Combined 68Ga-NOTA-Evans Blue Lymphoscintigraphy and 68Ga-NOTA-RM26 PET/CT Evaluation of Sentinel Lymph Node Metastasis in Breast Cancer Patients.,Bioconjugate Chemistry

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Combined 68Ga-NOTA-Evans Blue Lymphoscintigraphy and 68Ga-NOTA-RM26 PET/CT Evaluation of Sentinel Lymph Node Metastasis in Breast Cancer Patients.
Bioconjugate Chemistry ( IF 4.0 ) Pub Date : 2019-12-27 , DOI: 10.1021/acs.bioconjchem.9b00789
Jie Zang _{1,

2} , Qingxing Liu _{1,

2} , Huimin Sui _{1,

2} , Hua Guo _{1,

2} , Li Peng ₃ , Fang Li _{1,

2} , Lixin Lang ₄ , Orit Jacobson ₄ , Zhaohui Zhu _{1,

2} , Feng Mao ₃ , Xiaoyuan Chen ₄

Affiliation

In this study, we applied a new strategy to identify sentinel lymph node (SLN) metastasis by combining 68Ga-NOTA-Evans Blue (68Ga-NEB) for SLN mapping and 68Ga-NOTA-RM26 for LN metastasis detection in breast cancer patients. A total of 24 female patients with breast cancer diagnosed by core biopsy or suspected by mammography or ultrasonography were recruited and provided informed consent. All patients underwent 68Ga-NEB and 68Ga-NOTA-RM26 PET/CT imaging. Visual analysis of 68Ga-NEB PET/CT images was used to determine SLNs, and then compared with the 68Ga-NOTA-RM26 results and histopathological findings. SLNs were visualized in 24 of 24 patients (100.0%) within 4.0-10.0 (5.6 ± 1.4) min. All patients were pathologically diagnosed with breast cancer, and 12 patients had ipsilateral lymph node metastasis. By combining 68Ga-NEB and 68Ga-NOTA-RM26 images, 7/12 (58.3%) patients showed mild to intense uptake of 68Ga-NOTA-RM26 in SLNs, 1/12 patient (8.3%) had moderate uptake of 68Ga-NOTA-RM26 in the non-SLNs rather than SLN, indicating possible bypass lymphatic drainage, partially accounting for the false negatives in SLN biopsy during surgery. No false positives were found. The SUVmax of 68Ga-NOTA-RM26 activity in metastatic SLNs was significantly higher than that in non-metastatic SLNs (2.2 ± 2.3 vs 0.7 ± 0.1, P = 0.047). This study manifests the value of combination of 68Ga-NEB and 68Ga-NOTA-RM26 dual tracer PET/CT in preoperative evaluation of SLN metastasis in breast cancer patients, especially in those patients with lymphatic obstruction and bypass drainage. In general, positive 68Ga-NOTA-RM26 uptake in either SLN or other lymph nodes can apply lymph node dissection rather than intraoperative SLN biopsy.

中文翻译：

结合68Ga-NOTA-伊文思蓝淋巴显像和68Ga-NOTA-RM26 PET / CT评价乳腺癌患者前哨淋巴结转移。

在这项研究中，我们结合了用于乳腺癌患者的68Ga-NOTA-伊文思蓝（68Ga-NEB）和用于SLN定位的68Ga-NOTA-RM26来识别前哨淋巴结（SLN）转移的新策略。总共招募了24名经核心活检诊断或通过X线或超声检查怀疑为女性的女性乳腺癌患者，并征得其知情同意。所有患者均接受68Ga-NEB和68Ga-NOTA-RM26 PET / CT成像。使用68Ga-NEB PET / CT图像的视觉分析确定SLN，然后与68Ga-NOTA-RM26结果和组织病理学结果进行比较。在4.0-10.0（5.6±1.4）分钟内，在24例患者中的24例（100.0％）中显示了SLN。所有患者均经病理诊断为乳腺癌，其中12例患侧淋巴结转移。通过结合68Ga-NEB和68Ga-NOTA-RM26图像，7/12（58.3％）患者在SLNs中轻度至强烈摄取68Ga-NOTA-RM26，1/12患者（8.3％）适度摄取68Ga-NOTA -非SLN而不是SLN中的-RM26，表明可能有旁路淋巴引流，部分解释了手术期间SLN活检中的假阴性。没有发现假阳性。转移性SLNs中68Ga-NOTA-RM26活性的SUVmax显着高于非转移性SLNs（2.2±2.3 vs 0.7±0.1，P = 0.047）。这项研究表明68Ga-NEB和68Ga-NOTA-RM26双示踪PET / CT组合在乳腺癌患者，尤其是淋巴阻塞和旁路引流患者的SLN转移术前评估中的价值。一般来说，

更新日期：2020-01-07

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