Ex vivo sentinel lymph node mapping in colorectal cancer using [99mTc]Tc-HMPAO-patent blue liposomes: A hybrid radiotracer/dye approach

Document Type : Original Article

Authors

1 Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

2 Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

3 Department of Pathology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

4 Nanotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran

5 Department of Pharmaceutical Nanotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Introduction: To assess the effectiveness of [99mTc]Tc-HMPAO-Patent blue liposomes for sentinel lymph node (SLN) mapping in colorectal cancer (CRC) using combined visual and radiotracer detection in a single injection.
Methods: In this prospective study, 40 CRC patients underwent surgical resection. Post-resection, PEGylated or non-PEGylated [99mTc]Tc-HMPAO liposomes were injected peritumorally ex vivo. SLNs were identified by blue dye visualization and gamma probe detection, followed by pathological assessment.
Results: SLNs were not detected in 6 patients (15%). Among the 34 cases with SLN detection, 5 (14.7%) had metastatic involvement. In 2 cases with negative SLNs, non-sentinel nodes were positive, leading to pathological upstaging in 2 patients (5%). The overall detection rate was 85%, with sensitivities of 80% for colon and 50% for rectal cancer. The false-negative rate was 28%.
Conclusion: [99mTc]Tc-HMPAO-Patent blue liposomes offer an effective dual-modality approach for SLN mapping in CRC, enhancing staging accuracy, especially in colon cancer.

Keywords

Main Subjects

References

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