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Beitragstitel Sentimag and MRI Lymphangiography in Head and Neck cancer sentinel node biopsy
Beitragscode O02
  1. Nicolas Dulguerov Hôpitaux Universitaires Genève Präsentierende:r
  2. Michael Douek Kings College Hospitals London
  3. Minerva Becker HUG Hôpitaux Universitaires Genève
  4. Marc Pusztaszeri McGill University
  5. Pavel Dulguerov Hôpital de La Tour
Präsentationsform Vortrag
  • SGORL FV 2019
Abstract-Text Background: Sentinel lymph node (SLN) biopsy is a minimally invasive procedure which is validated in the evaluation of the presence of occult neck metastasis in early stage (T1-T2) squamous cell carcinoma of the oral cavity with clinically N0 neck. We present an original technique, using a small iron oxide nanoparticles (SPIO) dextran coated of 60 nm as a tracer and detected per- operatively with Sentimag. The SPIO offers the advantages of being detected in the lymph nodes during the pathologic exam and of being traceable during the magnetic resonance imaging. Last, it is not radioactive, facilitating its use in routine practice.
Material and Methods: Prospective translational clinical research study evaluating the feasability of this technique on 24 patients with cT1-T2N0 primary squamous cell carcinoma of the oral cavity and of the pharynx who underwent the tumor resection and a neck dissection after the peritumoral injection of the SPIO. A subgroup of 9 patients had an additional pre-operative MRI after the SPIO injection.
Results: No complication occurred. The sensitivity and specificity for the identification of lymph node metastasis were 25% and 89% (997 lymph nodes analysed). If SLN identification was extrapolated to the levels of the neck, sensitivity and specificity were 100 and 60% (94 neck levels analysed). Regarding the identification of the USPIO in the SLN, sensitivity and specificity were 58 and 96% (761 lymph nodes).
Conclusion: Sentimag with per-operative detection of SLN is a novel feasible surgical technique, which warrants some refinements. Despite poor sensitivity in SLN metastasis identification, it offers promising future perspectives.