Magnetic Localization System for Sentinel Lymph Node Biopsy: A Review of the Diagnostic Accuracy, Cost-Effectiveness, and Guidelines

Key Message

One systematic review with network meta-analysis and three non-randomized studies were identified regarding the diagnostic accuracy and safety of magnetic localization systems for sentinel lymph node biopsy. Evidence from one systematic review with network meta-analysis and three non-randomized studies suggested that the detection rate for sentinel lymph node biopsy with magnetic localization systems (using a superparamagnetic iron oxide tracer) was similar, or non-inferior, to sentinel lymph node biopsy using the radioisotope method (technetium-99 with or without blue dye). The network meta-analysis found that there was no statistically significant difference in false negative rate between these two methods, but there were no data on the false positive rate. The comparative safety of magnetic localization systems was difficult to establish due to limitations in how adverse effects were reported in eligible studies. However, magnetic localization systems for sentinel lymph node biopsy appeared to be generally safe based on the available information. The main safety concern with this procedure appeared to be skin staining/discolouration. Studies with explicit and detailed comparisons of adverse effects for magnetic localization systems versus the radioisotope method (technetium-99) with or without blue dye will be helpful in clarifying the comparative safety of this technique for sentinel lymph node biopsy.

No cost-effectiveness evidence or guidelines were identified. Therefore, the cost-effectiveness of magnetic localization systems for sentinel lymph node biopsy, and recommendations regarding the use of magnetic localization systems for this procedure, are unclear.