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From Local Invasion to Metastatic Cancer pp 123–133Cite as

Molecular Imaging of the Sentinel Lymph Node via Lymphoseek

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Part of the book series: Current Clinical Oncology ((CCO))

Abstract

Sentinel lymph node biopsy is performed with increasing frequency in patients undergoing surgery for early-stage cancer to avoid unnecessary lymphadenectomy in patients whose sentinel node is negative for metastatic disease. Mapping of the sentinel node via nuclear imaging involves the injection of a radiotracer into the vicinity of the tumor and the subsequent localization of the sentinel node by lymphoscintigraphy and gamma probe detection. Lymphoseek is a new radiotracer specifically designed for sentinel node mapping. It exhibits properties that are advantageous over other radiotracers such as filtered technetium-99m sulfur colloid. Preclinical studies demonstrate improved pharmacokinetic qualities and reduced radiation exposure, when using Lymphoseek compared with radiocolloids. Phase I and Phase II clinical trials conducted in breast cancer and melanoma patients confirmed Lymphoseek’s safety in patients and improved identification of the sentinel lymph node. Preclinical studies also demonstrate potential applications of Lymphoseek in patients with gastric, colon, or prostate cancer. Additionally, Lymphoseek can be applied in minimally invasive procedures, which is currently becoming an essential technique in surgery.

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References

  1. Schulze T, Mucke J, Markwardt J, Schlag PM, Bembenek A. Long-term morbidity of patients with early breast cancer after sentinel lymph node biopsy compared to axillary lymph node dissection. J Surg Oncol 2006;93:109–19.

    Article  PubMed  Google Scholar 

  2. Veronesi U, Galimberti V, Zurrida S, et al. Sentinel lymph node biopsy as an indicator for axillary dissection in early breast cancer. Eur J Cancer 2001;37:454–8.

    Article  PubMed  CAS  Google Scholar 

  3. Takei H, Suemasu K, Kurosumi M, et al. Sentinel lymph node biopsy alone has no adverse impact on the survival of patients with breast cancer. Breast J 2006;12:S157–64.

    Article  PubMed  Google Scholar 

  4. Takei H, Suemasu K, Kurosumi M, et al. Recurrence after sentinel lymph node biopsy with or without axillary lymph node dissection in patients with breast cancer. Breast Cancer 2007;14:16–24.

    Article  PubMed  Google Scholar 

  5. Styblo T, Aarsvold JN, Grant SF, et al. Sentinel lymph nodes: optimizing success. Semin Roentgenol 2001;36:261–9.

    Article  PubMed  CAS  Google Scholar 

  6. Schoder H, Glass EC, Pecking AP, et al. Molecular targeting of the lymphovascular system for imaging and therapy. Cancer Metastasis Rev 2006;25:185–201.

    Article  PubMed  Google Scholar 

  7. Morton DL, Wen D-R, Wong JH, et al. Technical details of intraoperative lymphatic mapping for early stage melanoma. Arch Surg 1992;127:392–9.

    Article  PubMed  CAS  Google Scholar 

  8. Mariani G, Moresco L, Viale G, et al. Radioguided sentinel lymph node biopsy in breast cancer surgery. J Nucl Med 2001;42:1198–215.

    PubMed  CAS  Google Scholar 

  9. Albertini JJ, Cruse CW, Rapaport D, et al. Intraoperative radiolymphoscintigraphy improves sentinel lymph node identification for patients with melanoma. Ann Surg 1996;223:217–24.

    Article  PubMed  CAS  Google Scholar 

  10. Clement O, Luciani A. Imaging the lymphatic system: possibilities and clinical applications. Eur Radiol 2004;14:1498–507.

    Article  PubMed  Google Scholar 

  11. Mariani G, Gipponi M, Moresco L, et al. Radioguided sentinel lymph node biopsy in malignant cutaneous melanoma. J Nucl Med 2002;43:811–27.

    PubMed  Google Scholar 

  12. Laurie SA, Khan DA, Gruchalla RS, Peters G. Anaphylaxis to isosulfan blue. Ann Allergy Asthma Immunol 2002;88:64–6.

    Article  PubMed  Google Scholar 

  13. Albo D, Wayne JD, Hunt KK, et al. Anaphylactic reactions to isosulfan blue dye during sentinel lymph node biopsy for breast cancer. Am J Surg 2001;182:393–8.

    Article  PubMed  CAS  Google Scholar 

  14. Krag DN, Weaver JC, Alex JC, Fairbank JT. Surgical resection and radiolocalization of the sentinel lymph node in breast cancer using a gamma probe. J Surg Oncol 1993;2:335–40.

    Article  CAS  Google Scholar 

  15. Krag DN, Weaver D, Ashikaga T, et al. The sentinel node in breast cancer – a multicenter validation study. N Engl J Med 1998;339:941–6.

    Article  PubMed  CAS  Google Scholar 

  16. Stern HS, McAfee JG, Subramanian G. Preparation, distribution and utilization of technetium-99m sulfur. J Nucl Med 1966;7:655–75.

    Google Scholar 

  17. Larson SM, Nelp WB. Radiopharmacology of a simplified technetium-99m-colloid preparation for photoscanning. J Nucl Med 1966;7:817–26.

    PubMed  CAS  Google Scholar 

  18. Vera DR, Wallace AM, Hoh CK, Mattrey RF. A synthetic macromolecule for sentinel node detection: [99mTc]DTPA-mannosyl-dextran. J Nucl Med 2001;42:951–9.

    PubMed  CAS  Google Scholar 

  19. Vera DR, Wisner ER, Stadalnik RC. Sentinel node imaging via a nonparticulate receptor-binding radiotracer. J Nucl Med 1997;38:530–5.

    PubMed  CAS  Google Scholar 

  20. Kawasaki T, Mizuno Y, Masuda T, Yamashina I. Mannan-binding protein in lymphoid tissues of rats. J Biochem (Tokyo) 1980;88:1891–4.

    CAS  Google Scholar 

  21. Hoh CK, Wallace AM, Vera DR. Preclinical studies of [99mTc]DPTA-mannosyl-dextran. Nucl Med Biol 2003;30:457–64.

    Article  PubMed  CAS  Google Scholar 

  22. Ellner SJ, Mendez J, Vera DR, Hoh CK, Ashburn WL, Wallace AM. Sentinel lymph node mapping of the colon and stomach using lymphoseek in a pig model. Ann Surg Oncol 2004;11:674–81.

    Article  PubMed  Google Scholar 

  23. Mendez J, Wallace AM, Hoh CK, Vera DR. Detection of gastric and colonic sentinel nodes via endoscopic administration of Lymphoseek in pigs. J Nucl Med 2003;44:1677–81.

    PubMed  CAS  Google Scholar 

  24. Salem CE, Hoh CK, Wallace AM, Vera DR. A preclinical study of prostate sentinel lymph node mapping with [99mTC]diethylenetetramine pentaacetic acid-mannosyl-dextran. J Urol 2006;175:744–8.

    Article  PubMed  Google Scholar 

  25. Wallace AM, Ellner SJ, Mendez J, et al. Minimally invasive sentinel lymph node mapping of the pig colon with lymphoseek. Surgery 2006;139:217–23.

    Article  PubMed  Google Scholar 

  26. Ellner SJ, Hoh CK, Vera DR, Darrah DD, Schulteis G, Wallace AM. Dose-dependent biodistribution of [99mTc]DTPA-mannosyl-dextran for breast cancer sentinel node mapping. Nucl Med Biol 2003;30:805–10.

    Article  PubMed  CAS  Google Scholar 

  27. Wallace AM, Hoh CK, Vera DR, Darrah D, Schulteis G. Lymphoseek: A molecular radiopharmceutical for sentinel node detection. Ann Surg Oncol 2003;10:531–8.

    Article  PubMed  Google Scholar 

  28. Wallace AM, Hoh CK, Darrah DD, Schulteis G, Vera DR. Sentinel lymph node mapping of breast cancer via intradermal administration of Lymphoseek. Nucl Med Biol 2007;34:849–53.

    Article  PubMed  CAS  Google Scholar 

  29. Wallace AM, Hoh CK, Ellner SJ, Darrah DD, Schulteis G, Vera DR. Lymphoseek: a molecular imaging agent for melanoma sentinel lymph node mapping. Ann Surg Oncol 2007;14:913–21.

    Article  PubMed  Google Scholar 

  30. Kim J RM, Leong S, Faries M, Scoggins CR, Orahood RC. A Phase 2, single arm, open-label, multicenter study to evaluate the safety and efficacy of Lymphoseek as a lymphoid tissue targeting agent in patients with known or suspected melanoma or breast cancer who are undergoing lymph node mapping. In Preparation.

    Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Surgery, Moores UCSD Cancer Center, University of California, San Diego, La Jolla, CA, USA

    Antonia Woehnl MD & Anne M. Wallace MD, FACS

  2. Department of Radiology, Rebecca and John Moores UCSD Comprehensive Cancer Center, University of California, San Diego, La Jolla, CA, USA

    Carl K. Hoh MD

  3. Departments of Medicine and Radiology, University of California, San Diego, CA, USA

    Jeanette Méndez MD

  4. Rebecca and John Moores UCSD Comprehensive Cancer Center, University of California, San Diego, La Jolla, CA, USA

    Denise D. Darrah RN

  5. Neoprobe Corporation, Dublin, OH, USA

    Richard C. Orahood MD, FACS

  6. Department of Radiology, Moores UCSD Cancer Center, University of California, San Diego, La Jolla, CA, USA

    David R. Vera PhD

Authors
  1. Antonia Woehnl MD
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  2. Carl K. Hoh MD
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  3. Jeanette Méndez MD
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  4. Denise D. Darrah RN
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  5. Richard C. Orahood MD, FACS
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  6. David R. Vera PhD
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  7. Anne M. Wallace MD, FACS
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Editor information

Editors and Affiliations

  1. Division of Surgical Oncology, University of California, San Francisco, Divisadero St. 1600, San Francisco, 94115, USA

    Stanley P. L. Leong

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© 2009 Humana Press, a part of Springer Science+Business Media, LLC

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Woehnl, A. et al. (2009). Molecular Imaging of the Sentinel Lymph Node via Lymphoseek. In: Leong, S. (eds) From Local Invasion to Metastatic Cancer. Current Clinical Oncology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60327-087-8_12

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  • DOI: https://doi.org/10.1007/978-1-60327-087-8_12

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  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-60327-086-1

  • Online ISBN: 978-1-60327-087-8

  • eBook Packages: MedicineMedicine (R0)

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