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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 99m Tc-sulfur colloid ( 99m Tc-SC) and 99m Tc-tilmanocept. Methods: A retrospective review of patients undergoing lymphoscintigraphy for breast cancer using 99m Tc-SC (June 1, 2010, to December 31, 2011) or 99m Tc-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 χ 2 test, Fisher exact test, and unequal variance t test, as appropriate. Results: In total, 76 patients, with 86 evaluated axillae, underwent lymphoscintigraphy: 29 with 99m Tc-SC and 47 with 99m Tc-tilmanocept. The mean SLN appearance time was 11.0 min for 99m Tc-SC and 19.3 min for 99m Tc-tilmanocept ( P = 0.003). There was no difference in the mean transit uptake percentage: 2.2% for 99m Tc-SC and 1.9% for 99m Tc-tilmanocept ( P = 0.55). 99m Tc-tilmanocept identified a greater proportion of intraoperative blue nodes than did 99m Tc-SC ( P = 0.03). There was no significant difference between 99m Tc-SC and 99m Tc-tilmanocept in the number of SLNs removed, number of patients with positive SLNs, or pain score. Conclusion:  99m Tc-SC use in lymphoscintigraphy is an acceptable alternative to 99m Tc-tilmanocept for SLN detection in breast cancer, on the basis of the similarity in intraoperative SLN identification and pain scores.

journal of nuclear medicine technology

<sup>99m</sup>Tc-Tilmanocept Versus <sup>99m</sup>Tc-Sulfur Colloid in Lymphoscintigraphy: Sentinel Lymph Node Identification and Patient-Reported Pain

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

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