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Development of sentinel lymph node biopsy technique in patients with salivary gland cancer using the IDEAL framework.

Research output: Contribution to journalArticle

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Development of sentinel lymph node biopsy technique in patients with salivary gland cancer using the IDEAL framework. / Schilling, Clare; Gnanasegaran, Gopinath; Vojnovicd, Boris; Thavaraj, Selvam; Ngu, Rose; McGurk, Mark.

In: European Journal of Surgical Oncology, Vol. 46, No. 11, 11.2020, p. 2029-2034.

Research output: Contribution to journalArticle

Harvard

Schilling, C, Gnanasegaran, G, Vojnovicd, B, Thavaraj, S, Ngu, R & McGurk, M 2020, 'Development of sentinel lymph node biopsy technique in patients with salivary gland cancer using the IDEAL framework.', European Journal of Surgical Oncology, vol. 46, no. 11, pp. 2029-2034. https://doi.org/10.1016/j.ejso.2020.05.015

APA

Schilling, C., Gnanasegaran, G., Vojnovicd, B., Thavaraj, S., Ngu, R., & McGurk, M. (2020). Development of sentinel lymph node biopsy technique in patients with salivary gland cancer using the IDEAL framework. European Journal of Surgical Oncology, 46(11), 2029-2034. https://doi.org/10.1016/j.ejso.2020.05.015

Vancouver

Schilling C, Gnanasegaran G, Vojnovicd B, Thavaraj S, Ngu R, McGurk M. Development of sentinel lymph node biopsy technique in patients with salivary gland cancer using the IDEAL framework. European Journal of Surgical Oncology. 2020 Nov;46(11):2029-2034. https://doi.org/10.1016/j.ejso.2020.05.015

Author

Schilling, Clare ; Gnanasegaran, Gopinath ; Vojnovicd, Boris ; Thavaraj, Selvam ; Ngu, Rose ; McGurk, Mark. / Development of sentinel lymph node biopsy technique in patients with salivary gland cancer using the IDEAL framework. In: European Journal of Surgical Oncology. 2020 ; Vol. 46, No. 11. pp. 2029-2034.

Bibtex Download

@article{add248ef15514688942193c91779e827,
title = "Development of sentinel lymph node biopsy technique in patients with salivary gland cancer using the IDEAL framework.",
abstract = "Background: Salivary cancer is rare and comprises a variety of histological subtypes and clinical behaviors. There is no agreed method of estimating the risk of occult metastasis or managing the clinically N0 neck.Sentinel node biopsy (SNB) may offer a solution but previous studies have not produced a reliable imaging protocol. This study uses novel technology and trial methodology to develop a reliable SNB technique, with primary aim to identify peri-and intraglandular sentinel nodes. Methods: IDEAL framework was used to undertake SNB in clinically node negative salivary gland cancer. Patients with cT1-2 N0 salivary cancer were eligible. Lymphoscintigraphy was undertaken using Tc-99 m labelled nanocoll. Injection technique as well as adjunctive use of freehand SPECT (fhSPECT), near-infrared (NIR) fluorescence imaging, and navigation-guided surgery were used and optimisied during the study protocol. Results: 10 patients were recruited. Initial protocol of peritumoural injection of Tc99 m nanocoll showed poor image resolution. Subsequent adjustment to single intratumoural injection allowed identification of intraglandular sentinel nodes. Fh/SPECT and NIR fluorescence imaging found intraglandular lymph nodes otherwise not recognizable to the naked eye. In two cases occult lymph node metastasis were identified. Conclusion: This study has shown the IDEAL framework is vital in allowing iterative changes in surgical protocol in the light of experience. This study has produced a reliable method for detection of sentinel nodes, in particular the ability to identify intra- and periglandular nodes with diagnosis of occult metastatic deposits and no false negative results. Our protocol can be readily transferred in to larger scale studies.",
keywords = "Fluorescence guided surgery, Freehand, IDEAL framework, Neck dissection, SPECT, Salivary gland malignancy, Sentinel node biopsy",
author = "Clare Schilling and Gopinath Gnanasegaran and Boris Vojnovicd and Selvam Thavaraj and Rose Ngu and Mark McGurk",
year = "2020",
month = nov,
doi = "10.1016/j.ejso.2020.05.015",
language = "English",
volume = "46",
pages = "2029--2034",
journal = "European Journal of Surgical Oncology",
issn = "0748-7983",
publisher = "W.B. Saunders Ltd",
number = "11",

}

RIS (suitable for import to EndNote) Download

TY - JOUR

T1 - Development of sentinel lymph node biopsy technique in patients with salivary gland cancer using the IDEAL framework.

AU - Schilling, Clare

AU - Gnanasegaran, Gopinath

AU - Vojnovicd, Boris

AU - Thavaraj, Selvam

AU - Ngu, Rose

AU - McGurk, Mark

PY - 2020/11

Y1 - 2020/11

N2 - Background: Salivary cancer is rare and comprises a variety of histological subtypes and clinical behaviors. There is no agreed method of estimating the risk of occult metastasis or managing the clinically N0 neck.Sentinel node biopsy (SNB) may offer a solution but previous studies have not produced a reliable imaging protocol. This study uses novel technology and trial methodology to develop a reliable SNB technique, with primary aim to identify peri-and intraglandular sentinel nodes. Methods: IDEAL framework was used to undertake SNB in clinically node negative salivary gland cancer. Patients with cT1-2 N0 salivary cancer were eligible. Lymphoscintigraphy was undertaken using Tc-99 m labelled nanocoll. Injection technique as well as adjunctive use of freehand SPECT (fhSPECT), near-infrared (NIR) fluorescence imaging, and navigation-guided surgery were used and optimisied during the study protocol. Results: 10 patients were recruited. Initial protocol of peritumoural injection of Tc99 m nanocoll showed poor image resolution. Subsequent adjustment to single intratumoural injection allowed identification of intraglandular sentinel nodes. Fh/SPECT and NIR fluorescence imaging found intraglandular lymph nodes otherwise not recognizable to the naked eye. In two cases occult lymph node metastasis were identified. Conclusion: This study has shown the IDEAL framework is vital in allowing iterative changes in surgical protocol in the light of experience. This study has produced a reliable method for detection of sentinel nodes, in particular the ability to identify intra- and periglandular nodes with diagnosis of occult metastatic deposits and no false negative results. Our protocol can be readily transferred in to larger scale studies.

AB - Background: Salivary cancer is rare and comprises a variety of histological subtypes and clinical behaviors. There is no agreed method of estimating the risk of occult metastasis or managing the clinically N0 neck.Sentinel node biopsy (SNB) may offer a solution but previous studies have not produced a reliable imaging protocol. This study uses novel technology and trial methodology to develop a reliable SNB technique, with primary aim to identify peri-and intraglandular sentinel nodes. Methods: IDEAL framework was used to undertake SNB in clinically node negative salivary gland cancer. Patients with cT1-2 N0 salivary cancer were eligible. Lymphoscintigraphy was undertaken using Tc-99 m labelled nanocoll. Injection technique as well as adjunctive use of freehand SPECT (fhSPECT), near-infrared (NIR) fluorescence imaging, and navigation-guided surgery were used and optimisied during the study protocol. Results: 10 patients were recruited. Initial protocol of peritumoural injection of Tc99 m nanocoll showed poor image resolution. Subsequent adjustment to single intratumoural injection allowed identification of intraglandular sentinel nodes. Fh/SPECT and NIR fluorescence imaging found intraglandular lymph nodes otherwise not recognizable to the naked eye. In two cases occult lymph node metastasis were identified. Conclusion: This study has shown the IDEAL framework is vital in allowing iterative changes in surgical protocol in the light of experience. This study has produced a reliable method for detection of sentinel nodes, in particular the ability to identify intra- and periglandular nodes with diagnosis of occult metastatic deposits and no false negative results. Our protocol can be readily transferred in to larger scale studies.

KW - Fluorescence guided surgery

KW - Freehand

KW - IDEAL framework

KW - Neck dissection

KW - SPECT

KW - Salivary gland malignancy

KW - Sentinel node biopsy

UR - http://www.scopus.com/inward/record.url?scp=85086850316&partnerID=8YFLogxK

U2 - 10.1016/j.ejso.2020.05.015

DO - 10.1016/j.ejso.2020.05.015

M3 - Article

VL - 46

SP - 2029

EP - 2034

JO - European Journal of Surgical Oncology

JF - European Journal of Surgical Oncology

SN - 0748-7983

IS - 11

ER -

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