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Exploring an Alternative Preoperative Sentinel Lymph Node Mapping Method Using a Magnetic Tracer and Magnetic
Loeki Aldenhoven1,2, Caroline Frotscher3, Rachelle Körver-Steeman3
1Department of Surgery, Zuyderland Medical Center, Sittard-Geleen, The Netherlands, l.aldenhoven@zuyderland.nl.
Summary
This study evaluates a non-radioactive magnetic tracer (SPIO) as an alternative to radioactive Technetium for sentinel lymph node biopsy in melanoma patients. The magnetic tracer shows promise in reducing radiation exposure and improving surgical logistics.
Area of Science:
- Oncology
- Medical Imaging
- Nanotechnology
Background:
- Sentinel lymph node biopsy (SLNB) is crucial for melanoma management.
- Current methods use radioactive Technetium (99mTc) and Patent Blue, posing risks of radiation exposure and logistical issues.
- Superparamagnetic iron-oxide (SPIO) nanoparticles offer a non-radioactive alternative.
Purpose of the Study:
- To evaluate the non-inferiority of pre-operative MRI with SPIO versus traditional lymphoscintigraphy (LS) and SPECT/CT using 99mTc for SLN status in melanoma.
- To assess the non-inferiority of SPIO/magnetometer compared to the gold standard (99mTc) for SLNB procedures.
Main Methods:
- Prospective, single-arm, non-inferiority study at Zuyderland Medical Center.
- 140 adult patients with stage I-II primary melanoma undergoing wide local excision and SLNB.
- Lymphatic mapping performed using both Magtrace® (SPIO) and 99mTc.
Main Results:
- Clinical trial registration number: NCT05145829.
- The MRI protocol was found feasible in a prior pilot study.
- The study aims to demonstrate non-inferiority within a 5% margin.
Conclusions:
- Eliminating radiation exposure benefits patients and healthcare professionals.
- SPIO offers logistical advantages, allowing injection days before surgery and MRI scanning.
- This approach avoids surgical delays, enhancing patient comfort and hospital efficiency.
