Christenhusz Anke, Mirzaei Nushin, Karakatsanis Andreas, Eriksson Staffan, Wärnberg Fredrik, Olofsson Bagge Roger, van der Palen Job, Simanowski Julia, Salamzadeh Sadaf, Ten Haken Bennie, Dassen Anneriet E, Alic Lejla
Magnetic Detection and Imaging Group, Technical Medical Centre, University of Twente, Enschede, The Netherlands.
Department of Surgery, Medisch Spectrum Twente, Enschede, The Netherlands.
Ann Surg Oncol. 2025 Mar;32(3):2079-2091. doi: 10.1245/s10434-024-16626-6. Epub 2024 Dec 17.
Superparamagnetic iron oxide nanoparticles (SPIO) are emerging as a viable alternative to technetium and blue dye. Our study was designed to evaluate the correlation between SPIO dose, injection site, and timing with sentinel lymph node (SLN) detection and iron content in retrieved SLNs.
This study combined individual patient data from three Dutch and five Swedish studies. Associations between SLN detection and dose, site, and timeframe of SPIO injection were examined. The iron content for each retrieved SLNs with or without metastases were calculated according to a predefined look up table based on probe counts and sensitivity setting. Analyses were conducted by using multivariable logistic and linear regression models using generalized estimating equation.
A total of 908 patients were included. The detection between the magnetic technique (96.6%) and the radioactive technique was comparable (96.6% vs. 96.8%, p = 0.75). The 1.0-mL SPIO dose was associated with the highest, and <0.5 mL of SPIO was associated with the lowest patient-based detection (100.0 and 96.6% respectively). An intratumoural injection was found to be less favourable compared with peritumoural and subareolar, whereas injection >168 hours before surgery demonstrated the highest patient-based detection.
The noninferiority of SPIO compared with technetium99m ± BD has been proven by several studies. A dose of 1 mL, around the areola, with a longer exposure time, appears to increase the SPIO uptake in the nodes and SLN detection. Metastatic burden in SLNs did not significantly impact the uptake of SPIO.
超顺磁性氧化铁纳米颗粒（SPIO）正成为锝和蓝色染料的一种可行替代物。我们的研究旨在评估SPIO剂量、注射部位和时间与前哨淋巴结（SLN）检测及回收的SLN中铁含量之间的相关性。
本研究合并了来自三项荷兰研究和五项瑞典研究的个体患者数据。研究了SLN检测与SPIO注射剂量、部位和时间范围之间的关联。根据基于探针计数和灵敏度设置的预定义查找表，计算每个回收的有无转移的SLN的铁含量。使用广义估计方程，通过多变量逻辑回归和线性回归模型进行分析。
共纳入908例患者。磁性技术（96.6%）和放射性技术的检测率相当（96.6%对96.8%，p = 0.75）。1.0 mL的SPIO剂量与最高的患者检测率相关，而<0.5 mL的SPIO与最低的患者检测率相关（分别为100.0%和96.6%）。发现肿瘤内注射与肿瘤周围和乳晕下注射相比不太有利，而术前>168小时注射显示出最高的患者检测率。
多项研究已证明SPIO与锝99m±亚甲蓝相比具有非劣效性。1 mL的剂量、在乳晕周围、更长的暴露时间似乎会增加SPIO在淋巴结中的摄取和SLN检测。SLN中的转移负担对SPIO的摄取没有显著影响。
