ABSTRACT
Vulvar cancer is a rare gynecological malignancy with mainly lymphatic spread. Sentinel node mapping plays an important role in the management of this gynecological malignancy. In the current study, we reported our experience in sentinel node mapping of vulvar cancer and review the literature accordingly. Since the introduction of sentinel node mapping to the surgical oncology community of our university in 2004, we had two operable vulvar cancer patients who were candidate for sentinel node mapping for inguinal lymph node staging. In the current study, we reported these two cases in details and a brief review of literature on sentinel node mapping in vulvar cancer was done. We specifically discussed the overall accuracy, importance of blue dye injection, learning curve effect, frozen section, excisional biopsy and location of the tumors. Overall sentinel node mapping is a safe and effective method for inguinal lymph node staging in vulvar cancers. In order to perform sentinel node mapping efficiently, paying attention to the details is of utmost importance
ABSTRACT
Solitary pulmonary nodule [SPN] is a frequent finding on the chest x-ray and computed tomography. Nuclear medicine techniques play an important role in the diagnosis and management of SPN. In the current review, we briefly will explain the different nuclear medicine modalities in this regard including positron emission tomography [PET] using 18-F-FDG, and 11-C-Methionine, and single photon emission computerized tomography [SPECT] using somatostatin receptor scintigraphy, 201-Thallium, and 99m-Tc-MIBI
ABSTRACT
Several radiotracers are being used for sentinel node mapping in patients with breast cancer. In the current study, we reported our experience with 99m-Tc Phytate for sentinel node mapping in Mashhad University of Medical Sciences. All breast cancer patients who underwent sentinel node mapping using 99m-Tc Phytate were included. All patients received intradermal peri-areolar injection of 0.5 mCi/0.lcc 99m-Tc Phytate. Lymphoscintiraphy was performed for 145 patients 5-10 minutes post-injection. The sentinel nodes were found during surgery using a hand-held gamma probe as well as blue dye technique. In total 165 patients were evaluated. Lymphoscintigraphy showed axillary sentinel nodes in 135 out of 145 patients [93%] following imaging. At least one sentinel node could be detected in all these 135 patients during surgery. In the remaining 10 patients with sentinel node non-visualization, 5 had sentinel node harvesting failure during surgery. Median number of sentinel nodes on the lymphoscintigraphy images was 1. Sentinel node detection rate was 95% [157/165]. In the 8 patients with sentinel node harvesting failure, 7 had pathologically involved axilla. Median number of harvested sentinel nodes was 1. Mean sentinel node to background count ratio was 10 +/- 2. 99m-Tc Phytate is an effective and highly successful radiotracer for sentinel node mapping. Sentinel node can be visualized in a short time after 99m-Tc Phytate injection on the lymphoscintigraphy images. The sentinel to background count during surgery is high which results in more convenient sentinel node harvesting and high detection rate
ABSTRACT
Many radiotracers have been used for sentinel node mapping with acceptable results. The main difference between these radiotracers is the particle size. In the current study, we reported defective labeling of Tc-99m antimony sulfide colloid which resulted in large particle size. Tc-99m-Antimony sulfide colloid was used for axillary sentinel node mapping of 45 breast cancer patients. The prepared kits were turbid and were used for the first 15 patients. For the remaining 30 patients, we used a filter [GyroDisc CA-PC Cellulose Acetate Membrane; 30 mm; Pore size: 0.2 micro m] after labeling to remove the possible large particles of the prepared kits. On the lymphoscintigraphy images, at least one sentinel node could be identified in 5 and 29 patients of the unfiltered and filtered groups respectively [p=0.00001]. Sentinel node detection by gamma probe was successful in 5 and 30 patients in the unfiltered and filtered groups respectively [p=0.000001]. Tc-99-Antimopny sulfide colloid is a suitable radiotracer for sentinel node mapping of the breast cancer patients. In case of any unusual turbidity of the labeled kit, it should not be used or at least be filtered before injection