Contribution of SLN investigation with 99mTc-nanocolloid in clinical staging of thyroid cancer: Technical feasibility

Maria Rosa Pelizzo, Domenico Rubello, Isabella Merante Boschin, Andrea Piotto, Costantino Paggetta, Antonio Toniato, Gian Luca De Salvo, Armando Giuliano, Giuliano Mariani, Dario Casara

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: It is a matter of controversy whether prophylactic lymph node dissection improves prognosis and survival in papillary thyroid carcinoma (PTC) patients without suspicion of lymph node metastases either clinically or on ultrasonography. It is possible that in such patients the use of lymphatic mapping and sentinel lymph node (SLN) biopsy, as are employed for other tumours, will be of assistance. The aim of this study was to evaluate the feasibility of preoperative 99mTc-nanocolloid lymphoscintigraphy and an intra-operative SLN procedure in the management of PTC patients. Methods: Twenty-five consecutive patients were entered in the study between April 2005 and October 2005. All had a preoperative diagnosis of malignancy obtained by fine-needle aspiration cytology (FNAC), without clinical or ultrasonographic evidence of loco-regional lymph node involvement. Patients underwent preoperative lymphoscintigraphy after the injection of 99mTc- nanocolloid [median 6 MBq (range 4-9 MBq) in 0.1-0.2 ml saline injected intratumorally under ultrasound guidance] and an intra-operative SLN procedure using a hand-held gamma probe. Surgery was performed by the same surgeon in all patients. Results: Preoperative lymphoscintigraphy identified at least one SLN in all patients. During surgery, using the gamma probe, the surgeon was able to find at least one SLN in all cases. A good correlation was found between preoperative imaging and probe results. Metastasis was found in at least one SLN in 12 (48%) patients. In seven (28%) patients the involved SLN was the most radioactive SLN, while in five (20%) patients a less radioactive SLN was involved by malignancy. Ten of these 12 patients had only micrometastases (

Original languageEnglish
Pages (from-to)934-938
Number of pages5
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume34
Issue number6
DOIs
Publication statusPublished - Jun 2007

Keywords

  • Lymphoscintigraphy
  • Papillary thyroid carcinoma
  • Sentinel lymph node procedure

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

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