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A novel method for sentinel lymph node mapping using magnetite in patients with non-small cell lung cancer.

Taku Nakagawa·Yoshihiro Minamiya·Yoshihisa Katayose·Hajime Saito·Kousei Taguchi·Hiroshi Imano·Hitoshi Watanabe·Katsuhiko Enomoto·Masato Sageshima·Tomoaki Ueda·Jun-ichi Ogawa
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Abstract

OBJECTIVE: The detection rate of sentinel lymph nodes in patients with non-small cell lung cancer using isosulfan blue dye is too low for clinical use. Although exposure to radioactivity is reportedly minimal, special procedures are nonetheless required when a radioactive isotope is used as a tracer. Therefore, to eliminate the need for a radioactive tracer and to obtain a better detection rate than is obtained with isosulfan blue dye, we have developed a novel method that employs magnetite as the tracer. The aim of the present study was to test the feasibility of this technique. METHODS: The tracer employed was ferumoxides, a colloidal superparamagnetic iron oxide of nonstoichiometric magnetite. Thirty-eight non-small cell lung cancer patients participated in the study; each received 5 mL of ferumoxides, injected around the tumor intraoperatively. Fifteen minutes after injection, lung resection and lymph node dissection were carried out. The magnetic force within the lymph nodes was measured using a highly sensitive handheld magnetometer ex vivo. All lymph nodes were also subjected to conventional histological analysis. RESULTS: The rate of detection of sentinel lymph nodes was 81.6% (31/38). The accuracy, sensitivity, and false-negative rates were 96.8% (30/31), 85.7% (6/7), and 14.3% (1/7), respectively. CONCLUSION: Intraoperative sentinel lymph node mapping using ferumoxides and a highly sensitive magnetometer is a safe, accurate, and sensitive way to detect sentinel lymph nodes in non-small cell lung cancer patients.

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AdultAgedCarcinoma, Non-Small-Cell LungContrast MediaDextransFalse Negative ReactionsFemaleFerrosoferric OxideHumansIronLung NeoplasmsLymph Node ExcisionLymphatic MetastasisMagnetite NanoparticlesMaleMiddle AgedNeoplasm StagingOxidesSensitivity and SpecificitySentinel Lymph Node BiopsyEvaluation StudyJournal ArticleResearch Support, Non-U.S. Gov't

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Taku Nakagawa, Yoshihiro Minamiya, Yoshihisa Katayose, Hajime Saito, Kousei Taguchi, Hiroshi Imano, Hitoshi Watanabe, Katsuhiko Enomoto, Masato Sageshima, Tomoaki Ueda, Jun-ichi Ogawa. 2003. A novel method for sentinel lymph node mapping using magnetite in patients with non-small cell lung cancer.. https://doi.org/10.1016/s0022-5223(03)00216-2

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