Tilmanocept 50microgram kit for radiopharmaceutical preparation

Introduction. Technetium-labeled sulfur colloid (TSC) is a radiolabeled mapping agent commonly used for sentinel lymph node biopsy (SLNBx). Tilmanocept, a CD206 receptor-targeted mapping agent, has gained recent popularity due to potential advantages of rapid and quick uptake to the SLNs. The objectives of this study were to assess (1) the difference in the number of SLNs harvested using tilmanocept versus TSC and (2) the difference in time to transcutaneous localization when using an intraoperative injection approach. Methods. Patients undergoing breast conservation and SLNBx were consented and randomized to receive either 0.5 mCi of filtered TSC or 0.5 mCi of tilmanocept injected intradermally immediately after induction of anesthesia. Axillary transcutaneous gamma detector probe counts were taken at 1-minute intervals until a hot spot was identified. SLNs were then identified and excised. Additional nodes were excised if their counts per second (cps) were greater than 10% of the cps of the hottest SLN. The number of SLNs was based on both number of nodes collected intraoperatively and the number recorded in the final pathology report. Results. The study population consisted of 86 patients, 48 randomized to tilmanocept and 38 to TSC. There were no significant differences in patient or tumor characteristics between the two groups. Localization rates were 100% for both cohorts. The mean number of SLNs identified and removed was not significantly different ( p = 0.34 , intraoperatively; p = 0.57 , pathology reported). Time to transcutaneous localization was 3.3 ± 2.0 minutes for tilmanocept and 3.9 ± 2.3 minutes for TSC ( p = 0.19 ). The average cps for the hottest node was 2,180.0 ± 2,460.5 in the tilmanocept group compared to 2,679.3 ± 2,687.5 in the TSC group ( p = 0.94 ). Conclusion. There was no significant difference in the number of SLNs harvested or in the time to transcutaneous localization when using tilmanocept versus TSC as the radiolabeled mapping agents for intraoperative injection and mapping. Either agent can be used without any significant difference in performance.

Abstract licence: CC BY 4.0

The kidneys play a vital role in filtration, excretion, and metabolic regulation, making accurate functional assessment essential for diagnosis, monitoring, and management of renal diseases. While conventional imaging modalities such as ultrasonography, computed tomography (CT), and multiparametric magnetic resonance imaging (MRI) provide structural and functional information, nuclear medicine techniques enable more detailed evaluation of renal physiology at the molecular level. This review provides a comprehensive overview of functional renal imaging using both conventional renal scintigraphy and emerging positron emission tomography (PET) radiopharmaceuticals. Established renal scintigraphy radiopharmaceuticals, including 99mTc-DTPA, 99mTc-DMSA, 99mTc-MAG3, and 99mTc-EC, have long been applied to assess glomerular filtration rate (GFR) and effective renal plasma flow (ERPF). PET radiopharmaceuticals, offering higher sensitivity, superior quantification, and molecular insight, are increasingly investigated for similar purposes, with 68Ga-EDTA, 68Ga-DTPA, 68Ga-NOTA, 68Ga-DOTA, and 18F-FDS for GFR assessment and 11C-PABA, 18F-PFH, Re-(CO)3(18F-FEDA), and Al-18F-NODA-butyric acid for ERPF evaluation. Additional PET tracers, including 68Ga-IRDye800-tilmanocept, 18F-FDG, and 68Ga-PSMA-11, have been explored for glomerular mesangial function, renal tumors, and split renal function, respectively. By systematically summarizing both renal scintigraphy and PET approaches, this review highlights current and emerging PET radiopharmaceuticals for renal functional imaging and discusses their potential clinical applications and future perspectives in precision nephrology.

Abstract licence: CC BY