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Jonathan T Unkart, James Proudfoot, Anne M Wallace
No prior studies have compared Tc-99m tilmanocept (TcTM) one-day and two-day injection protocols for sentinel lymph node (SLN) biopsy in breast cancer (BC). We retrospectively identified patients with clinically node-negative BC undergoing SLN biopsy at our institution. Patients received a single, intradermal peritumoral injection of TcTM on day of surgery or day prior to surgery in addition to an intraoperative injection of isosulfan blue dye. Univariable and multivariable Poisson regression count models were constructed to assess the effects of injection timing, radiologist, patient and surgeon characteristics on the number of removed SLNs...
March 2, 2018: Breast Journal
Jonathan T Unkart, Anne M Wallace
99m Tc-tilmanocept received recent Food and Drug Administration approval for lymphatic mapping in 2013. However, to our knowledge, no prior studies have evaluated the use of 99m Tc-tilmanocept as a single agent in sentinel lymph node (SLN) biopsy in breast cancer. Methods: We executed this retrospective pilot study to assess the ability of 99m Tc-tilmanocept to identify sentinel nodes as a single agent in clinically node-negative breast cancer patients. Patients received a single intradermal injection overlying the tumor of either 18...
September 2017: Journal of Nuclear Medicine Technology
Jonathan T Unkart, Ava Hosseini, Anne M Wallace
INTRODUCTION: No prior trials have compared sentinel lymph node (SLN) identification outcomes between Tc-99m tilmanocept (TcTM) and Tc-99m sulfur colloid (TcSC) in breast cancer (BC). METHODS: We report on the secondary outcomes from a randomized, double-blinded, single surgeon clinical trial comparing post-injection site pain between TcTM and TcSC. Patients were randomized to receive a preoperative single, peritumoral intradermal injection of TcTM or TcSC. The number of total, "hot", and blue nodes detected and removed were compared between groups...
December 2017: Journal of Surgical Oncology
Zohreh Varasteh, Fabien Hyafil, Nadège Anizan, Devy Diallo, Rachida Aid-Launais, Sarajo Mohanta, Yuanfang Li, Miriam Braeuer, Katja Steiger, Jonathan Vigne, Zhengtao Qin, Stephan G Nekolla, Jean-Etienne Fabre, Yvonne Döring, Dominique Le Guludec, Andreas Habenicht, David R Vera, Markus Schwaiger
BACKGROUND: Atherosclerotic plaque phenotypes are classified based on the extent of macrophage infiltration into the lesions, and the presence of certain macrophage subsets might be a sign for plaque vulnerability. The mannose receptor (MR) is over-expressed in activated macrophages. Tilmanocept is a tracer that targets MR and is approved in Europe and the USA for the detection of sentinel lymph nodes. In this study, our aim was to evaluate the potential of (111)In-labelled tilmanocept for the detection of MR-positive macrophages in atherosclerotic plaques of apolipoprotein E-knockout (ApoE-KO) mouse model...
December 2017: EJNMMI Research
O O Adesanya, C E Hutchinson
BACKGROUND: There is a long history of nuclear medicine developments in orthopaedics beginning in the early 20(th) century. Technetium-99m ((99m)Tc) has a short half-life of six hours, emits 140 keV gamma rays and is the most widely used isotope, imaged with the Anger (gamma) camera. Gamma image quality and test sensitivity in painful prosthetic joints can be improved with single photon emission computed tomography (SPECT) and SPECT/CT. Positron Emission Tomography-Computed Tomography (PET-CT) with Sodium Fluoride ((18)F-NaF) and (18)Fluorine-fluorodeoxyglucose ((18)F-FDG) PET have promising and limited roles respectively in the investigation of painful prosthetic joints...
2017: Open Orthopaedics Journal
Hak J Lee, Christopher V Barback, Carl K Hoh, Zhengtao Qin, Kareem Kader, David J Hall, David R Vera, Christopher J Kane
The primary objective was to test the ability of a laparoscopic camera system to detect the fluorescent signal emanating from sentinel lymph nodes (SLNs) approximately 2 d after injection and imaging of a positron-emitting molecular imaging agent into the submucosa of the porcine urinary bladder. Methods: Three female pigs underwent a submucosal injection of the bladder with fluorescent-tagged tilmanocept, radiolabeled with both (68)Ga and (99m)Tc. One hour after injection, a pelvic PET/CT scan was acquired for preoperative SLN mapping...
April 2017: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
Frederick O Cope, Bonnie Abbruzzese, James Sanders, Wendy Metz, Kristyn Sturms, David Ralph, Michael Blue, Jane Zhang, Paige Bracci, Wiam Bshara, Spencer Behr, Toby Maurer, Kenneth Williams, Joshua Walker, Allison Beverly, Brooke Blay, Anirudh Damughatla, Mark Larsen, Courtney Mountain, Erin Neylon, Kaeli Parcel, Kapil Raghuraman, Kevin Ricks, Lucas Rose, Akhilesh Sivakumar, Nicholas Streck, Bryan Wang, Christopher Wasco, Amifred Williams, Michael McGrath
In considering the challenges of approaches to clinical imaging, we are faced with choices that sometimes are impacted by rather dogmatic notions about what is a better or worse technology to achieve the most useful diagnostic image for the patient. For example, is PET or SPECT most useful in imaging any particular disease dissemination? The dictatorial approach would be to choose PET, all other matters being equal. But is such a totalitarian attitude toward imaging selection still valid? In the face of new receptor targeted SPECT agents one must consider the remarkable specificity and sensitivity of these agents...
March 2016: Nuclear Medicine and Biology
Zhengtao Qin, Carl K Hoh, David J Hall, David R Vera
INTRODUCTION: We report an "instant kit" method to radiolabel fluorescent-tilmanocept with (68)Ga and (99m)Tc for tri-modal molecular imaging of sentinel lymph nodes (SLNs). METHODS: Solutions of sodium acetate, (68)GaCl(3) and Na(99m)TcO(4) were added successively to a "kit vial" containing lyophilized 800CW-tilmanocept, SnCl(2), trehalose and ascorbic acid. After a 30-min incubation, the pH was neutralized with PBS. No purification was required. Radiochemical and fluorescence purity was measured by HPLC and ITLC techniques...
December 2015: Nuclear Medicine and Biology
Jonathan T Unkart, Jennifer L Baker, Ava Hosseini, Carl K Hoh, Mark S Wallace, David R Vera, Anne M Wallace
BACKGROUND: No prior studies have examined injection pain associated with Technetium-99m Tilmanocept (TcTM). METHODS: This was a randomized, double-blinded study comparing postinjection site pain between filtered Technetium Sulfur Colloid (fTcSC) and TcTM in breast cancer lymphoscintigraphy. Pain was evaluated with a visual analogue scale (VAS) (0-100 mm) and the short-form McGill Pain Questionnaire (SF-MPQ). The primary endpoint was mean difference in VAS scores at 1-min postinjection between fTcSC and TcTM...
December 2015: Annals of Surgical Oncology
Abul K Azad, Murugesan V S Rajaram, Wendy L Metz, Frederick O Cope, Michael S Blue, David R Vera, Larry S Schlesinger
γ-Tilmanocept ((99m)Tc-labeled-tilmanocept or [(99m)Tc]-tilmanocept) is the first mannose-containing, receptor-directed, radiolabeled tracer for the highly sensitive imaging of sentinel lymph nodes in solid tumor staging. To elucidate the mannose-binding receptor that retains tilmanocept in this microenvironment, human macrophages were used that have high expression of the C-type lectin mannose receptor (MR; CD206). Cy3-labeled tilmanocept exhibited high specificity binding to macrophages that was nearly abolished in competitive inhibition experiments...
September 1, 2015: Journal of Immunology: Official Journal of the American Association of Immunologists
Devaki Shilpa Surasi, Janis O'Malley, Pradeep Bhambhvani
Preoperative lymphatic mapping in conjunction with intraoperative γ-probe detection is widely used for sentinel node localization in melanoma, breast cancer, and other malignancies. (99m)Tc-radiocolloids have been the standard radiotracers used for sentinel node mapping. (99m)Tc-tilmanocept is a receptor-binding molecular imaging agent approved by the U.S. Food and Drug Administration for lymphatic mapping and lymph node localization in breast cancer, melanoma, clinically node-negative squamous cell carcinoma of the oral cavity, and other solid tumors...
June 2015: Journal of Nuclear Medicine Technology
Amit Agrawal, Francisco J Civantos, Kevin T Brumund, Douglas B Chepeha, Nathan C Hall, William R Carroll, Russell B Smith, Robert P Zitsch, Walter T Lee, Yelizaveta Shnayder, David M Cognetti, Karen T Pitman, Dennis W King, Lori A Christman, Stephen Y Lai
BACKGROUND: [(99m)Tc]Tilmanocept, a novel CD206 receptor-targeted radiopharmaceutical, was evaluated in an open-label, phase III trial to determine the false negative rate (FNR) of sentinel lymph node biopsy (SLNB) relative to the pathologic nodal status in patients with intraoral or cutaneous head and neck squamous cell carcinoma (HNSCC) undergoing tumor resection, SLNB, and planned elective neck dissection (END). Negative predictive value (NPV), overall accuracy of SLNB, and the impact of radiopharmaceutical injection timing relative to surgery were assessed...
October 2015: Annals of Surgical Oncology
Michael A Liss, Sean P Stroup, Zhengtao Qin, Carl K Hoh, David J Hall, David R Vera, Christopher J Kane
OBJECTIVE: To investigate positron emission tomography/computed tomography (PET/CT) preoperative imaging and intraoperative detection of a fluorescent-labeled receptor-targeted radiopharmaceutical in a prostate cancer animal model. MATERIALS AND METHODS: Three male beagle dogs underwent an intraprostatic injection of fluorescent-tagged tilmanocept, radiolabeled with both gallium Ga-68 and technetium Tc-99m. One hour after injection, a pelvic PET/CT scan was performed for preoperative sentinel lymph node (SLN) mapping...
October 2014: Urology
Jennifer L Baker, Minya Pu, Christopher A Tokin, Carl K Hoh, David R Vera, Karen Messer, Anne M Wallace
BACKGROUND: The efficacy of sentinel lymph node (SLN) surgery requires targeted removal of first-draining nodes; however, frequently more nodes are removed than necessary. [(99m)Tc]tilmanocept (TcTM) is a molecular-targeted radiopharmaceutical specifically designed for SLN mapping. We evaluated technical outcomes of SLN biopsy in breast cancer patients mapped with TcTM + vital blue dye (VBD) versus filtered [(99m)Tc]sulfur colloid (fTcSC) + VBD. METHODS: There were 84 versus 115 patients in the TcTM versus fTcSC cohorts, respectively...
January 2015: Annals of Surgical Oncology
Christoph Tausch, Astrid Baege, Christoph Rageth
Two decades ago, lymphatic mapping of sentinel lymph nodes (SLN) was introduced into surgical cancer management and was termed sentinel node navigated surgery. Although this technique is now routinely performed in the management of breast cancer and malignant melanoma, it is still under investigation for use in other cancers. The radioisotope technetium ((99m)Tc) and vital blue dyes are among the most widely used enhancers for SLN mapping, although near-infrared fluorescence imaging of indocyanine green is also becoming more commonly used...
2014: OncoTargets and Therapy
Michael A Liss, Salman Farshchi-Heydari, Zhengtao Qin, Sean A Hickey, David J Hall, Christopher J Kane, David R Vera
UNLABELLED: An ideal substance to provide convenient and accurate targeting for sentinel lymph node (SLN) mapping during robotic-assisted surgery has yet to be found. We used an animal model to determine the ability of the FireFly camera system to detect fluorescent SLNs after administration of a dual-labeled molecular imaging agent. METHODS: We injected the footpads of New Zealand White rabbits with 1.7 or 8.4 nmol of tilmanocept labeled with (99m)Tc and a near-infrared fluorophore, IRDye800CW...
September 2014: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
Ava Hosseini, Jennifer L Baker, Christopher A Tokin, Zhengtao Qin, David J Hall, Dwayne G Stupak, Tomoko Hayashi, Anne M Wallace, David R Vera
BACKGROUND: Dendritic cells (DC) are localized in close proximity to cancer cells in many well-known tumors, and thus maybe a useful target for tumor margin assessment. MATERIALS AND METHODS: [(99m)Tc]- cyanine 7 (Cy7)-tilmanocept was synthesized and in vitro binding assays to bone marrow-derived DC were performed. Fifteen mice, implanted with either 4T1 mouse mammary or K1735 mouse melanoma tumors, were administered 1.0 nmol of [(99m)Tc]-Cy7-tilmanocept via tail vein injection...
August 2014: Journal of Surgical Research
Anna M Marcinow, Nathan Hall, Eric Byrum, Theodoros N Teknos, Matthew O Old, Amit Agrawal
IMPORTANCE: Sentinel lymph node biopsy has been proposed as an alternative to up-front elective neck dissection (END) for determination of pathologic nodal status in patients undergoing surgical treatment for oral cavity squamous cell carcinoma (OSCC) with clinically negative neck (cN0). Sentinel lymph node biopsy using current standard tracer agents and imaging adjuncts such as radiolabeled sulfur-colloid and planar lymphoscintigraphy (LS), however, is associated with several drawbacks...
September 2013: JAMA Otolaryngology—Head & Neck Surgery
Zhengtao Qin, David J Hall, Michael A Liss, Carl K Hoh, Christopher J Kane, Anne M Wallace, David R Vera
The optical properties of a receptor-targeted probe designed for dual-modality mapping of the sentinel lymph node (SLN) was optimized. Specific fluorescence brightness was used as the design criterion, which was defined as the fluorescence brightness per mole of the contrast agent. Adjusting the molar ratio of the coupling reactants, IRDye 800CW-NHS-ester and tilmanocept, enabled us to control the number of fluorescent molecules attached to each tilmanocept, which was quantified by H1 nuclear magnetic resonance spectroscopy...
October 2013: Journal of Biomedical Optics
Anne M Wallace, Linda K Han, Stephen P Povoski, Kenneth Deck, Schlomo Schneebaum, Nathan C Hall, Carl K Hoh, Karl K Limmer, Helen Krontiras, Thomas G Frazier, Charles Cox, Eli Avisar, Mark Faries, Dennis W King, Lori Christman, David R Vera
BACKGROUND: Sentinel lymph node (SLN) surgery is used worldwide for staging breast cancer patients and helps limit axillary lymph node dissection. [(99m)Tc]Tilmanocept is a novel receptor-targeted radiopharmaceutical evaluated in 2 open-label, nonrandomized, within-patient, phase 3 trials designed to assess the lymphatic mapping performance. METHODS: A total of 13 centers contributed 148 patients with breast cancer. Each patient received [(99m)Tc]tilmanocept and vital blue dye (VBD)...
August 2013: Annals of Surgical Oncology
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