title: Comparison between preoperative versus intraoperative injection of technetium-99 m neomannosyl human serum albumin for sentinel lymph node identification in early stage lung cancer.
abstract: OBJECTIVE
  We aimed to evaluate the results of sentinel lymph node mapping according to injection time (preoperative vs. intraoperative) of technetium-99m neomannosyl human serum albumin (99mTc-MSA) in patients with lung cancer.
  
  
  METHODS
  Data of 82 patients (55 men; mean age 62.9±9.3 years) who were candidates for lobectomy with mediastinal lymph node dissection for clinical stage I non-small cell lung cancer were retrospectively reviewed. (99m)Tc-MSA was administered at the peritumoral region under chest computed tomographic guidance, 1 to 2 h before surgery (preoperation group, n=48) or soon after thoracotomy (intraoperation group, n=34).
  
  
  RESULTS
  Patients' demographic data, except type of operation, did not differ between the two groups. Sentinel lymph nodes were detected in 46 patients (95.8%) in the preoperation group and 33 patients (97.1%) in the intraoperation group (P=.243). The mean number of sentinel nodes per patient was 2.1 in the preoperation group and 2.6 in the intraoperation group (P=.068). No falsely negative sentinel nodes were detected in any of the 17 patients with N1 or N2 disease (0%) in either group. Administration of the intraoperative injection could save additional cost (US$607) and time (70 min) in each patient.
  
  
  CONCLUSIONS
  Sentinel node identification using 99mTc-MSA appears to provide similar excellent results in both preoperative and intraoperative injection. Therefore, intraoperative injection of 99mTc-MSA may be preferred as a result of lower cost and less waste of time.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea. kimhyunkoo@korea.ac.kr
authors.forename: Hyun Koo
authors.initials: HK
authors.lastname: Kim
authors.forename: Sungeun
authors.initials: S
authors.lastname: Kim
authors.forename: Ho Kyung
authors.initials: HK
authors.lastname: Sung
authors.forename: Yun-Sang
authors.initials: YS
authors.lastname: Lee
authors.forename: Jae Min
authors.initials: JM
authors.lastname: Jeong
authors.forename: Young Ho
authors.initials: YH
authors.lastname: Choi
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary / Q000601:surgery; D002282:Adenocarcinoma, Bronchiolo-Alveolar / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary / Q000601:surgery; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008175:Lung Neoplasms / Q000473:pathology*; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008482:Mediastinum; D059146:Metastasectomy / Q000379:methods; D008875:Middle Aged; D009367:Neoplasm Staging; D018307:Neoplasms, Squamous Cell / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary / Q000601:surgery; D015609:Organotechnetium Compounds / Q000008:administration & dosage*; D011292:Premedication; D011877:Radionuclide Imaging; D021701:Sentinel Lymph Node Biopsy / Q000379:methods
chemical_list: D015609:Organotechnetium Compounds; C557199:technetium j99m neomannosyl human serum albumin