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J Thorac Cardiovasc Surg 2003;126:563-567
© 2003 The American Association for Thoracic Surgery
General thoracic surgery |
a Second Department of Surgery, Akita University School of Medicine, Akita City, Japan
b First Department of Pathology, Akita University School of Medicine, Akita City, Japan
c Division of Clinical Pathology, Akita University Hospital, Akita City, Japan
d Kansai Research Institute, Kyoto Research Park 17, Kyoto, Japan
Received for publication September 30, 2002; revisions received November 25, 2002; revisions received December 9, 2002; accepted for publication January 9, 2003.
* Address for reprints: Yoshihiro Minamiya, MD, Associate Professor of Thoracic Surgery, Second Department of Surgery, Akita University School of Medicine, 1-1-1 Hondo, Akita City 010-8543, Japan
minamiya{at}med.akita-u.ac.jp
OBJECTIVE: The detection rate of sentinel lymph nodes in patients with non–small cell lung cancer using isosulfan blue dye is too low for clinical use. Although exposure to radioactivity is reportedly minimal, special procedures are nonetheless required when a radioactive isotope is used as a tracer. Therefore, to eliminate the need for a radioactive tracer and to obtain a better detection rate than is obtained with isosulfan blue dye, we have developed a novel method that employs magnetite as the tracer. The aim of the present study was to test the feasibility of this technique.
METHODS: The tracer employed was ferumoxides, a colloidal superparamagnetic iron oxide of nonstoichiometric magnetite. Thirty-eight non–small cell lung cancer patients participated in the study; each received 5 mL of ferumoxides, injected around the tumor intraoperatively. Fifteen minutes after injection, lung resection and lymph node dissection were carried out. The magnetic force within the lymph nodes was measured using a highly sensitive handheld magnetometer ex vivo. All lymph nodes were also subjected to conventional histological analysis.
RESULTS: The rate of detection of sentinel lymph nodes was 81.6% (31/38). The accuracy, sensitivity, and false-negative rates were 96.8% (30/31), 85.7% (6/7), and 14.3% (1/7), respectively.
CONCLUSION: Intraoperative sentinel lymph node mapping using ferumoxides and a highly sensitive magnetometer is a safe, accurate, and sensitive way to detect sentinel lymph nodes in non–small cell lung cancer patients.
Key Words: 10
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