1. Transvaginal ultrasound-guided myometrial injection of radiotracer (TUMIR): A new method for sentinel lymph node detection in endometrial cancer
- Author
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Torné, Aureli, Pahisa, Jaume, Vidal-Sicart, Sergi, Martínez-Roman, Sergio, Paredes, Pilar, Puerto, Bienvenido, Albela, Sonia, Fusté, Pere, Perisinotti, Andrés, and Ordi, Jaume
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TRANSVAGINAL ultrasonography , *INTRAMUSCULAR injections , *RADIOACTIVE tracers , *RADIOISOTOPES in medical diagnosis , *SENTINEL lymph node biopsy , *LONGITUDINAL method ,DIAGNOSIS of endometrial cancer - Abstract
Abstract: Objective: The objective of this prospective study was to determine the feasibility, safety and performance of a new method for sentinel lymph node (SLN) detection in endometrial cancer (EC) using transvaginal ultrasound-guided myometrial injection of radiotracer (TUMIR). Methods: From 2006 to 2011, 74 patients with high-risk EC were included in the study. Twenty-four hours before surgery 148MBq of 99mTc-nanocolloid (8mL) was injected into two spots in the anterior and posterior myometrium using an ultrasound-guided transvaginal puncture. SLN was localized preoperatively by lymphoscintigraphy and intraoperatively with gamma probe. After SLN biopsy the patients underwent a complete laparoscopic pelvic and paraaortic lymphadenectomy. Results: The TUMIR method was successfully achieved in 67/74 patients (90.5%). SLN was identified in 55 women (74.3%). No adverse effects were observed. Pelvic drainage was observed in 87.2% of women and paraaortic SLN was identified in 45.4%, with 12.8% of the patients draining only in this area. The mean number of SLN retrieved was 2.8 per patient (range 1 to 9). Metastatic disease was found in 13 (23.6%) patients. Metastatic involvement of the paraaortic lymph nodes was observed in 4 (30.7%) cases. All were identified by TUMIR. The sensitivity and negative predictive value of SLN detected by TUMIR to detect metastasis were 92.3% (95% CI 22.9–100) and 97.7% (95% CI 82.0–100), respectively. Conclusions: TUMIR is a safe, feasible method to detect SLN in patients with EC, has a good detection rate and provides representative information of the lymphatic drainage of EC. [Copyright &y& Elsevier]
- Published
- 2013
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