Magnetic sentinel lymph node biopsy and localization properties of a magnetic tracer in an in vivo porcine model
Magnetic sentinel lymph node biopsy and localization properties of a magnetic tracer in an in vivo porcine model
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DOI：
10.1007/s10549-013-2657-0
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发表时间：
2013-08-01
影响因子：
3.8
通讯作者：
Douek, Michael
中科院分区：
文献类型：
--
作者：
Anninga, Bauke;Ahmed, Muneer;Douek, Michael
早期不可触及的乳腺癌的治疗标准是通过导丝引导定位和前哨淋巴结活检（SLNB）进行广泛的局部切除。这在技术上具有缺点，并且由于依赖于放射性同位素。我们评估了使用磁示踪剂的定位能力和同步性能的SLNB使用手持式磁力计在猪模型作为一种新的替代目前的标准。收到IRCAD伦理审查委员会（斯特拉斯堡（法国））的伦理批准。将不同体积（0.1-5 mL）的磁性示踪剂皮下注射到16只小型猪的左侧和右侧第3腹股沟乳腺的乳晕中。4小时后，在注射部位和腹股沟进行磁力计计数。磁力计用于定位来自引流腹股沟淋巴结的任何体内信号。进行磁性SLNB，然后切除注射部位。对前哨淋巴结（SLN）的铁含量进行分级和定量。对所有切除的标本进行称重并计算体积。进行单变量分析以评价相关性。磁性SLNB在所有小型猪中均获得成功。磁力计计数与前哨淋巴结铁含量呈显著相关（r = 0.86; p < 0.01）。SLN的H&E和Perl染色分级与铁含量（p = 0.001; p = 0.003）和磁力计计数（p < 0.001; p = 0.004）显著相关。在所有情况下，注射后4小时，峰值计数对应于原始磁性示踪剂注射部位。切除的注射部位标本的平均体积和重量分别为2.9 cm（3）（SD 0.81）和3.1 g（SD 0.85）。每千日元0.5 mL磁性示踪剂的注射与切除标本的体积（p = 0.05）和重量（p = 0.01）显著增加相关。SLNB和定位可以使用磁性示踪剂在体内进行。这可能为病灶定位和同期SLNB治疗不可触及的乳腺癌提供一种可行的替代方案。
The standard for the treatment of early non-palpable breast cancers is wide local excision directed by wire-guided localization and sentinel lymph node biopsy (SLNB). This has drawbacks technically and due to reliance upon radioisotopes. We evaluated the use of a magnetic tracer for its localization capabilities and concurrent performance of SLNB using a handheld magnetometer in a porcine model as a novel alternative to the current standard. Ethical approval by the IRCAD Ethics Review Board, Strasbourg (France) was received. A magnetic tracer was injected in varying volumes (0.1-5 mL) subcutaneously into the areolar of the left and right 3rd inguinal mammary glands in 16 mini-pigs. After 4 h magnetometer counts were taken at the injection sites and in the groins. The magnetometer was used to localize any in vivo signal from the draining inguinal lymph nodes. Magnetic SLNB followed by excision of the injection site was performed. The iron content of sentinel lymph nodes (SLNs) were graded and quantified. All excised specimens were weighed and volumes were calculated. Univariate analyses were performed to evaluate correlation. Magnetic SLNB was successful in all mini-pigs. There was a significant correlation (r = 0.86; p < 0.01) between magnetometer counts and iron content of SLNs. Grading of SLNs on both H&E and Perl's staining correlated significantly with the iron content (p = 0.001; p = 0.003) and magnetometer counts (p < 0.001; p = 0.004). The peak counts corresponded to the original magnetic tracer injection sites 4 h after injection in all cases. The mean volume and weight of excised injection site specimens was 2.9 cm(3) (SD 0.81) and 3.1 g (SD 0.85), respectively. Injection of a parts per thousand yen0.5 mL magnetic tracer was associated with significantly greater volume (p = 0.05) and weight of excision specimens (p = 0.01). SLNB and localization can be performed in vivo using a magnetic tracer. This could provide a viable alternative for lesion localization and concurrent SLNB in the treatment of non-palpable breast cancer.