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Feasibility of sentinel lymph node dissection using Tc-99m phytate in papillary thyroid carcinoma
- Feasibility of sentinel lymph node dissection using Tc-99m phytate in papillary thyroid carcinoma
- Paek, Se Hyun; Yi, Ka Hee; Kim, Su-Jin; Choi, June Young; Lee, Kyu Eun; Park, Young Joo; Park, Do-Joon; Kang, Keon Wook; Chung, June-Key
- Ewha Authors
- Issue Date
- Journal Title
- ANNALS OF SURGICAL TREATMENT AND RESEARCH
- 2288-6575; 2288-6796
- vol. 93, no. 5, pp. 240 - 245
- Sentinel lymph node biopsy; Papillary thyroid cancer; Phytate; Gamma-probe; Single-photon emission-computed tomography
- KOREAN SURGICAL SOCIETY
- SCIE; SCOPUS; KCI
- 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 (SPECTj 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.
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