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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 S.H.; Yi K.H.; Kim S.-J.; Choi J.Y.; Lee K.E.; Park Y.J.; Park D.-J.; Kang K.W.; Chung J.-K.
- Ewha Authors
- Issue Date
- Journal Title
- Annals of Surgical Treatment and Research
- Annals of Surgical Treatment and Research vol. 93, no. 5, pp. 240 - 245
- Gamma-probe; Papillary thyroid cancer; Phytate; Sentinel lymph node biopsy; Single-photon emissioncomputed tomography
- Korean Surgical Society
- SCIE; SCOPUS; KCI
- Document Type
- 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. [Ann Surg Treat Res 2017;93(5):240-245] Copyright © 2017, the Korean Surgical Society.
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