Abbas Alibakhshi, Saeed Farzanehfar, Mahya Zarei, Mohammad Eftekhari, Maziar Motiee, Maryam Naseri, Mehrshad Abbasi
{"title":"Sentinel lymph node biopsy for papillary thyroid cancer: the effect of dose, tracer and application of massage.","authors":"Abbas Alibakhshi, Saeed Farzanehfar, Mahya Zarei, Mohammad Eftekhari, Maziar Motiee, Maryam Naseri, Mehrshad Abbasi","doi":"10.22038/AOJNMB.2020.50491.1345","DOIUrl":null,"url":null,"abstract":"Objectives In patients with papillary thyroid cancer (PTC), sentinel lymph node (SLN) radio-guided biopsy is not routinely used for detection of involved neck lymph nodes (NLN); 99mTc- antimony sulfide colloid (99mTc- ASC) has been used for this purpose. In this study, besides 99mTc-ASC another radiotracer, 99mTc-phytate (99mTc-P) with different doses and injection methods were evaluated. Methods Twenty-two patients, scheduled to undergo thyroidectomy for PTC, were injected for radio-guided SLN biopsy in the morning of operation in 3 groups: intra tumoral injection of about 1 mCi 99mTc-P (group A; n=5); peritumoral injection of less than 3 mCi 99mTc-ASC (group B; n=6); and peritumoral injection of 3 to 5 mCi 99mTc-ASC with application of massage (group C; n=9). A patient refused to complete the study. A patient with follicular thyroid cancer was also excluded. No NLN was detected in the pre-operative ultra-sonographic examinations of all patients. Central neck dissection was done for all the participants. The presence of radio guided detected NLN and results of pathology were assessed. Results In group A and B, no SLN was detected. NLNs were resected in 4 patients in group A and B; 2 of them involved by the tumor. In group C, 6 out of 9 patients (66.7%) had between 1 to 6 SLNs; the procedure failed to detect NLN in a patient in group C with surgically resected reactive NLN (failure rate 1 out of 7). Conclusion The results underscored the significance of SLN radio guided biopsy in patients with PTC; the radiotracer, dose and method of injection may affect the detection rate.","PeriodicalId":8503,"journal":{"name":"Asia Oceania Journal of Nuclear Medicine and Biology","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7701222/pdf/AOJNMB-9-09.pdf","citationCount":"3","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Asia Oceania Journal of Nuclear Medicine and Biology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.22038/AOJNMB.2020.50491.1345","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 3
Abstract
Objectives In patients with papillary thyroid cancer (PTC), sentinel lymph node (SLN) radio-guided biopsy is not routinely used for detection of involved neck lymph nodes (NLN); 99mTc- antimony sulfide colloid (99mTc- ASC) has been used for this purpose. In this study, besides 99mTc-ASC another radiotracer, 99mTc-phytate (99mTc-P) with different doses and injection methods were evaluated. Methods Twenty-two patients, scheduled to undergo thyroidectomy for PTC, were injected for radio-guided SLN biopsy in the morning of operation in 3 groups: intra tumoral injection of about 1 mCi 99mTc-P (group A; n=5); peritumoral injection of less than 3 mCi 99mTc-ASC (group B; n=6); and peritumoral injection of 3 to 5 mCi 99mTc-ASC with application of massage (group C; n=9). A patient refused to complete the study. A patient with follicular thyroid cancer was also excluded. No NLN was detected in the pre-operative ultra-sonographic examinations of all patients. Central neck dissection was done for all the participants. The presence of radio guided detected NLN and results of pathology were assessed. Results In group A and B, no SLN was detected. NLNs were resected in 4 patients in group A and B; 2 of them involved by the tumor. In group C, 6 out of 9 patients (66.7%) had between 1 to 6 SLNs; the procedure failed to detect NLN in a patient in group C with surgically resected reactive NLN (failure rate 1 out of 7). Conclusion The results underscored the significance of SLN radio guided biopsy in patients with PTC; the radiotracer, dose and method of injection may affect the detection rate.