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Related Concept Videos

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Positron Emission Tomography (PET) is a medical imaging technique that provides crucial insights into the body's physiological functions at a molecular level. It is an indispensable resource for diagnosing, staging, and monitoring various illnesses, notably cancer, neurological disorders, and cardiovascular conditions.
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Positron emission tomography (PET) is a medical imaging technique involving radiopharmaceuticals — substances that emit short-lived radiation. Although the first PET scanner was introduced in 1961, it took 15 more years before radiopharmaceuticals were combined with the technique and revolutionized its potential.
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Related Experiment Video

Updated: Jul 15, 2025

A Practical Guide for the Production and PET/CT Imaging of 68Ga-DOTATATE for Neuroendocrine Tumors in Daily Clinical Practice
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Sentinel lymph node detection in thyroid carcinoma using [68Ga]Ga-tilmanocept PET/CT: a proof-of-concept study.

Lisa H de Vries1, Lutske Lodewijk1, Tessa Ververs2,3

  • 1Department of Surgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.

European Journal of Nuclear Medicine and Molecular Imaging
|September 29, 2023
PubMed
Summary

Sentinel lymph node biopsy for thyroid cancer staging is improved with [68Ga]Ga-tilmanocept PET/CT. This novel tracer effectively visualizes lymph nodes, aiding in accurate cancer staging and personalized treatment strategies.

Keywords:
68Ga-tilmanocept PET/CTICG-99mTc-nanocolloidSentinel lymph nodeThyroid carcinoma

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Area of Science:

  • Nuclear medicine
  • Oncology
  • Surgical oncology

Background:

  • Sentinel lymph node (SLN) biopsy is underutilized in thyroid carcinoma staging due to limitations of conventional Tc-99m tracers, such as the shine-through effect.
  • The shine-through effect from Tc-99m tracers can obscure nearby SLNs, hindering accurate staging.

Purpose of the Study:

  • To evaluate the feasibility and effectiveness of using the novel positron emission tomography (PET) tracer [68Ga]Ga-tilmanocept for SLN visualization in thyroid carcinoma.
  • To assess the potential of [68Ga]Ga-tilmanocept PET/CT in improving neck staging for thyroid cancer patients.

Main Methods:

  • Patients with thyroid carcinoma received ultrasound-guided peritumoral injections of [68Ga]Ga-tilmanocept and ICG-[99mTc]Tc-nanocolloid.
  • [68Ga]Ga-tilmanocept PET/CT scans were performed at 15 and 60 minutes post-injection to identify SLNs.
  • Intraoperative SLN biopsy was guided by ICG-[99mTc]Tc-nanocolloid, with subsequent resection of the corresponding lymph node level for pathological analysis.

Main Results:

  • The study included 10 patients (7 differentiated thyroid carcinoma, 3 medullary thyroid carcinoma), with 6 being clinically node-negative.
  • A median of 3 SLNs were detected and resected per patient using [68Ga]Ga-tilmanocept PET/CT.
  • The SLN procedure detected (micro)metastases in 9 out of 10 patients, leading to upstaging in 5 of 6 clinically node-negative individuals. SLNs were predominantly found in the lateral neck compartment.

Conclusions:

  • [68Ga]Ga-tilmanocept PET/CT successfully identified SLNs in all evaluated thyroid carcinoma patients.
  • The combination of [68Ga]Ga-tilmanocept PET/CT and ICG-[99mTc]Tc-nanocolloid facilitated accurate surgical detection and resection of SLNs.
  • This imaging technique shows promise for enhancing neck staging in thyroid cancer, paving the way for more personalized treatment approaches based on lymph node status.