Eliane R Nieuwenhuis1, Barry Kolenaar2, Alexander J M van Bemmel3, Jurrit J Hof4, Joop van Baarlen5, Anke Christenhusz6, Joost J Pouw7, Bernard Ten Haken7, Lejla Alic8, Remco de Bree9. 1. Magnetic Detection and Imaging Group, Technical Medical Centre, University of Twente, Enschede, the Netherlands; Department of Maxillofacial Surgery - Head and Neck Surgical Oncology, Medisch Spectrum Twente, Enschede, the Netherlands. 2. Department of Maxillofacial Surgery - Head and Neck Surgical Oncology, Medisch Spectrum Twente, Enschede, the Netherlands. 3. Department of Otorhinolaryngology - Head and Neck Surgical Oncology, Medisch Spectrum Twente, Enschede, the Netherlands. 4. Department of Radiology, Medisch Spectrum Twente, Enschede, the Netherlands. 5. Laboratorium Pathologie Oost Nederland, Hengelo, the Netherlands. 6. Magnetic Detection and Imaging Group, Technical Medical Centre, University of Twente, Enschede, the Netherlands; Department of Surgery, Medisch Spectrum Twente, Enschede, the Netherlands. 7. Magnetic Detection and Imaging Group, Technical Medical Centre, University of Twente, Enschede, the Netherlands. 8. Magnetic Detection and Imaging Group, Technical Medical Centre, University of Twente, Enschede, the Netherlands. Electronic address: l.alic@utwente.nl. 9. Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, the Netherlands.
Abstract
OBJECTIVES: To assess the feasibility and merits of a complete magnetic approach for a sentinel lymph node biopsy (SLNB) procedure in oral cancer patients. MATERIALS AND METHODS: This study included ten oral cancer patients (stage cT1-T2N0M0) scheduled for elective neck dissection (END). Superparamagnetic iron oxide nanoparticles (SPIO) were administered peritumorally prior to surgery. A preoperative MRI was acquired to identify lymph nodes (LNs) with iron uptake. A magnetic detector was used to identify magnetic hotspots prior, during, and after the SLNB procedure. The resected sentinel LNs (SLNs) were evaluated using step-serial sectioning, and the neck dissection specimen was assessed by routine histopathological examination. A postoperative MRI was acquired to observe any residual iron. RESULTS: Of ten primary tumors, eight were located in the tongue, one floor-of-mouth (FOM), and one tongue-FOM transition. SPIO injections were experienced as painful by nine patients, two of whom developed a tongue swelling. In eight patients, magnetic SLNs were successfully detected and excised during the magnetic SLNB procedure. During the END procedure, additional magnetic SLNs were identified in three patients. Histopathology confirmed iron deposits in sinuses of excised SLNs. Three SLNs were harboring metastases, of which one was identified only during the END procedure. The END specimens revealed no further metastases. CONCLUSION: A complete magnetic SLNB procedure was successfully performed in eight of ten patients (80% success rate), therefore the procedure seems feasible. Recommendations for further investigation are made including: use of anesthetics, magnetic tracer volume, planning preoperative MRI, comparison to conventional technique and follow-up.
OBJECTIVES: To assess the feasibility and merits of a complete magnetic approach for a sentinel lymph node biopsy (SLNB) procedure in oral cancer patients. MATERIALS AND METHODS: This study included ten oral cancer patients (stage cT1-T2N0M0) scheduled for elective neck dissection (END). Superparamagnetic iron oxide nanoparticles (SPIO) were administered peritumorally prior to surgery. A preoperative MRI was acquired to identify lymph nodes (LNs) with iron uptake. A magnetic detector was used to identify magnetic hotspots prior, during, and after the SLNB procedure. The resected sentinel LNs (SLNs) were evaluated using step-serial sectioning, and the neck dissection specimen was assessed by routine histopathological examination. A postoperative MRI was acquired to observe any residual iron. RESULTS: Of ten primary tumors, eight were located in the tongue, one floor-of-mouth (FOM), and one tongue-FOM transition. SPIO injections were experienced as painful by nine patients, two of whom developed a tongue swelling. In eight patients, magnetic SLNs were successfully detected and excised during the magnetic SLNB procedure. During the END procedure, additional magnetic SLNs were identified in three patients. Histopathology confirmed iron deposits in sinuses of excised SLNs. Three SLNs were harboring metastases, of which one was identified only during the END procedure. The END specimens revealed no further metastases. CONCLUSION: A complete magnetic SLNB procedure was successfully performed in eight of ten patients (80% success rate), therefore the procedure seems feasible. Recommendations for further investigation are made including: use of anesthetics, magnetic tracer volume, planning preoperative MRI, comparison to conventional technique and follow-up.
Authors: Mischa de Ridder; Cornelis P J Raaijmakers; Frank A Pameijer; Remco de Bree; Floris C J Reinders; Patricia A H Doornaert; Chris H J Terhaard; Marielle E P Philippens Journal: Cancers (Basel) Date: 2022-06-20 Impact factor: 6.575
Authors: Eliane R Nieuwenhuis; Barry Kolenaar; Jurrit J Hof; Joop van Baarlen; Alexander J M van Bemmel; Anke Christenhusz; Tom W J Scheenen; Bernard Ten Haken; Remco de Bree; Lejla Alic Journal: Cancers (Basel) Date: 2022-01-28 Impact factor: 6.639