title: Sentinel node mapping in papillary thyroid carcinoma using combined radiotracer and blue dye methods.
abstract: BACKGROUND
  In the current study, we evaluated the accuracy of sentinel node mapping in thyroid cancer patients using both radiotracer and blue dye.
  
  
  METHODS
  30 patients with a diagnosis of papillary thyroid carcinoma (PTC) were included in the study; 2-3 hours before surgery, 0.5 mCi 99m-Tc-Antimony Sulfide Colloid was injected intra-tumourally. 15 minutes post-injection, lymphoscintigraphy images of the neck were obtained. Immediately after anaesthesia induction, 0.5 mL patent blue V was also injected in the same fashion. Sentinel lymph nodes were detected intraoperatively using gamma probe and blue dye. Total thyroidectomy was performed for all patients with dissection of central neck lymph nodes as well as sampling of the lateral neck lymph nodes.
  
  
  RESULTS
  At least one sentinel node could be identified during surgery in 19 patients (63.3%). The median number of sentinel nodes per patient was 1. Sentinel nodes in 12 patients were pathologically involved. No false negative case was noted. Upstaging occurred in six patients (20%).
  
  
  CONCLUSIONS
  Sentinel node mapping in papillary thyroid carcinoma is a feasible technique with high accuracy for the detection of lymph node involvement. This technique can guide surgeons to perform central lymph node dissection only in patients with pathologically involved sentinel nodes. Although SLN detection in the lateral neck lymph nodes increases the extension of lymphadenectomy, SLN mapping can result in upstaging in older patients (> 45 years of age) or treatment plan change in younger patients (< 45 years of age) by the detection of lateral lymph node involvement.
authors.forename: Mahdi
authors.initials: M
authors.lastname: Assadi
authors.forename: Mohammad
authors.initials: M
authors.lastname: Yarani
authors.forename: Seyed Rasoul
authors.initials: SR
authors.lastname: Zakavi
authors.forename: Ali
authors.initials: A
authors.lastname: Jangjoo
authors.forename: Bahram
authors.initials: B
authors.lastname: Memar
authors.forename: Giorgio
authors.initials: G
authors.lastname: Treglia
authors.forename: Mohsen
authors.initials: M
authors.lastname: Aliakbarian
authors.forename: Mostafa
authors.initials: M
authors.lastname: Mehrabibahar
authors.affiliation: raminsadeghi1355@yahoo.com.
authors.forename: Ramin
authors.initials: R
authors.lastname: Sadeghi
mesh_terms: D000328:Adult; D002291:Carcinoma, Papillary / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009367:Neoplasm Staging; D011877:Radionuclide Imaging; D021701:Sentinel Lymph Node Biopsy; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery