Percutaneous radioisotope injection for sentinel node biopsy in lung cancer

preliminary study for clinical trial

Abstract

We introduce the method and feasibility of percutaneous radioisotope injection for identification of senti nel lymph node in lung cancer . Six consecutive patients with clinical N0 lung cancers were eligible for this clinical trial. Patients first underwent body surface marking under CT guidance . Then, 99mTc-tin colloid was injected percutaneously in the RI examination room. RI labeled lymph nodes were detected at thoracotomy and at the completion of entire lymph node dissection by a handheld gamma probe . RI injection accounted for minor morbidities consisting of slight pneumothorax and slight hemoptysis not requiring any therapy . In vivo identification of RI labeled lymph node was disturbed due to airway seeding of radioisotope . Ex vivo sentinel lymph node was identified in 5 of 6 patients . Localization of sentinel node were level 12 in 2 cases, level 11 in one case and level 5 in one case. All the patients showed pathological N0 disease . According to this preliminary study, utility as well as some problems were proposed . Further study will be required to verify the value of sentinel lymph node biopsy in lung cancer.