Sentinel node mapping in papillary thyroid carcinoma using combined radiotracer and blue dye methods

Area of Science:

• Oncology
• Surgical Pathology
• Nuclear Medicine

Background:

• Evaluating the accuracy of sentinel node mapping in thyroid cancer patients.
• Utilizing both radiotracer and blue dye for sentinel node identification.

Purpose of the Study:

• To assess the efficacy of sentinel lymph node (SLN) mapping in papillary thyroid carcinoma (PTC).
• To determine the accuracy of SLN detection using combined radiotracer and blue dye techniques.

Main Methods:

• 30 papillary thyroid carcinoma patients underwent intra-tumoural injection of 99m-Tc-Antimony Sulfide Colloid and Patent Blue V.
• Lymphoscintigraphy images were obtained post-injection, followed by intraoperative SLN detection using gamma probe and blue dye.
• All patients underwent total thyroidectomy with central and lateral neck lymph node dissection/sampling.

Main Results:

• Sentinel lymph nodes were identified in 63.3% of patients (19/30), with a median of 1 SLN per patient.
• Pathological involvement was found in 12 patients' sentinel nodes, with no false negatives reported.
• Upstaging of the disease occurred in 20% of patients (6/30).

Conclusions:

• Sentinel node mapping is a feasible and accurate technique for detecting lymph node metastasis in PTC.
• SLN mapping can guide surgeons to perform central lymph node dissection selectively in affected patients.
• SLN detection may lead to upstaging or altered treatment plans, particularly in older patients or when lateral node involvement is identified.