Using radioguided sentinel lymph node biopsies could improve estimation of disease severity in papillary thyroid carcinoma

A new imaging method could help physicians detect serious types of papillary thyroid carcinoma (PTC) more accurately, according to research published in the Journal of the American Medical Association Otolaryngology—Head & Neck Surgery.

The study authors said they hoped to find a way to identify serious cases of PTC and reduce the incidence of underestimating the disease.

“Our results suggest that occult metastases are unobserved and underestimated on initial staging owing to the low detection rate by ultrasonography and the lack of proper intraoperative LN dissection, especially in the lateral compartments,” study authors wrote. "To that effect, cervical nodal metastasis in PTC may be more frequent than expected."

Researchers performed and analyzed the results of single-photon emission computed tomography/computed tomography (SPECT/CT) scans and radioguided sentinel lymph node biopsies (rSLNB) on 37 patients with thyroid nodules that were suspected of being PTC cases.

The scans found that 17 of the patients, or 46 percent, showed metastatic lymph nodes. Based on the scans, treatment plans were changed for 14 patients, or almost 38 percent of participants. Doctors were able to get a better view of their nodules through the use of rSLNB scans, meaning they were better able to detect cervical lymph node metastases where they wouldn’t have been able to without the use of rSLNB, which could have led to an underestimating of the severity of the disease.

They also found that incidence of lymph node metastases and the size of a participants’ tumor were correlated, meaning the presence of lymph node metastases could be more important for estimating the cancer’s severity than is currently accepted.

A more precise ability to detect the severity of PTC with a chance to change treatment plans could be useful to patients and their physicians who are hoping to stop or slow the spread of the cancer to the lymph nodes and decrease chances the cancer will recur, therefore increasing survival chances.