Sentinel Lymph Node Localization with Contrast-enhanced Ultrasound and an I-125 Seed: A Perfect Prospective Advancement Research Study
Abstract: Introduction: Our goal was to examine the advancement of microbubble-enhanced sentinel lymph node (SLN) localization with positioning of an I-125 seed in breast cancer patients as a potential option for SLN localization with nanocolloid. The study is conducted and reported following the IDEAL recommendations for evaluation of a brand-new method at Stage 2a (Potential Development Research Study). Techniques: Fourteen successive clients with 15 lesions underwent microbubble-enhanced SLN localization with placement of an I-125 seed after the basic SLN localization (nanocolloid). We put an I-125 seed within or near the SLN following its recognition using intradermally injected microbubbles. The SLN was excised directed by nanocolloid and the SLN including the I-125 seed was looked for. All technical adjustments are explained and standardized outcomes determined. Results: Twelve (80%) microbubble treatments with I-125 seed placements were technically effective. In 3 cases no microbubble-enhancing lymph node could be detected. Intraoperatively, we discovered 9 I-125 seeds within 0.5 cm of the nanocolloid confirmed SLN. One I-125 seed was discovered beside a non-SLN and two I-125 seeds were not near any lymph node. In general, the treatment was successful in 60% (9 out of 15) of the cases. Conclusion: Provided the low success rate, we conclude that microbubble-enhanced SLN is not a feasible option to the standard SLN treatment. Adjustments to this technique did not enhance its performance. Planned study (NTR3690 http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=3690) was stopped early due to this conclusion and results reported in order to provide a complete and transparent record of the evolution of technique. Highlights: The existing SLN procedure with nanocolloid is extremely accurate, though logistically made complex and time consuming. A brand-new SLN treatment with microbubbles and an I-125 seed can be carried out days or weeks prior to the surgical SLN treatment. SLN localization with microbubbles and an I-125 seed proved not to be a viable alternative to the basic SLN treatment. Modifications to this technique did not improve its performance.
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