99mTc-Tilmanocept Versus 99mTc-Sulfur Colloid in Lymphoscintigraphy: Sentinel Lymph Node Identification and Patient-Reported Pain

Brittany L. Murphy, Allison R. Woodwick, Katie M. Murphy, Kimberly J. Chandler, Geoffrey B. Johnson, Christopher H. Hunt, Patrick Peller, James W. Jakub, Andrew C. Homb

Research output: Contribution to journalArticle

Abstract

Lymphoscintigraphy plays a vital role in sentinel lymph node (SLN) identification in oncologic breast surgery. The effectiveness of SLN localization and the degree of patient pain were compared between filtered 99mTc-sulfur colloid (99mTc-SC) and 99mTc-tilmanocept. Methods: A retrospective review of patients undergoing lymphoscintigraphy for breast cancer using 99mTc-SC (June 1, 2010, to December 31, 2011) or 99mTc-tilmanocept (June 1, 2013, to January 31, 2014) was performed. SLN appearance time and uptake, SLN pathology, proportion of positive SLNs removed, and pain scores were compared for each radiopharmaceutical using the χ2 test, Fisher exact test, and unequal variance t test, as appropriate. Results: In total, 76 patients, with 86 evaluated axillae, underwent lymphoscintigraphy: 29 with 99mTc-SC and 47 with 99mTc-tilmanocept. The mean SLN appearance time was 11.0 min for 99mTc-SC and 19.3 min for 99mTc-tilmanocept (P = 0.003). There was no difference in the mean transit uptake percentage: 2.2% for 99mTc-SC and 1.9% for 99mTc-tilmanocept (P = 0.55). 99mTc-tilmanocept identified a greater proportion of intraoperative blue nodes than did 99mTc-SC (P = 0.03). There was no significant difference between 99mTc-SC and 99mTc-tilmanocept in the number of SLNs removed, number of patients with positive SLNs, or pain score. Conclusion:99mTc-SC use in lymphoscintigraphy is an acceptable alternative to 99mTc-tilmanocept for SLN detection in breast cancer, on the basis of the similarity in intraoperative SLN identification and pain scores.

Original languageEnglish (US)
Pages (from-to)300-304
Number of pages5
JournalJournal of nuclear medicine technology
Volume47
Issue number4
DOIs
StatePublished - Dec 1 2019

Keywords

  • lymphoscintigraphy
  • Lymphoseek
  • sulfur colloid
  • tilmanocept

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging

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    Murphy, B. L., Woodwick, A. R., Murphy, K. M., Chandler, K. J., Johnson, G. B., Hunt, C. H., Peller, P., Jakub, J. W., & Homb, A. C. (2019). 99mTc-Tilmanocept Versus 99mTc-Sulfur Colloid in Lymphoscintigraphy: Sentinel Lymph Node Identification and Patient-Reported Pain. Journal of nuclear medicine technology, 47(4), 300-304. https://doi.org/10.2967/jnmt.118.225342