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Gamma probe and ultrasound guided fine needle aspiration cytology of the sentinel node (GULF) trial - overview of the literature, pilot and study protocol

Overview of attention for article published in BMC Cancer, April 2017
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Title
Gamma probe and ultrasound guided fine needle aspiration cytology of the sentinel node (GULF) trial - overview of the literature, pilot and study protocol
Published in
BMC Cancer, April 2017
DOI 10.1186/s12885-017-3236-2
Pubmed ID
Authors

Charlotte M.C. Oude Ophuis, Lisa B. Koppert, Cécile de Monyé, Carolien H.M. van Deurzen, Senada Koljenović, Alexander C.J. van Akkooi, Cornelis Verhoef, Dirk J. Grünhagen

Abstract

Sentinel node (SN) biopsy (SNB) detects clinically occult metastases of breast cancer and melanoma in 20-30%. Wound infections, seroma and lymph edema occur in up to 10%. Targeted ultrasound (US) of the SN, (with fine needle aspiration cytology (FNAC) if appropriate) has been investigated as a minimally invasive alternative, but reported sensitivity rates are too low to replace SNB. Our hypothesis is that the use of a handheld gamma probe concomitant with US may improve sensitivity. Our aim is to provide an overview of the current literature on preoperative nodal staging of clinical N0 melanoma patients, report on a pilot, and present a study protocol for a minimally invasive alternative to the SNB: Gamma probe and Ultrasound guided Fine needle aspiration cytology of the sentinel node (GULF trial). The GULF trial is a multicenter open single arm observational trial. Newly diagnosed cT1b-4N0M0 cutaneous melanoma or cT1-3N0M0 breast cancer patients, aged >18 years, presenting for SNB are eligible. 120 patients will be included for preoperative targeted gamma probe guided US and FNAC of the SN. Afterwards all patients proceed to surgical SNB. Primary endpoint is the sensitivity of FNAC. Secondary endpoints include SN identification rate and the histopathological compatibility of Core Needle Biopsy and FNAC vs. SNB. Secondary endpoints were investigated in a pilot with 10 FNACs and marker placements, and 10 FNACs combined with Core Needle Biopsy. A pilot in 20 patients showed that SN identification rate was 90%, supporting the feasibility of this technique. There is broad experience with US (in combination with FNAC) prior to SNB, but sensitivity and specificity are too low to completely abandon SNB. Promising alternative techniques potentially will replace SNB in the future but more evidence is needed in the form of prospective studies. Accurate identification of the SN for US-FNAC has been proven feasible in our pilot. When adequate sensitivity can be reached, US-FNAC provides a minimally invasive alternative for the surgical SNB procedure. The GULF trial is registered in the Netherlands Trial Registry (NTR), ID: NRT5193 . May 1st 2015.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 28 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 28 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 5 18%
Student > Master 4 14%
Other 3 11%
Student > Doctoral Student 3 11%
Student > Bachelor 2 7%
Other 7 25%
Unknown 4 14%
Readers by discipline Count As %
Medicine and Dentistry 12 43%
Agricultural and Biological Sciences 2 7%
Biochemistry, Genetics and Molecular Biology 1 4%
Nursing and Health Professions 1 4%
Immunology and Microbiology 1 4%
Other 3 11%
Unknown 8 29%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 14 April 2017.
All research outputs
#20,413,129
of 22,963,381 outputs
Outputs from BMC Cancer
#6,522
of 8,345 outputs
Outputs of similar age
#270,116
of 310,001 outputs
Outputs of similar age from BMC Cancer
#106
of 138 outputs
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So far Altmetric has tracked 8,345 research outputs from this source. They receive a mean Attention Score of 4.3. This one is in the 1st percentile – i.e., 1% of its peers scored the same or lower than it.
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We're also able to compare this research output to 138 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.