99mTc nanocolloid indicyanine green

an hybrid tracer for breast sentinel node procedures

Juan Gambini, Enzo Silvera, Matias Musetti, Thomas Quinn, Guang Zhong Yang, Santiago Matalonga, Juan Hermida, Omar Alonso, Pablo Cabral

Research output: Contribution to journalMeeting Abstract

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Abstract

Introduction
Breast sentinel lymph node biopsy (SLNB) evaluates if cancer has spread outside the breast, by allowing the identification of the node that has the highest probability of harboring metastastis. Once it is identified and removed during surgery, histologic examination looks for the presence of metastasis. If metastasis are identified, the patient will have an axillary dissection performed, if no metastasis are identified, the patient can spare the axillary dissection with its associated morbility. SLNB procedures are performed with radiotracers or with dyes, or a combination of both. Recently, the hybrid tracer (fluorescent-radioactive) 99mTc nanocolloid indocyanine green (99mTc NC ICG) has been described. The aim of our work is to describe our experience with the hybrid tracer in breast SLN biopsy. Materials Patients were inyected periareolary subcutaneous in the same cuadrant of the lesions. Planar Scintigraphic and SPECT/CT (Mediso Anyscan) images were later acquired. During the SLNB a gamma probe (Europrobe) and our own developed near infrared (NIR) visualization system was used to localize the SLN. This combination allowed surgeons to guide them to the SLN using the acoustic cue provided from the gamma probe and the images from the NIR visualization system. Once the nodes were found they were removed and examined histopathologically. Patients who had positive SLNB underwent axillary dissection.

Results
SLNB with 99mTc NC ICG allowed us to use their complementary fluorescent and radioactive properties in order to find the SLN. In this way, the gamma probe guided us to the region where the node was, and fluorescence made it easy to remove it and spare the rest of surrounding tissue. In this way we could remove 38 nodes, being 4 positive. All radioactive nodes where fluorescent.

Conclusions
SLNB with 99mTc NC ICG could be performed without complications, having no adverse effects on patients. The hybrid tracer adds a visual cue with to the procedure aiding surgeons on SLN localization and removal.
Original languageEnglish
Article number1231
JournalThe Journal of Nuclear Medicine
Volume60
Issue numberSupplement 1
Publication statusPublished - 1 May 2019

Cite this

Gambini, J., Silvera, E., Musetti, M., Quinn, T., Yang, G. Z., Matalonga, S., ... Cabral, P. (2019). 99mTc nanocolloid indicyanine green: an hybrid tracer for breast sentinel node procedures. The Journal of Nuclear Medicine, 60(Supplement 1), [1231].
Gambini, Juan ; Silvera, Enzo ; Musetti, Matias ; Quinn, Thomas ; Yang, Guang Zhong ; Matalonga, Santiago ; Hermida, Juan ; Alonso, Omar ; Cabral, Pablo. / 99mTc nanocolloid indicyanine green : an hybrid tracer for breast sentinel node procedures. In: The Journal of Nuclear Medicine. 2019 ; Vol. 60, No. Supplement 1.
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title = "99mTc nanocolloid indicyanine green: an hybrid tracer for breast sentinel node procedures",
abstract = "IntroductionBreast sentinel lymph node biopsy (SLNB) evaluates if cancer has spread outside the breast, by allowing the identification of the node that has the highest probability of harboring metastastis. Once it is identified and removed during surgery, histologic examination looks for the presence of metastasis. If metastasis are identified, the patient will have an axillary dissection performed, if no metastasis are identified, the patient can spare the axillary dissection with its associated morbility. SLNB procedures are performed with radiotracers or with dyes, or a combination of both. Recently, the hybrid tracer (fluorescent-radioactive) 99mTc nanocolloid indocyanine green (99mTc NC ICG) has been described. The aim of our work is to describe our experience with the hybrid tracer in breast SLN biopsy. Materials Patients were inyected periareolary subcutaneous in the same cuadrant of the lesions. Planar Scintigraphic and SPECT/CT (Mediso Anyscan) images were later acquired. During the SLNB a gamma probe (Europrobe) and our own developed near infrared (NIR) visualization system was used to localize the SLN. This combination allowed surgeons to guide them to the SLN using the acoustic cue provided from the gamma probe and the images from the NIR visualization system. Once the nodes were found they were removed and examined histopathologically. Patients who had positive SLNB underwent axillary dissection.ResultsSLNB with 99mTc NC ICG allowed us to use their complementary fluorescent and radioactive properties in order to find the SLN. In this way, the gamma probe guided us to the region where the node was, and fluorescence made it easy to remove it and spare the rest of surrounding tissue. In this way we could remove 38 nodes, being 4 positive. All radioactive nodes where fluorescent.ConclusionsSLNB with 99mTc NC ICG could be performed without complications, having no adverse effects on patients. The hybrid tracer adds a visual cue with to the procedure aiding surgeons on SLN localization and removal.",
author = "Juan Gambini and Enzo Silvera and Matias Musetti and Thomas Quinn and Yang, {Guang Zhong} and Santiago Matalonga and Juan Hermida and Omar Alonso and Pablo Cabral",
year = "2019",
month = "5",
day = "1",
language = "English",
volume = "60",
journal = "The Journal of Nuclear Medicine",
issn = "0161-5505",
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Gambini, J, Silvera, E, Musetti, M, Quinn, T, Yang, GZ, Matalonga, S, Hermida, J, Alonso, O & Cabral, P 2019, '99mTc nanocolloid indicyanine green: an hybrid tracer for breast sentinel node procedures', The Journal of Nuclear Medicine, vol. 60, no. Supplement 1, 1231.

99mTc nanocolloid indicyanine green : an hybrid tracer for breast sentinel node procedures. / Gambini, Juan; Silvera, Enzo; Musetti, Matias; Quinn, Thomas; Yang, Guang Zhong; Matalonga, Santiago; Hermida, Juan; Alonso, Omar; Cabral, Pablo.

In: The Journal of Nuclear Medicine, Vol. 60, No. Supplement 1, 1231, 01.05.2019.

Research output: Contribution to journalMeeting Abstract

TY - JOUR

T1 - 99mTc nanocolloid indicyanine green

T2 - an hybrid tracer for breast sentinel node procedures

AU - Gambini, Juan

AU - Silvera, Enzo

AU - Musetti, Matias

AU - Quinn, Thomas

AU - Yang, Guang Zhong

AU - Matalonga, Santiago

AU - Hermida, Juan

AU - Alonso, Omar

AU - Cabral, Pablo

PY - 2019/5/1

Y1 - 2019/5/1

N2 - IntroductionBreast sentinel lymph node biopsy (SLNB) evaluates if cancer has spread outside the breast, by allowing the identification of the node that has the highest probability of harboring metastastis. Once it is identified and removed during surgery, histologic examination looks for the presence of metastasis. If metastasis are identified, the patient will have an axillary dissection performed, if no metastasis are identified, the patient can spare the axillary dissection with its associated morbility. SLNB procedures are performed with radiotracers or with dyes, or a combination of both. Recently, the hybrid tracer (fluorescent-radioactive) 99mTc nanocolloid indocyanine green (99mTc NC ICG) has been described. The aim of our work is to describe our experience with the hybrid tracer in breast SLN biopsy. Materials Patients were inyected periareolary subcutaneous in the same cuadrant of the lesions. Planar Scintigraphic and SPECT/CT (Mediso Anyscan) images were later acquired. During the SLNB a gamma probe (Europrobe) and our own developed near infrared (NIR) visualization system was used to localize the SLN. This combination allowed surgeons to guide them to the SLN using the acoustic cue provided from the gamma probe and the images from the NIR visualization system. Once the nodes were found they were removed and examined histopathologically. Patients who had positive SLNB underwent axillary dissection.ResultsSLNB with 99mTc NC ICG allowed us to use their complementary fluorescent and radioactive properties in order to find the SLN. In this way, the gamma probe guided us to the region where the node was, and fluorescence made it easy to remove it and spare the rest of surrounding tissue. In this way we could remove 38 nodes, being 4 positive. All radioactive nodes where fluorescent.ConclusionsSLNB with 99mTc NC ICG could be performed without complications, having no adverse effects on patients. The hybrid tracer adds a visual cue with to the procedure aiding surgeons on SLN localization and removal.

AB - IntroductionBreast sentinel lymph node biopsy (SLNB) evaluates if cancer has spread outside the breast, by allowing the identification of the node that has the highest probability of harboring metastastis. Once it is identified and removed during surgery, histologic examination looks for the presence of metastasis. If metastasis are identified, the patient will have an axillary dissection performed, if no metastasis are identified, the patient can spare the axillary dissection with its associated morbility. SLNB procedures are performed with radiotracers or with dyes, or a combination of both. Recently, the hybrid tracer (fluorescent-radioactive) 99mTc nanocolloid indocyanine green (99mTc NC ICG) has been described. The aim of our work is to describe our experience with the hybrid tracer in breast SLN biopsy. Materials Patients were inyected periareolary subcutaneous in the same cuadrant of the lesions. Planar Scintigraphic and SPECT/CT (Mediso Anyscan) images were later acquired. During the SLNB a gamma probe (Europrobe) and our own developed near infrared (NIR) visualization system was used to localize the SLN. This combination allowed surgeons to guide them to the SLN using the acoustic cue provided from the gamma probe and the images from the NIR visualization system. Once the nodes were found they were removed and examined histopathologically. Patients who had positive SLNB underwent axillary dissection.ResultsSLNB with 99mTc NC ICG allowed us to use their complementary fluorescent and radioactive properties in order to find the SLN. In this way, the gamma probe guided us to the region where the node was, and fluorescence made it easy to remove it and spare the rest of surrounding tissue. In this way we could remove 38 nodes, being 4 positive. All radioactive nodes where fluorescent.ConclusionsSLNB with 99mTc NC ICG could be performed without complications, having no adverse effects on patients. The hybrid tracer adds a visual cue with to the procedure aiding surgeons on SLN localization and removal.

M3 - Meeting Abstract

VL - 60

JO - The Journal of Nuclear Medicine

JF - The Journal of Nuclear Medicine

SN - 0161-5505

IS - Supplement 1

M1 - 1231

ER -

Gambini J, Silvera E, Musetti M, Quinn T, Yang GZ, Matalonga S et al. 99mTc nanocolloid indicyanine green: an hybrid tracer for breast sentinel node procedures. The Journal of Nuclear Medicine. 2019 May 1;60(Supplement 1). 1231.