Detection of the sentinel node using a magnetic tracer in thyroid cancer. A technical pilot study

Area of Science:

• Oncology
• Nuclear Medicine
• Surgical Innovation

Background:

• Sentinel node biopsy is crucial for cancer staging but lacks a standard method in thyroid disease.
• Paramagnetic tracers show promise for sentinel node detection, successfully used in breast cancer and melanoma.
• Papillary thyroid cancer staging often requires accurate lymph node assessment.

Purpose of the Study:

• To evaluate the efficacy of a super paramagnetic iron oxide tracer for intraoperative sentinel node detection in papillary thyroid cancer.
• To assess the utility of this tracer in patients with clinically node-negative thyroid cancer.
• To determine if the tracer facilitates accurate staging and subsequent treatment decisions.

Main Methods:

• Prospective pilot study involving a class IIa medical device (paramagnetic tracer).
• Super paramagnetic iron oxide (2mL) injected for sentinel node localization in T1-T2 papillary thyroid tumors.
• Ferromagnetic activity detected in adjacent nodes within ten minutes for intraoperative analysis.

Main Results:

• Sentinel nodes were successfully located in all cases.
• Intraoperative histology confirmed sentinel node positivity in 80% of patients (metastases: 20% macrometastases, 60% micrometastases).
• Treatment included total thyroidectomy with central or lateral lymph node dissection based on sentinel node findings; 80% received radioactive iodine therapy.

Conclusions:

• Super paramagnetic iron oxide tracer is a viable tool for sentinel node detection in papillary thyroid cancer.
• This technique aids in precise staging and guides appropriate therapeutic interventions.
• Further research may establish this tracer as a standard for thyroid cancer management.