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EP1321 Sentinel node identification with the Sentimag/Sienna+ system
  1. T Panoskaltsis1,
  2. J Kontis2,
  3. A Zouridis1,
  4. P Theodorou1,
  5. F Anyfantaki1,
  6. A Nonni3 and
  7. N Vlahos1
  1. 1Medical School | Gynaecological Oncology Unit | 2nd Academic Department, Aretaieion
  2. 2Academic Department of General Surgery, Aretaieion Hospital
  3. 31st Department of Histopathology, Medical School, National and Kapodistrian University of Athens, Athens, Greece


Introduction/Background The identifcation of sentinel node in the surgical management of endometrial cancer has become a standard procedure in many countries worldwide. However, different media and techniques have been used with various sensitivity and specificity rates. We present a method, which has not been extensively studied so far.

Methodology We have started a pilot feasibility study on the use of Sentimag/Sienna+ system. With a handheld non-radioactive detector we sought to magnetically mark and locate sentinel nodes in patients operated for endometrial cancer. A solution of superparamagnetic iron oxide particles (60nm) was injected at 3 and 9 o’clock of the uterine cervix and the probe aimed to detect the magnetic signature generated by these particles in the pelvic lymph nodes. So far, the method has been evaluated mostly in breast cancer patients and there is limited experience with prostate cancer and only one report on 12 endometrial cancer patients.

Results So far, we have evaluated the method in two patients with a grade2 endometrioid adenocarcinoma, where Magnetic Resonance Imaging (MRI) showed <50% myometrial invasion, and one patient with a grade3 endometrioid adenocarcinoma, with >50% myometrial invasion on MRI. In none of these cases, enlarged lymph nodes were identified. The tracer injection occurred just before the operation in two and one hour before in another case. Sentinel nodes were easily identified in all cases, except for one pelvic side in one patient. Visibly, pigmented nodes were observed with an earlier injection. Identification was easy with standard histopathology.

Abstract EP1321 Figure 1

H+E Lymph node with brownish pigmentation within the histiocytes (X200)

Abstract EP1321 Figure 2

Histochemistry, the granules are Pearl’s positive (X200)

Conclusion We believe that the technique deserves further evaluation as it appears to easily identify sentinel nodes, with no major costs, in endometrial cancer patients. A laparoscopic probe would help to establish its role in the majority of cases performed with endoscopic surgery.

Disclosure Nothing to disclose

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