在甲状腺癌中使用Ga-tilmanocept PET/CT检测哨兵淋巴结:一项概念验证研究
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
概括
用[68Ga]Ga-tilmanocept PET/CT改善了用于甲状腺癌分期的哨兵淋巴结活检. 这种新型的追踪器有效地可视化淋巴结,有助于精确的癌症分期和个性化治疗策略.
科学领域:
- 核医学是一种核医学.
- 在瘤学瘤学.
- 手术瘤学手术瘤学
背景情况:
- 哨兵淋巴结 (SLN) 活检在甲状腺癌分期中未得到充分利用,这是由于传统Tc-99m标记物的局限性,例如透光效应.
- 来自Tc-99m追踪器的透光效应可以掩盖附近的SLN,阻碍准确的分期.
研究的目的:
- 评估使用新型正子发射断层扫描 (PET) 追踪器[68Ga]Ga-tilmanocept用于甲状腺癌中SLN可视化的可行性和有效性.
- 评估[68Ga]Ga-tilmanocept PET/CT在改善甲状腺癌患者部分期方面的潜力.
主要方法:
- 患有甲状腺癌的患者接受了超声波导向的围注射[68Ga]Ga-tilmanocept和ICG-[99mTc]Tc-nanocolloid.
- [68Ga]Ga-tilmanocept PET/CT扫描在注射后15分钟和60分钟进行,以确定SLN.
- 在手术期间的SLN活检由ICG-[99mTc]Tc-纳米合体指导,随后对相应的淋巴结水平进行切除以进行病理分析.
主要成果:
- 这项研究包括10名患者 (7例分化甲状腺癌,3例髓性甲状腺癌),其中6例是临床结节阴性.
- 通过使用[68Ga]Ga-tilmanocept PET/CT.检测和切除每名患者中位数为3个SLN.
- 在SLN程序检测到 (微) 转移在10分之9的患者,导致在6个临床节点阴性个体中的5个上升阶段. 主要发现SLN是在子侧部的隔间.
结论:
- [68Ga]Ga-tilmanocept PET/CT在所有评估的甲状腺癌患者中成功识别了SLN.
- [68Ga]Ga-tilmanocept PET/CT和ICG-[99mTc]Tc-纳米聚合物的组合促进了精确的手术检测和SLN切除.
- 这种成像技术显示了增强甲状腺癌部分期的前景,为基于淋巴结状况的更个性化治疗方法铺平了道路.
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