Feasibility of sentinel lymph node dissection using Tc-99m phytate in papillary thyroid carcinoma.
10.4174/astr.2017.93.5.240
- Author:
Se Hyun PAEK
1
;
Ka Hee YI
;
Su Jin KIM
;
June Young CHOI
;
Kyu Eun LEE
;
Young Joo PARK
;
Do Joon PARK
;
Keon Wook KANG
;
June Key CHUNG
Author Information
1. Department of Surgery, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Sentinel lymph node biopsy;
Papillary thyroid cancer;
Phytate;
Gamma-probe;
Single-photon emission-computed tomography
- MeSH:
Biopsy;
Breast;
Cervix Uteri;
Endometrial Neoplasms;
Female;
Humans;
Lymph Node Excision*;
Lymph Nodes*;
Neoplasm Metastasis;
Phytic Acid*;
Prospective Studies;
Sensitivity and Specificity;
Sentinel Lymph Node Biopsy;
Thyroid Gland*;
Thyroid Neoplasms*;
Tomography, Emission-Computed, Single-Photon
- From:Annals of Surgical Treatment and Research
2017;93(5):240-245
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Various methods of sentinel lymph node (SLN) biopsy in thyroid cancer have been introduced. Tc-99m phytate as a radiotracer has been successfully utilized for SLN biopsy in breast, cervix, and endometrial cancer. We assessed the feasibility of SLN dissection using Tc-99m phytate in papillary thyroid carcinoma (PTC). METHODS: Seventeen patients with PTC were prospectively enrolled. Ultrasound-guided peritumoral injection of 55.5 MBq Tc-99m phytate in 0.25-mL normal saline was performed. Preoperative single-photon emission-computed tomography (SPECT) and intraoperative gamma-probe were used for SLN detection during operation. RESULTS: Identification rate of SLNs was 70.6% (12 of 17) with SPECT, and 88.2% (15 of 17) with gamma-probe. Combined SPECT and gamma-probe had identification rates of 88.2% (15 of 17). Identification rates of SLNs in central LN compartments were 82.4% (14 of 17) and 41.2% (7 of 17) in lateral LN compartments. Overall sensitivity, specificity, positive predictive value, and negative predictive value of the results of SLN biopsy were 91.6%, 100%, 88.4%, and 100%, respectively. Eight patients (47.1%) had metastasis in SLNs; all patients had SLN metastasis in the central compartment and 2 patients had SLN metastasis in both the central and lateral compartments. CONCLUSION: Combined SPECT and gamma-probe could detect SLNs with an 88.2% identification rate in PTC. SLN biopsy using Tc-99m phytate is technically feasible. Further investigation is warranted for clinical application of Tc-99m phytate in PTC.
