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99Tc Nanocolloid sentinel node procedure in thyroid carcinoma.
Isabella Merante Boschin1, Antonio Toniato, Andrea Piotto
1Surgical Pathology, University of Padua School of Medicine, Istituto Oncologico Veneto (IOV), Padua, Italy. isabella.meranteboschin@unipd.it
Langenbeck'S Archives of Surgery
|July 16, 2008
Summary
Radiocolloid lymphoscintigraphy and gamma probe procedures for sentinel lymph node biopsy in papillary thyroid carcinoma can help avoid unnecessary 131-I therapy in patients without lymph node metastasis.
Area of Science:
- Oncology
- Nuclear Medicine
- Surgical Pathology
Background:
- Papillary thyroid carcinoma (PTC) management involves accurate staging.
- Sentinel lymph node biopsy (SLNB) is crucial for staging.
- Identifying lymph node involvement impacts treatment decisions.
Purpose of the Study:
- To assess the effectiveness of radiocolloid lymphoscintigraphy for SLNB in PTC.
- To evaluate the utility of handheld gamma probe in SLNB procedures.
- To determine the role of these techniques in clinical staging of PTC.
Main Methods:
- Sixty-five PTC patients underwent pre-operative radiocolloid lymphoscintigraphy.
- Intraoperative sentinel lymph node (SLN) localization was performed using a handheld gamma probe.
- Patients were followed up for 2, 6 months, and annually.
Main Results:
- Sentinel lymph node metastases were detected in 52% of patients.
- Mean Thyroglobulin levels differed significantly between N0 and N1 cases before and after 131-I therapy (p=0.03 and p=0.005).
- Fifty-one patients received ablative 131-I therapy.
Conclusions:
- SLNB with radiocolloid lymphoscintigraphy and gamma probe is effective for staging PTC.
- Patients classified as N0 by SLNB may avoid unnecessary ablative 131-I therapy.
- This approach can refine treatment strategies and reduce patient exposure to radiation.
