Magnetic Technique for Sentinel Lymph Node Biopsy in Melanoma

The MELAMAG Trial

Bauke Anninga, Samantha H. White, Marc Moncrieff, Peter Dziewulski, Jenny L. C. Geh, Joost Klaase, Hans Garmo, Fernanda Castro, Sarah Pinder, Quentin A. Pankhurst, Margaret A. Hall-Craggs, Michael Douek, Multicentre Trialists Group MELAMAG Multicentre Trialists Group

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Sentinel lymph node biopsy (SLNB) in melanoma is currently performed using the standard dual technique (radioisotope and blue dye). The magnetic technique is non-radioactive and provides a brown color change in the sentinel lymph node (SLN) through an intradermal injection of a magnetic tracer, and utilizes a handheld magnetometer. The MELAMAG Trial compared the magnetic technique with the standard technique for SLNB in melanoma. Methods: Clinically node-negative patients with primary cutaneous melanoma were recruited from four centers. SLNB was undertaken after intradermal administration of both the standard (blue dye and radioisotope) and magnetic tracers. The SLN identification rate per patient, with the two techniques, was compared. Results: A total of 133 patients were recruited, 129 of which were available for final analysis. The sentinel node identification rate was 97.7 % (126/129) with the standard technique and 95.3 % (123/129) with the magnetic technique [2.3 % difference; 95 % upper confidence limit (CL) 6.4; 5.4 % discordance]. With radioisotope alone, the SLN identification rate was 95.3 % (123/129), as with the magnetic technique (0 % difference; 95 % upper CL 4.5; 7.8 % discordance). The lymph node retrieval rate was 1.99 nodes per patient overall, 1.78 with the standard technique and 1.87 with the magnetic technique. Conclusions: The magnetic technique is feasible for SLNB in melanoma with a high SLN identification rate, but is associated with skin staining. When compared with the standard dual technique, it did not reach our predefined non-inferiority margin.

Original languageEnglish (US)
Pages (from-to)2070-2078
Number of pages9
JournalAnnals of surgical oncology
Volume23
Issue number6
DOIs
StatePublished - Jun 1 2016
Externally publishedYes

Fingerprint

Sentinel Lymph Node Biopsy
Melanoma
Radioisotopes
Coloring Agents
Intradermal Injections
Skin
Color
Lymph Nodes
Staining and Labeling
Sentinel Lymph Node

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Anninga, B., White, S. H., Moncrieff, M., Dziewulski, P., L. C. Geh, J., Klaase, J., ... MELAMAG Multicentre Trialists Group, M. T. G. (2016). Magnetic Technique for Sentinel Lymph Node Biopsy in Melanoma: The MELAMAG Trial. Annals of surgical oncology, 23(6), 2070-2078. https://doi.org/10.1245/s10434-016-5113-7

Magnetic Technique for Sentinel Lymph Node Biopsy in Melanoma : The MELAMAG Trial. / Anninga, Bauke; White, Samantha H.; Moncrieff, Marc; Dziewulski, Peter; L. C. Geh, Jenny; Klaase, Joost; Garmo, Hans; Castro, Fernanda; Pinder, Sarah; Pankhurst, Quentin A.; Hall-Craggs, Margaret A.; Douek, Michael; MELAMAG Multicentre Trialists Group, Multicentre Trialists Group.

In: Annals of surgical oncology, Vol. 23, No. 6, 01.06.2016, p. 2070-2078.

Research output: Contribution to journalArticle

Anninga, B, White, SH, Moncrieff, M, Dziewulski, P, L. C. Geh, J, Klaase, J, Garmo, H, Castro, F, Pinder, S, Pankhurst, QA, Hall-Craggs, MA, Douek, M & MELAMAG Multicentre Trialists Group, MTG 2016, 'Magnetic Technique for Sentinel Lymph Node Biopsy in Melanoma: The MELAMAG Trial', Annals of surgical oncology, vol. 23, no. 6, pp. 2070-2078. https://doi.org/10.1245/s10434-016-5113-7
Anninga, Bauke ; White, Samantha H. ; Moncrieff, Marc ; Dziewulski, Peter ; L. C. Geh, Jenny ; Klaase, Joost ; Garmo, Hans ; Castro, Fernanda ; Pinder, Sarah ; Pankhurst, Quentin A. ; Hall-Craggs, Margaret A. ; Douek, Michael ; MELAMAG Multicentre Trialists Group, Multicentre Trialists Group. / Magnetic Technique for Sentinel Lymph Node Biopsy in Melanoma : The MELAMAG Trial. In: Annals of surgical oncology. 2016 ; Vol. 23, No. 6. pp. 2070-2078.
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abstract = "Background: Sentinel lymph node biopsy (SLNB) in melanoma is currently performed using the standard dual technique (radioisotope and blue dye). The magnetic technique is non-radioactive and provides a brown color change in the sentinel lymph node (SLN) through an intradermal injection of a magnetic tracer, and utilizes a handheld magnetometer. The MELAMAG Trial compared the magnetic technique with the standard technique for SLNB in melanoma. Methods: Clinically node-negative patients with primary cutaneous melanoma were recruited from four centers. SLNB was undertaken after intradermal administration of both the standard (blue dye and radioisotope) and magnetic tracers. The SLN identification rate per patient, with the two techniques, was compared. Results: A total of 133 patients were recruited, 129 of which were available for final analysis. The sentinel node identification rate was 97.7 {\%} (126/129) with the standard technique and 95.3 {\%} (123/129) with the magnetic technique [2.3 {\%} difference; 95 {\%} upper confidence limit (CL) 6.4; 5.4 {\%} discordance]. With radioisotope alone, the SLN identification rate was 95.3 {\%} (123/129), as with the magnetic technique (0 {\%} difference; 95 {\%} upper CL 4.5; 7.8 {\%} discordance). The lymph node retrieval rate was 1.99 nodes per patient overall, 1.78 with the standard technique and 1.87 with the magnetic technique. Conclusions: The magnetic technique is feasible for SLNB in melanoma with a high SLN identification rate, but is associated with skin staining. When compared with the standard dual technique, it did not reach our predefined non-inferiority margin.",
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T1 - Magnetic Technique for Sentinel Lymph Node Biopsy in Melanoma

T2 - The MELAMAG Trial

AU - Anninga, Bauke

AU - White, Samantha H.

AU - Moncrieff, Marc

AU - Dziewulski, Peter

AU - L. C. Geh, Jenny

AU - Klaase, Joost

AU - Garmo, Hans

AU - Castro, Fernanda

AU - Pinder, Sarah

AU - Pankhurst, Quentin A.

AU - Hall-Craggs, Margaret A.

AU - Douek, Michael

AU - MELAMAG Multicentre Trialists Group, Multicentre Trialists Group

PY - 2016/6/1

Y1 - 2016/6/1

N2 - Background: Sentinel lymph node biopsy (SLNB) in melanoma is currently performed using the standard dual technique (radioisotope and blue dye). The magnetic technique is non-radioactive and provides a brown color change in the sentinel lymph node (SLN) through an intradermal injection of a magnetic tracer, and utilizes a handheld magnetometer. The MELAMAG Trial compared the magnetic technique with the standard technique for SLNB in melanoma. Methods: Clinically node-negative patients with primary cutaneous melanoma were recruited from four centers. SLNB was undertaken after intradermal administration of both the standard (blue dye and radioisotope) and magnetic tracers. The SLN identification rate per patient, with the two techniques, was compared. Results: A total of 133 patients were recruited, 129 of which were available for final analysis. The sentinel node identification rate was 97.7 % (126/129) with the standard technique and 95.3 % (123/129) with the magnetic technique [2.3 % difference; 95 % upper confidence limit (CL) 6.4; 5.4 % discordance]. With radioisotope alone, the SLN identification rate was 95.3 % (123/129), as with the magnetic technique (0 % difference; 95 % upper CL 4.5; 7.8 % discordance). The lymph node retrieval rate was 1.99 nodes per patient overall, 1.78 with the standard technique and 1.87 with the magnetic technique. Conclusions: The magnetic technique is feasible for SLNB in melanoma with a high SLN identification rate, but is associated with skin staining. When compared with the standard dual technique, it did not reach our predefined non-inferiority margin.

AB - Background: Sentinel lymph node biopsy (SLNB) in melanoma is currently performed using the standard dual technique (radioisotope and blue dye). The magnetic technique is non-radioactive and provides a brown color change in the sentinel lymph node (SLN) through an intradermal injection of a magnetic tracer, and utilizes a handheld magnetometer. The MELAMAG Trial compared the magnetic technique with the standard technique for SLNB in melanoma. Methods: Clinically node-negative patients with primary cutaneous melanoma were recruited from four centers. SLNB was undertaken after intradermal administration of both the standard (blue dye and radioisotope) and magnetic tracers. The SLN identification rate per patient, with the two techniques, was compared. Results: A total of 133 patients were recruited, 129 of which were available for final analysis. The sentinel node identification rate was 97.7 % (126/129) with the standard technique and 95.3 % (123/129) with the magnetic technique [2.3 % difference; 95 % upper confidence limit (CL) 6.4; 5.4 % discordance]. With radioisotope alone, the SLN identification rate was 95.3 % (123/129), as with the magnetic technique (0 % difference; 95 % upper CL 4.5; 7.8 % discordance). The lymph node retrieval rate was 1.99 nodes per patient overall, 1.78 with the standard technique and 1.87 with the magnetic technique. Conclusions: The magnetic technique is feasible for SLNB in melanoma with a high SLN identification rate, but is associated with skin staining. When compared with the standard dual technique, it did not reach our predefined non-inferiority margin.

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