National equipment of intraoperatory gamma detection in the identification of sentinel lymph node in animal model

Paula Cristina Fada Dos Santos,Fábio Xerfan Nahas,Renato Santos De Oliveira Filho,Lydia Masako Ferreira,Ivan Dunshee De Abranches Oliveira Santos

doi:10.1590/s0102-86502009000300006

Abstract

To investigate a national equipment of intraoperatory gamma detection in the identification of sentinel lymph node. Thirty young adult male rats were used. After anesthetized, animals were divided into two groups of 15 animals each. Animals from group A received dextram 500 - Tc99 radiopharmaceutical and patent blue V and those from group B received only patent blue V to map the lymphatic drainage. The presence of radiation in the background area, in the area of injection and of the ex vivo sentinel lymph node of group A were measured. After the exeresis, each lymph node in group A and in group B was mixed forming a new random sequence and the radioactive reading of each lymph node was carried out, using both pieces of equipment. The hottest sentinel lymph node was identified by the national equipment when radiation was measured in the area of limphatic drainage after the Dextran 500 was injected. Also, the ex vivo sentinel lymph node. The national equipment has also detected radiation in the lymph nodes that had not received radiopharmaceutical, leading to false positive, checked by the application of Mann-Whitney tests and Student's paired t-tests. The Cronbach alpha has shown high internal consistency of data 0.9416. The national equipment of intraoperatory gamma detection identifies the LS and showed false positives LS and needs improvement.

Highlights

The use of intraoperatory gamma detection has already been established in oncology to identify sentinel lymph nodes in melanoma[1,2,3,4], in breast cancer[5,6,7,8,9,10] and its application for other tumors such as vulva[8,9,10]
The SLB in melanoma was established by Morton et al.[19], at first only using the vital blue dye that allows for the microstaging of solid tumors
The IPEN equipment detected radiation even in lymph nodes which had not received the radiopharmaceutical, leading to a false-positive, as verified by the Mann-Whitney’s test and Student’s paired-t testes). This was found when the values of gamma radiation measured with the pieces of intraoperatory gamma detection equipment of each ex vivo sentinel lymph node were analyzed (Table 1) – Cronbach Alpha showed a high internal consistency of the data (0.9188)

Summary

Introduction

The use of intraoperatory gamma detection has already been established in oncology to identify sentinel lymph nodes in melanoma[1,2,3,4], in breast cancer[5,6,7,8,9,10] and its application for other tumors such as vulva[8,9,10]. The SLB in melanoma was established by Morton et al.[19], at first only using the vital blue dye that allows for the microstaging of solid tumors. These tumors, in the beginning, spread preferably through the lymphatic system. The IGD has already been included in the official staging of melanoma and of breast cancer in accordance with the AJCC/UICC (American Joint Committee on Cancer Staging System)[20]

Methods

Results

Conclusion