title: Sentinel node mapping for node positive oral cancer: potential to predict multiple metastasis.
abstract: OBJECTIVE
  The objective of this study is to evaluate lymph node mapping for clinically positive neck metastasis using a sentinel node navigation technique.
  
  
  METHODS
  99mTc-labeled rhenium sulfide was injected as a radiotracer in 10 patients with squamous cell carcinoma of the tongue. After surgery, lymph nodes were classified into two categories according to the radioactive accumulation: nodes with radioactivity and nodes without radioactivity. The ratio of the metastatic area (RMA) of pathologically metastatic lymph nodes was measured.
  
  
  RESULTS
  In 5 of 10 cases, all of the metastatic nodes had radioactive accumulation. In one case with three metastatic nodes, radioactivity was not detected in one metastatic node, although it was detected in the other two nodes. In the other four cases, there were no radioactivities in any of the metastatic nodes. RMA of lymph nodes in which radioactivity was not detected was higher than that of lymph nodes in which radioactivity was detected. None of the nodes in which radioactivity was detected was fully occupied by metastatic carcinoma cells. In each case, in comparing the clinically positive lymph nodes, RMA of the nodes in which no radioactivity was detected was higher than that of the nodes in which radioactivity was detected.
  
  
  CONCLUSIONS
  The principle behind the sentinel node technique is detection of the node that has the most lymph flow from the tumor through injection of the tracer into the circumference of the tumor. When no radioactive accumulation is found in clinically positive metastatic lymph nodes, the possibility of metastasis to other lymph nodes should be highly suspected.
authors.affiliation: Department of Otolaryngology, Fukushima Medical University School of Medicine, Fukushima, Japan. tmtzk@fmu.ac.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Matsuzuka
authors.forename: Makoto
authors.initials: M
authors.lastname: Kano
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ogawa
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Miura
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Tada
authors.forename: Takamichi
authors.initials: T
authors.lastname: Matsui
authors.forename: Shuji
authors.initials: S
authors.lastname: Yokoyma
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Masahiro
authors.initials: M
authors.lastname: Suzuki
authors.forename: Koichi
authors.initials: K
authors.lastname: Omori
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000473:pathology* / Q000556:secondary; D005260:Female; D005927:Glossectomy; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009367:Neoplasm Staging; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D021701:Sentinel Lymph Node Biopsy; D013671:Technetium Tc 99m Sulfur Colloid; D014062:Tongue Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*
chemical_list: D019275:Radiopharmaceuticals; C512413:nanocis; D013671:Technetium Tc 99m Sulfur Colloid