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Sentinel lymph node radiolocalization with 99mTc filtered tin colloid in clinically node-negative squamous cell carcinomas of the oral cavity.

Jeong HS, Baek CH, Son YI, Cho DY, Chung MK, Min JY, Ko YH, Kim BT - J. Korean Med. Sci. (2006)

Bottom Line: In all cases, the status of the sentinel node accurately predicted the pathologic status of the neck with the false negative rate being 0%.The negative predictive value for the absence of cervical metastases was 100%.In conclusion, our radiolocalization technique of sentinel nodes using 99mTc filtered tin colloid in N0 squamous cell carcinomas of the oral cavity is technically feasible and appears to accurately predict the presence of the occult metastatic disease.

View Article: PubMed Central - PubMed

Affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT
The objective of this study was to evaluate the feasibility of sentinel lymph node biopsy by using a radiotracer lymphatic mapping technique in patients with squamous cell carcinoma of the oral cavity, and the diagnostic value of this technique. We studied twenty patients with previously untreated squamous cell carcinomas of the oral cavity and N0 necks. After the peritumoral injection of 99mTc filtered tin colloid preoperatively, lymphoscintigraphy and intraoperative mapping using a gamma detector were performed to localize sentinel nodes. An open biopsy of the sentinel node was followed by complete neck dissection. We identified the sentinel nodes in 19 of 20 patients (95.0%) by lymphoscintigraphy and in all (100%) by intraoperative gamma detector. In all cases, the status of the sentinel node accurately predicted the pathologic status of the neck with the false negative rate being 0%. The negative predictive value for the absence of cervical metastases was 100%. In conclusion, our radiolocalization technique of sentinel nodes using 99mTc filtered tin colloid in N0 squamous cell carcinomas of the oral cavity is technically feasible and appears to accurately predict the presence of the occult metastatic disease.

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Related in: MedlinePlus

The detection of sentinel node using a handheld gamma probe. After localization on the skin surface, the skin flaps for elective neck dissection are raised and the hand held gamma probe (sterilely wrapped) is used to precisely identify any radioactive nodes.
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Related In: Results  -  Collection

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Figure 4: The detection of sentinel node using a handheld gamma probe. After localization on the skin surface, the skin flaps for elective neck dissection are raised and the hand held gamma probe (sterilely wrapped) is used to precisely identify any radioactive nodes.

Mentions: Intraoperatively, all radioactive lymph nodes were identified with a handheld gamma probe (Navigator GPS, Tyco Health Care, Mansfield, MA, U.S.A.) that was used to identify radioactive sentinel nodes (Fig. 3), including those marked preoperatively through the surface by lymphoscintigraphy. To reduce the detection of radiation from the injection site, the primary tumor was removed first with an adequate resection margin according to current accepted treatment standards. After localization on the skin surface, the skin flaps for elective neck dissection were raised and the hand held gamma probe (sterilely wrapped) was used to precisely identify any radioactive nodes (Fig. 4). Lymph nodes with radioactivity counts greater than threefold the background counts were considered the sentinel lymph nodes (4, 9) We also adopted the following criteria for these lymph nodes: 1) the highly radioactive in vivo before incision, 2) the highly radioactive ex vivo, and 3) decreased radioactivity in the lymphatic bed after removal of the highly radioactive node (9). After removal of sentinel lymph nodes, all patients then received elective neck dissection.


Sentinel lymph node radiolocalization with 99mTc filtered tin colloid in clinically node-negative squamous cell carcinomas of the oral cavity.

Jeong HS, Baek CH, Son YI, Cho DY, Chung MK, Min JY, Ko YH, Kim BT - J. Korean Med. Sci. (2006)

The detection of sentinel node using a handheld gamma probe. After localization on the skin surface, the skin flaps for elective neck dissection are raised and the hand held gamma probe (sterilely wrapped) is used to precisely identify any radioactive nodes.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2721997&req=5

Figure 4: The detection of sentinel node using a handheld gamma probe. After localization on the skin surface, the skin flaps for elective neck dissection are raised and the hand held gamma probe (sterilely wrapped) is used to precisely identify any radioactive nodes.
Mentions: Intraoperatively, all radioactive lymph nodes were identified with a handheld gamma probe (Navigator GPS, Tyco Health Care, Mansfield, MA, U.S.A.) that was used to identify radioactive sentinel nodes (Fig. 3), including those marked preoperatively through the surface by lymphoscintigraphy. To reduce the detection of radiation from the injection site, the primary tumor was removed first with an adequate resection margin according to current accepted treatment standards. After localization on the skin surface, the skin flaps for elective neck dissection were raised and the hand held gamma probe (sterilely wrapped) was used to precisely identify any radioactive nodes (Fig. 4). Lymph nodes with radioactivity counts greater than threefold the background counts were considered the sentinel lymph nodes (4, 9) We also adopted the following criteria for these lymph nodes: 1) the highly radioactive in vivo before incision, 2) the highly radioactive ex vivo, and 3) decreased radioactivity in the lymphatic bed after removal of the highly radioactive node (9). After removal of sentinel lymph nodes, all patients then received elective neck dissection.

Bottom Line: In all cases, the status of the sentinel node accurately predicted the pathologic status of the neck with the false negative rate being 0%.The negative predictive value for the absence of cervical metastases was 100%.In conclusion, our radiolocalization technique of sentinel nodes using 99mTc filtered tin colloid in N0 squamous cell carcinomas of the oral cavity is technically feasible and appears to accurately predict the presence of the occult metastatic disease.

View Article: PubMed Central - PubMed

Affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT
The objective of this study was to evaluate the feasibility of sentinel lymph node biopsy by using a radiotracer lymphatic mapping technique in patients with squamous cell carcinoma of the oral cavity, and the diagnostic value of this technique. We studied twenty patients with previously untreated squamous cell carcinomas of the oral cavity and N0 necks. After the peritumoral injection of 99mTc filtered tin colloid preoperatively, lymphoscintigraphy and intraoperative mapping using a gamma detector were performed to localize sentinel nodes. An open biopsy of the sentinel node was followed by complete neck dissection. We identified the sentinel nodes in 19 of 20 patients (95.0%) by lymphoscintigraphy and in all (100%) by intraoperative gamma detector. In all cases, the status of the sentinel node accurately predicted the pathologic status of the neck with the false negative rate being 0%. The negative predictive value for the absence of cervical metastases was 100%. In conclusion, our radiolocalization technique of sentinel nodes using 99mTc filtered tin colloid in N0 squamous cell carcinomas of the oral cavity is technically feasible and appears to accurately predict the presence of the occult metastatic disease.

Show MeSH
Related in: MedlinePlus