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Vidal-Sicart S, Rioja ME, Prieto A, Goñi E, Gómez I, Albala MD, Lumbreras L, León LF, Gómez JR, Campos F. Sentinel Lymph Node Biopsy in Breast Cancer with 99mTc-Tilmanocept: A Multicenter Study on Real-Life Use of a Novel Tracer. J Nucl Med 2021; 62:620-627. [PMID: 33037087 DOI: 10.2967/jnumed.120.252064] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 09/15/2020] [Indexed: 11/16/2022] Open
Abstract
99mTc-tilmanocept is a novel radiopharmaceutical for sentinel lymph node (SLN) biopsy in breast cancer. Our aim was to describe results with 99mTc-tilmanocept in a heterogeneous group of breast cancer patients scheduled for SLN biopsy. Methods: Radiotracer preparation followed the manufacturer's indications. Local protocols for SLN detection within 9 participant centers were not changed for the entire duration of the study. In total, 344 patients with T1-T4, N0-N2 breast cancer (352 lesions) were included. Superficial (intradermal or periareolar) or deep (peritumoral or intratumoral) injections were performed. The doses were adjusted depending on the scheduled time for surgery. Results: Lymphoscintigraphy was able to depict at least 1 SLN in 339 of 352 breast lesions (96.3%), and the intraoperative SLN detection rate reached 97.2%. On univariable analysis, SLN detection rates did not differ by age, clinical T or N stage, tumor location, histologic subtype, or prior neoadjuvant therapy. Lymphoscintigraphy showed higher SLN detection in patients with a normal weight (body mass index < 25) than in those who were overweight or obese (body mass index ≥ 25), at 99.2% versus 94.6%, respectively (P = 0.031). The proportion of patients with preoperative lymphoscintigraphic detection or excised SLNs was higher with superficial than deep injections. Reinjected cases were significantly lower when superficial injection was chosen first (P < 0.001). Injection site and the tumor markers human epidermal growth factor receptor 2 and estrogen receptor had an impact on preoperative SLN visualization and intraoperative localization. In 80 cases, SLN biopsy resulted in a positive lymph node. During a mean follow-up of 19 mo, no axillary recurrences were observed. Conclusion: Whatever the protocol, 99mTc-tilmanocept showed good results in a heterogeneous breast cancer population, although the best results were achieved when a superficial injection was chosen.
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Affiliation(s)
- Sergi Vidal-Sicart
- Nuclear Medicine Department, Hospital Clínic Barcelona, Barcelona, Spain
| | - María Eugenia Rioja
- Nuclear Medicine Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Andrea Prieto
- Nuclear Medicine Department, Hospital Puerta de Hierro, Madrid, Spain
| | - Elena Goñi
- Nuclear Medicine Department, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Isabel Gómez
- Nuclear Medicine Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Luis Lumbreras
- Nuclear Medicine Department, Hospital Regional Universitario de Málaga, Málaga, Spain
| | | | - José Ramón Gómez
- Nuclear Medicine Department, Hospital Torrecárdenas, Almería, Spain
| | - Francisco Campos
- Nuclear Medicine Department, Hospital Clínic Barcelona, Barcelona, Spain
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Vilar Tabanera A, Ajuria O, Rioja ME, Cabañas Montero J. Selective Neck Dissection Guided by a Radioactive I125 Seed for Papillary Thyroid Carcinoma Recurrence. Cir Esp 2020; 98:478-481. [PMID: 32505561 DOI: 10.1016/j.ciresp.2020.04.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 04/20/2020] [Accepted: 04/26/2020] [Indexed: 11/26/2022]
Abstract
Lymph nodes are the most common place of recurrence of papillary thyroid cancer, and surgery can be considered a therapeutic option. The risks of surgery increase with every intervention. We present 3 cases of cervical non palpable thyroid cancer recurrence managed with I125 seed radioguided cervical dissection from 2017 to 2019. Two of the cases had already a thyroidectomy and central compartment lymphadenectomy performed. The seed was placed guided by US on the lesion and its position was confirmed afterwards. The target was successfully localized in 100% of cases. There was no post surgery complications. There was no evidence of recurrence with a mean follow up of 15 months. Radioguided surgery using I125 seed it is a save technique and it offers a precise localization of the non palpable thyroid cancer recurrence.
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Affiliation(s)
- Alberto Vilar Tabanera
- Sección de Cirugía Endocrina, Servicio de Cirugía General y Digestivo, Hospital Ramón y Cajal, Madrid, España.
| | - Odile Ajuria
- Servicio de Medicina Nuclear, Hospital Ramón y Cajal, Madrid, España
| | | | - Jacobo Cabañas Montero
- Sección de Cirugía Endocrina, Servicio de Cirugía General y Digestivo, Hospital Ramón y Cajal, Madrid, España
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Gorrín MR, Rodríguez-Mendiola N, Saico SP, de Nicolás VD, Rioja ME, Quereda C. Hydrothorax secondary to a malpositioned peritoneal dialysis catheter. Perit Dial Int 2015; 35:365-6. [PMID: 26015422 DOI: 10.3747/pdi.2014.00133] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Maite Rivera Gorrín
- Nephrology, Hospital Ramón y Cajal Alcalá de Henares University Madrid, Spain
| | | | - Saúl Pampa Saico
- Nephrology, Hospital Ramón y Cajal Alcalá de Henares University Madrid, Spain
| | | | - María Eugenia Rioja
- Nuclear Medicine Services Hospital Ramón y Cajal Alcalá de Henares University Madrid, Spain
| | - Carlos Quereda
- Nephrology, Hospital Ramón y Cajal Alcalá de Henares University Madrid, Spain
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García-Talavera P, Ruano R, Rioja ME, Cordero JM, Razola P, Vidal-Sicart S. [Radioguided surgery in neuroendocrine tumors. A review of the literature]. Rev Esp Med Nucl Imagen Mol 2014; 33:358-65. [PMID: 25107596 DOI: 10.1016/j.remn.2014.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 07/08/2014] [Accepted: 07/09/2014] [Indexed: 11/26/2022]
Abstract
Radioguided surgery can be a useful technique in the localization of neuroendocrine tumors. It detects more and smaller lesions compared to pre-surgical imaging and intraoperative digital palpation by the surgeon. It detects residual lesions and also indicates the shortest access route to the lesion. Nevertheless, its use has not become widespread because of technical difficulties. There is a limited number of published series, a lack of standardized protocol because of the great variability regarding type of radiopharmaceutical, dose of radiotracer, timing between injection and surgery. In this paper, we review these issues, describing the experience of different authors in diverse tumors.
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Affiliation(s)
- P García-Talavera
- Servicio de Medicina Nuclear, Hospital Clínico Universitario de Valladolid, Valladolid, España.
| | - R Ruano
- Servicio de Medicina Nuclear, Hospital Clínico Universitario de Salamanca, Salamanca, España
| | - M E Rioja
- Servicio de Medicina Nuclear, Hospital Universitario Ramón y Cajal, Madrid, España
| | - J M Cordero
- Servicio de Medicina Nuclear, Hospital General Universitario de Ciudad Real, Ciudad Real, España
| | - P Razola
- Servicio de Medicina Nuclear, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - S Vidal-Sicart
- Servicio de Medicina Nuclear, Hospital Clínic de Barcelona, Barcelona, España
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Vidal-Sicart S, Rioja ME, Paredes P, Keshtgar MR, Valdés Olmos RA. Contribution of perioperative imaging to radioguided surgery. Q J Nucl Med Mol Imaging 2014; 58:140-160. [PMID: 24835290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Radioguided surgery has been investigated and applied to almost any neoplastic disease that is surgically treated. The impact of radioguided surgery on the surgical management of cancer patients includes relevant and real-time information to the surgeon regarding the location and extent of the disease, as well as regarding the assessment of surgical resection margins. Despite the fact that sentinel lymph node biopsy has been worldwide accepted as a highly accurate staging method for various solid cancers (among which breast cancer and cutaneous melanoma), some potential intraoperative drawbacks still remain. This article provides an update on currently available perioperative techniques regarding the use of radiotracers for radioguided surgery and sentinel lymph node mapping and biopsy, in particular in combination with vital dyes or other agents. The integration of computer technology and data processing makes it possible to integrate anatomic and functional images together with 3D rendering systems. This facilitates the targeted-tissue perioperative localization, especially in anatomically complex areas. Furthermore, we provide an update on advances in the integration of intraoperative imaging devices as well as optical tracers for the surgical management of patients. Evidence is emerging that these devices, together with new potential tracers, may improve intraoperative identification of sentinel nodes and/or tumors. A detailed presentation on a portable gamma camera in breast cancer patients, and the application of perioperative imaging devices in gynaecological cancers are included. Other important procedures, such as ROLL and RSL for occult lesion excision in the breast and other organs, are extensively discussed.
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Affiliation(s)
- S Vidal-Sicart
- Nuclear Medicine Department Hospital Clínic, Barcelona, Spain -
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Collado MV, Ruiz-Tovar J, García-Villanueva A, Rojo R, Latorre L, Rioja ME, González-Palacios F. Sentinel lymph node biopsy in selected cases of ductal carcinoma in situ. Clin Transl Oncol 2010; 12:499-502. [DOI: 10.1007/s12094-010-0543-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Barrasa A, Javier Fernández-Merino F, Cabañas J, Prado M, Eugenia Rioja M, Díez L, Rojo R, Collado M, García-Villanueva A, Cabañas L. Cirugía radiodirigida del adenoma de paratiroides. Cir Esp 2004. [DOI: 10.1016/s0009-739x(04)78972-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Phytophthora cactorum, P. cryptogea, P. gonapodyides, and P. megasperma were isolated from necrotic root and crown tissues or the rhizospheres of apple trees exhibiting typical symptoms of Phytophthora root and crown rot in the Central Valley of Chile. Representative isolates of all four species were pathogenic on a variety of apple rootstocks and scions in trials conducted on excised shoots and 1-year-old MM.106 rootstock grown for 4 months in infested potting medium. P. cactorum was the most frequently isolated species and the most virulent in pot tests, although a significant Phytophthora sp.-apple genotype interaction was observed. This is the first report of any species other than P. cactorum causing root and crown rot of apple trees in Chile.
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Affiliation(s)
- B A Latorre
- Facultad de Agronomía e Ingeniería Forestal, Pontificia Universidad Católica de Chile, Casilla 306-22, Santiago, Chile
| | - M E Rioja
- Facultad de Agronomía e Ingeniería Forestal, Pontificia Universidad Católica de Chile, Casilla 306-22, Santiago, Chile
| | - W F Wilcox
- New York State Agricultural Experiment Station, Cornell University, Geneva 14456
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Rueda Núñez F, Catalá Sanz MP, González Diéguez C, Brito Pérez JM, Rioja ME, Maitre Azcárate MJ. [Cardiac fibroma: diagnosis and surgical treatment]. An Esp Pediatr 1999; 50:177-80. [PMID: 10199031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Affiliation(s)
- F Rueda Núñez
- Servicio de Cardiología Pediátrica, Hospital Ramón y Cajal, Madrid
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