Comparative research on 99m Tc-Rituximab and 99m Tc-sulfur colloid in sentinel lymph node imaging of breast cancer.

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  • Additional Information
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 100967800 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2407 (Electronic) Linking ISSN: 14712407 NLM ISO Abbreviation: BMC Cancer Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : BioMed Central, [2001-
    • Subject Terms:
      Breast Neoplasms/*pathology ; Colloids/*chemistry ; Organotechnetium Compounds/*administration & dosage ; Rituximab/*chemistry ; Sentinel Lymph Node/*diagnostic imaging ; Sulfur Radioisotopes/*chemistry ; Technetium/*chemistry; Adult ; Aged ; Axilla ; Cohort Studies ; Female ; Half-Life ; Humans ; Lymphoscintigraphy/methods ; Middle Aged ; Radiopharmaceuticals ; Sentinel Lymph Node/pathology ; Sentinel Lymph Node Biopsy
    • Abstract:
      Background: 99m Tc-Rituximab is a new specific radiopharmaceutical that binds to the CD20 receptor which is highly expressed on the surface of B cells. We conducted a study in which 99m Tc-Rituximab was compared with filtered 99m Tc-sulfur colloid (fTcSC) for sentinel lymph node (SLN) detection in patients with breast cancer.
      Method: The study is divided into three parts. 1. Initially, 25 patients were selected for an internal controlled trial to received both 99m Tc-Rituximab and fTcSC, the interval time is separated by ≥2 days. 2. Then, 91 patients were selected for a randomized controlled trial (41 and 50 patients in the 99m Tc-Rituximab and fTcSC groups, respectively). All patients were administered either agent at the 6- and 12-o' clock positions by subareolar injection technique. SLN mapping was then performed 2 h after injection. 3. Serial dynamic images were further acquired for 2 h in 31 patients (22 and 9 patients from 99m Tc-Rituximab and fTcSC cohorts, respectively).
      Results: The identification rate of lymphoscintigraphy and SLNB in all and axilla regions for 99m Tc-Rituximab and 99m Tc-SC were 98.5% vs 98.7, 100% vs 98.4%, respectively. The mean number of SLNs identified by 99m Tc-Rituximab and fTcSC was respectively 2.72 and 3.28, with a significant difference of P = 0.013 (paired sample t-test). The difference exists in the internal mammary and clavicular area, not in the axillary. The mean number of axillary sentinel lymph node biopsy (SLNB) for 99m Tc-Rituximab and fTcSC was 2.95 vs 3.14, respectively, and no significant difference existed. 99m Tc-Rituximab also exhibited a significantly faster injection site clearance rate when compared with fTcSC (0.193 ± 0.057 h - 1 vs 0.021 ± 0.007 h - 1 , respectively).
      Conclusion: No significant difference was observed in identification rate and number of axillary SLN imaging and SLNB, between the two tracers. Compared to fTcSC, 99m Tc-Rituximab based imaging demonstrated a fewer number of secondary lymph nodes and had faster injection site clearance rate.
      Trial Registration: www.chictr.org.cn, ChiCTR1900024990 (retrospectively registered August 6, 2019).
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    • Grant Information:
      No.201803D31139 Shanxi Provincial Key Research and Development Project
    • Contributed Indexing:
      Keywords: Breast cancer; CD20; Radiopharmaceuticals; Sentinel lymph node mapping
    • Accession Number:
      0 (Colloids)
      0 (Organotechnetium Compounds)
      0 (Radiopharmaceuticals)
      0 (Sulfur Radioisotopes)
      4F4X42SYQ6 (Rituximab)
      7440-26-8 (Technetium)
    • Publication Date:
      Date Created: 20191017 Date Completed: 20200226 Latest Revision: 20200226
    • Publication Date:
      20240105
    • Accession Number:
      PMC6794795
    • Accession Number:
      10.1186/s12885-019-6197-9
    • Accession Number:
      31615471