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Lee J, Na KY, Lee J, et al. The usefulness and accuracy of sentinel lymph node biopsy using single photon emission computed tomography/computed tomography with 99mTc phytate to detect locoregional lymph node metastases in patients with papillary thyroid carcinoma. J Korean Surg Soc. 2013;84(4):195-201doi: 10.4174/jkss.2013.84.4.195.
Lee, J., Na, K. Y., Lee, J., Lee, S. J., An, Y. S., Yoon, J. K., & Soh, E. Y. (2013). The usefulness and accuracy of sentinel lymph node biopsy using single photon emission computed tomography/computed tomography with 99mTc phytate to detect locoregional lymph node metastases in patients with papillary thyroid carcinoma. Journal of the Korean Surgical Society, 84(4), 195-201. https://doi.org/10.4174/jkss.2013.84.4.195
Lee, Jeonghun, et al. "The usefulness and accuracy of sentinel lymph node biopsy using single photon emission computed tomography/computed tomography with 99mTc phytate to detect locoregional lymph node metastases in patients with papillary thyroid carcinoma." Journal of the Korean Surgical Society vol. 84,4 (2013): 195-201. doi: https://doi.org/10.4174/jkss.2013.84.4.195
Lee J, Na KY, Lee J, Lee SJ, An YS, Yoon JK, Soh EY. The usefulness and accuracy of sentinel lymph node biopsy using single photon emission computed tomography/computed tomography with 99mTc phytate to detect locoregional lymph node metastases in patients with papillary thyroid carcinoma. J Korean Surg Soc. 2013 Apr;84(4):195-201. doi: 10.4174/jkss.2013.84.4.195. Epub 2013 Mar 26. PMID: 23577313; PMCID: PMC3616272.
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J Korean Surg Soc. 2013 Apr;84(4):195-201. doi: 10.4174/jkss.2013.84.4.195. Epub 2013 Mar 26.

The usefulness and accuracy of sentinel lymph node biopsy using single photon emission computed tomography/computed tomography with 99mTc phytate to detect locoregional lymph node metastases in patients with papillary thyroid carcinoma.

Journal of the Korean Surgical Society

Jeonghun Lee, Kuk Young Na, Jandee Lee, Su Jin Lee, Young Sil An, Joon Kee Yoon, Euy Young Soh

Affiliations

  1. Department of Surgery, Ajou University School of Medicine, Suwon, Korea.

PMID: 23577313 PMCID: PMC3616272 DOI: 10.4174/jkss.2013.84.4.195

Abstract

PURPOSE: Regional lymph node (LN) metastases are detected in 57-85% of patients with papillary thyroid carcinoma (PTC) and are associated with increased tumor recurrence. However, the management of lymphatic disease in patients with PTC has been ongoing source of debate. We have prospectively assessed the usefulness and accuracy of sentinel LN (SLN) biopsy for the detection of LN metastases in patients with PTC on preoperative imaging using single photon emission computed tomography/computed tomography (SPECT/CT) and 99mTc phytate.

METHODS: We prospectively assessed 39 patients with PTC who had risk factors for recurrence or with the necessity of intraoperative LN sampling for suspicious LN metastases on preoperative imaging from August 2010 to March 2011. The patients underwent preoperative lymphoscintigraphy and SPETC/CT and intraoperative SLN biopsy (SLNB).

RESULTS: 99mTc lymphoscintigraphy and SPECT/CT localized SLN in 38 patients (97.4%), with the gamma probe identifying 2.15 mean SLNs in the lateral neck of the 39 patients. Skip metastasis was found in one patient, and lateral compartment LN metastasis in 17 (43.5%). The sensitivity, specificity, and accuracy of SLNB for lateral compartment LN metastasis were 88.2%, 100%, and 94.8%, respectively. SLNB was more accurate and useful for lateral than for central compartment LN metastasis.

CONCLUSION: SPECT/CT improved SLN detection and anatomical localization compared with lymphoscintigraphy. SLNB in patients with risk factors for recurrence or the necessity of intraoperative LN sampling for suspected LN metastases on preoperative imaging was accurate in detecting LN metastases and may help in deciding whether to perform lateral compartment dissection in patients with PTC.

Keywords: Papillary thyroid cancer; Sentinel lymph node biopsy; Single photon emission computed tomography; X-ray computed tomography

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