Preoperative lymphoscintigraphy for detection of sentinel lymph node in patients with gastric cancer--initial experience.
BACKGROUND
Preoperative lymphoscintigraphy may be informative when assessing nodal status in patients with early gastric cancer, especially for surgeons who are scheduled to introduce or have just introduced SLN biopsy.


METHODS
A total of 80 patients with clinical T1N0M0 gastric cancer were injected with technetium-99 m tin-colloid and then underwent preoperative lymphoscintigraphy. The detection rate of SLN per lymphatic basin was determined on the basis of the results of confirmatory lymph node dissection.


RESULTS
By means of lymphoscintigraphy, 71 of 106 basins were found (67%; 95% confidence interval [CI], 57.2-75.9%). Patients were stratified into the following subgroups: successful (S; all basins visualized), partially successful (PS; some basins visualized), and unsuccessful (U; none visualized). The body mass index (BMI) was significantly higher in the U (24.0 +/- 2.5) than in the S (22.3 +/- 2.4) group (P = 0.037). All patients in the U group had a single basin. Multivariate analysis showed that BMI was associated with unsuccessful lymphoscintigraphy (OR, 1.43; 95% CI, 1.06-1.92; P = 0.019), whereas all factors were similar between the S and PS groups.


CONCLUSIONS
BMI affects SLN detection during lymphoscintigraphy. Unsuccessful lymphoscintigraphy suggests that SLNs are located in a single basin. When lymphoscintigraphy is positive, no preoperative factors can predict whether all lymphatic basins can be visualized.
Nakahara
Tadaki
T
Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan. n-tadaki0909@k6.dion.ne.jp
Kitagawa
Yuko
Y
Yakeuchi
Hiroya
H
Fujii
Hirofumi
H
Suzuki
Takayuki
T
Mukai
Makio
M
Kitajima
Masaki
M
Kubo
Atsushi
A
D015992:Body Mass Index; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011300:Preoperative Care; D011379:Prognosis; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D021701:Sentinel Lymph Node Biopsy; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D017556:Technetium Compounds; D017971:Tin Compounds
D019275:Radiopharmaceuticals; D017556:Technetium Compounds; D017971:Tin Compounds; C033493:technetium Tc 99m tin colloid