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
Sentinel lymph node biopsy is the standard procedure for lymph node staging in intermediate thickness melanoma. In Iran, this procedure has not been addressed sufficiently. In this study, we report our experience in this area. Ten consecutive patients with intermediate thickness melanoma where included in our study. 1.5 mCi of Tc-99m antimony sulfide colloid in two divided dose was injected around the tumor. All patients underwent surgery 2-4 hours after injection of the tracer. Patent blue V dye was also used for 8 patients. Using a hand-held gamma probe, the sentinel nodes were harvested and sent to the pathologist for frozen section and H and E review. For patients with positive sentinel nodes, lymph node dissection was performed. At least one sentinel node could be harvested in all patients. The mean number of sentinel nodes was 1.66. Detection rate with radiotracer and blue dye was 100% and 75% respectively. 30% of the patients had positive sentinel nodes. One patient in the pediatric age range and one head and neck melanoma were included in our study with successful sentinel node mapping. Sentinel lymph node biopsy using Tc-99m antimony sulfide colloid is a reliable and safe method in melanoma patients which can help in treatment planning and patient's ultimate prognosis
ABSTRACT
Radio-guided parathyroid surgery along with other minimally invasive surgeries constitutes the main surgical treatment procedures for different kinds of hyperparathyroidism. In this article we have reported our experience of radio-guided parathyroid surgery using Tc-99m sestamibi. Ten patients with hyperparathyroidism included in our study. Twenty mCi of Tc-99m sestamibi was injected intravenously to the patients in the day of surgery. All patients underwent surgery 4 hours after injection of the tracer. Abnormal parathyroid glands were localized by surgical gamma probe during surgery and were removed. Eight out of 10 patients had single adenoma. One patient had parathyroid hyperplasia secondary to chronic renal failure. The one remaining patient had persistent hyperparathyroidism with previous unsuccessful parathyroid surgeries. Except for the patient with parathyroid hyperplasia, parathyroid hormone [PTH] level of all other patients decreased after surgery including the patient with persistent hyperparathyroidism. Minimally invasive radio-guided parathyroid surgery is an easy and safe method for surgical treatment of hyperparathyroidism. With the increasing availability of surgical gamma probes and nuclear medicine facilities in Iran considering this kind of approach for surgical treatment of hyperparathyroidism seems rational