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Nuklearmedizin 2004; 43(01): 10-15
DOI: 10.1055/s-0038-1623908
Original Article
Schattauer GmbH

First experiences with a new radiopharmaceutical for sentinel lymph node detection in malignant melanoma

99mTc colloidal rhenium sulphideErste Erfahrungen mit einem neuen Radiopharmakon für die WächterlymphknotenDetektion beim malignen Melanom 99mTc markiertes kolloidales Rheniumsulfid
M. Weiss
1   Klinik und Poliklinik für Nuklearmedizin (Direktor: Prof. Dr. med. K. Hahn)
,
R. A. Schmid
1   Klinik und Poliklinik für Nuklearmedizin (Direktor: Prof. Dr. med. K. Hahn)
,
C. Kunte
2   Dermatologische Klinik (Direktor: Professor Dr. med. G. Plewig), Ludwig-Maximilians-Universität München
,
B. Konz
2   Dermatologische Klinik (Direktor: Professor Dr. med. G. Plewig), Ludwig-Maximilians-Universität München
,
K. Hahn
1   Klinik und Poliklinik für Nuklearmedizin (Direktor: Prof. Dr. med. K. Hahn)
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Publikationsverlauf

Eingegangen: 16. September 2003

06. November 2003

Publikationsdatum:
11. Januar 2018 (online)

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Summary

Aim of this study was to localize the sentinel lymph node by lymphoscintigraphy using technetium-99m colloidal rhenium sulphide (Nanocis®), a new commercially available radiopharmaceutical. Due to the manufacturers’ instructions it is licensed for lymphoscintigraphy. Patients, methods: 35 consecutive patients with histologically proved malignant melanoma, but without clinical evidence of metastases, were preoperatively examined by injecting 20-40 MBq Nanocis® with (mean particle size: 100 nm; range: 50-200 nm) intradermally around the lesion. Additionally blue dye was injected intaoperatively. A hand-held gamma probe guided sentinel node biopsy. Results: During surgery, the preoperatively scintigraphically detected sentinel lymph nodes were identified in 34/35 (97%) patients. The number of sentinel nodes per patient ranged from one to four (mean: n = 1.8). Histologically, metastatic involvement of the sentinel lymph node was found in 12/35 (34%) patients; the sentinel lymph node positive-rate (14/63 SLN) was 22%. Thus, it is comparable to the findings of SLN-mapping using other technetium-99m-labeled nanocolloides. Conclusion: 99mTc-bound colloidal rhenium sulphide is also suitable for sentinel node mapping.

Zusammenfassung

Ziel dieser Studie war es, den Wächterlymphknoten (SLN) mittels Lymphszintigraphie unter Einsatz von Technetium-99m markiertem kolloidalem Rheniumsulfid (Nanocis®), einem neuen, kommerziell erhältlichen Radiopharmakon für lymphszintigraphische Untersuchungen zu lokalisieren. Patienten, Methoden: 35 konsekutive Patienten mit histologisch gesichertem malignen Melanom, jedoch ohne klinische Hinweise auf (Fern-) Metastasierung, wurden präoperativ nach intradermaler, peritumoraler Injektion von 20-40 MBq Nanocis® (durchschnittliche Partikelgröße: 100 nm; Streubreite: 50-200 nm) untersucht. Zusätzlich erfolgte intraoperativ eine Blaufärbung. Die intraoperative SLN-Detektion wurde mit einer Hand-Gammasonde durchgeführt. Ergebnisse: Intraoperativ konnten bei 34/35 Patienten (97%) insgesamt 63 zuvor szintigraphisch detektierte und auf der Haut markierte Wächterlymphknoten mittels Gammasonde gefunden werden. Mittels Blaufärbung ließen sich lediglich 41/63 (65%) Wächterlymphknoten darstellen. Die Anzahl der Wächterlymphknoten pro Patient betrug 1-4 (Mittel: n = 1,8). Der histologische Befund bestätigte den metastatischen Befall der SLN bei 12/35 (34%) Patienten. Die SLN-positiv-Rate (14/63 SLN) betrug 22%. Sie ist mit den Ergebnissen der SLN-Diagnostik mittels anderer Technetium-99m markierter Nanokolloide vergleichbar. Schlussfolgerung: An Tc-99m gebundenes kolloidales Rheniumsulfid eignet sich zur SLN-Diagnostik.

Keywords

Malignant melanoma - rhenium sulphide - sentinel lymph node - scintigraphy

Schlüsselwörter

Malignes Melanom - Rheniumsulfid - Wächterlymphknoten - Szintigraphie
 

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