Background
Sentinel node biopsy
Ultrasound guided fine needle aspiration cytology
Literature overview
Author, year | Study Design |
N
| US Setting | FNAC/other technique | Sens (%) | Spec (%) | PPV (%) | NPV (%) |
---|---|---|---|---|---|---|---|---|
Rossi [61], 2000 | Not mentioned | 69 | Pre-lympho | No | 33 | 100 | 100 | 86 |
Rossi [25], 2003 | Prospective, monocentric | 125 | Pre-lympho | FNAC if US suspicious | US alone: Not mentioned | - | - | - |
US-FNAC: 39 | 100 | 100 | 85 | |||||
Hocevar [62], 2004 | Prospective, monocentric | 57 | unknown | FNAC if US suspicious | US alone: 71 | 84 | 59 | 90 |
US-FNAC: Not mentioned | - | - | - | |||||
Testori [63], 2005 | Retrospective, monocentric | 88 | unknown | No | 94 | 90 | 64 | 99 |
Starritt [64], 2005 | Prospective, monocentric | 31 all SN + | Post-lympho | No | NA | NA | NA | NA |
Voit [65], 2006 | Prospective, monocentric | 127 | Post-lympho | FNAC if US suspicious | US alone: 79 | 72 | 53 | 90 |
FNAC alone: 59 | 100 | 100 | 85 | |||||
US-FNAC: 82 | 72 | 54 | 91 | |||||
Van Rijk [26], 2006 | Retrospective, monocentric | 107 | Pre-lympho | FNAC if US suspicious | US alone: 34 | 87 | - | - |
US-FNAC: 4.7 | 100 | - | - | |||||
Sibon [66], 2007 | Prospective, monocentric | 131 | Pre-lympho | No | 9 | 96 | 43 | - |
Kunte [67], 2009 | Prospective, monocentric | 25 | Pre- and post-lympho | No | 33 | 100 | 100 | 88 |
Voit [30], 2009 | Prospective, monocentric | 400 | Post-lympho | FNAC if US suspicious | 65 | 99 | 93 | 92 |
Sanki [60], 2009 | Prospective, monocentric | 716 | Post-lympho | No | 33 | 97 | 60 | 88 |
De Giorgi [36], 2010 | Prospective monocentric | 15 | Post-lympho | Standard CEUS | CEUS: 100 | 62 | 55 | 100 |
Voit [31], 2010 | Prospective monocentric | 400 | Post lympho | FNAC if US suspicious | All Berlin criteria combined: 82 | 80 | 52 | 94 |
Hinz [58], 2011 | Prospective monocentric | 81 | Pre and post lympho | No | 22 | 100 | 100 | 96 |
Chai [68], 2012 | Retrospective monocentric | 325 | Pre-lympho | FNAC if US suspicious | 34 | 86 | 37 | 84 |
Marone [69], 2012 | Prospective monocentric | 623 | Pre-lympho | No | 15 | 100 | 100 | 87 |
Pilko [70], 2012 | Retrospective Monocentric | 405 | Pre-lympho | FNAC if US suspicious | Not mentioned | - | - | - |
Stoffels [71], 2012 | Retrospective Monocentric | 221 | Pre-lympho | FNAC if US suspicious | 14 | 97 | 100 | 97 |
Hinz [72], 2013 | Retrospective Monocentric | 20 | Pre-lympho &, pre PET-CT | No If US malig. Direct LND | 12 | 100 | 100 | 74 |
Ulrich [73], 2014 In German
| Prospective monocentric | 800 | Post lympho | FNAC if US suspicious | US-FNAC: 56 | 99 | 92 | 89 |
Voit [32], 2014 | Prospective monocentric | 1000 | Post lympho | FNAC if US suspicious | US alone: 71 | - | - | - |
US-FNAC: 51 | 99 | 99 | 89 | |||||
Voit [33], 2016 | Prospective monocentric | 1000 | Post lympho | FNAC if US suspicious | US alone: 71 | - | - | - |
US-FNAC: 51 | 99 | 99 | 89 |
Author, yr | Topic | No. of patients | Technique | Sens (%) | Spec (%) |
---|---|---|---|---|---|
Hinz [72], 2013 | Elastography | 36 | US + power Doppler: | 81 | 76 |
Elastography: | 91 | 76 | |||
Combined: | 95 | 76 | |||
Ogata [35], 2014 | Elastography | 12 | US: | 77 | 57 |
Elastography: | 100 | 71 | |||
Stoffels [37], 2015 | MSOT and indocyanin green | 20 | MSOT | 100 | 48.6 |
Rationale for a new trial
SN identification
Cytology or histology?
Hypotheses GULF trial
Study aims
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To present a study protocol for a minimally invasive alternative to the sentinel node biopsy (GULF trial), with as primary objective to determine whether an acceptable sensitivity for US and gamma probe guided FNAC can be achieved.
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Secondary objective is 1) the identification rate of the SN and 2) the histological results of CNB versus FNAC and versus SNB.