Results: Lymphoscintigraphy showed sentinel nodes in the axilla in 101 patients (85%) in the large particle group and in 104 patients (87%) in the small particle group. The mean number of visualized nodes in the axilla was 1.7 in the small particle group and 1.3 in the large particle group (P < 0.05). No radioactive nodes were found in the axilla during the operation in 22 patients (18%) in the small particle group and 11 patients (9%) in the large particle group (P < 0.06). Patients who avoided axillary clearance had a similar number of harvested radioactive nodes irrespective of the particle size of the tracer.

Conclusions: It can be concluded that the success rate in the identification of axillary sentinel nodes may be higher when using the smaller particles, despite the similar visualization rate in lymphoscintigraphy. The number of harvested radioactive nodes was not affected by the particle size of the tracer in patients who avoided axillary clearance.

Publication types

  • Clinical Trial
  • Comparative Study
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Axilla / diagnostic imaging*
  • Axilla / pathology
  • Breast Neoplasms / diagnostic imaging*
  • Breast Neoplasms / pathology
  • Case-Control Studies
  • Humans
  • Lymph Nodes / diagnostic imaging*
  • Lymph Nodes / pathology
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Particle Size
  • Radionuclide Imaging
  • Radiopharmaceuticals / chemistry
  • Radiopharmaceuticals / classification
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Sentinel Lymph Node Biopsy / methods*
  • Technetium Tc 99m Aggregated Albumin / chemistry*
  • Technetium Tc 99m Aggregated Albumin / classification

Substances

  • Radiopharmaceuticals
  • Technetium Tc 99m Aggregated Albumin