Using Carbon Nanoparticles to Map Lateral Neck Lymph Nodes in Papillary Thyroid Cancer
Posted: Thursday, March 12, 2020
According to research presented at the 2019 American Thyroid Association Annual Meeting in Chicago (Abstract 38), the use of carbon nanoparticles was successful in mapping the lateral neck lymph nodes in patients with papillary thyroid cancer. “This method has a potential role of lateral neck sentinel lymph node biopsy in [papillary thyroid cancer],” concluded Nai-si Huang, MD, of Fudan University Shanghai Cancer Center in China, and colleagues.
The multicenter study included 122 patients with papillary thyroid cancer who had lymph nodes that looked suspicious on ultrasound or CT imaging but were not abnormal to the touch. All patients underwent modified lateral neck dissections after injection of carbon nanoparticles into the thyroid glands. After the separation of dyed and undyed lateral lymph nodes, patients underwent thyroidectomies and central neck compartment dissections. Among the 122 enrolled patients, 125 neck dissections were performed, including 117 with lateral neck metastasis, 7 with central neck metastasis, and 1 without metastasis of any kind.
All neck compartments had a markedly increased risk of metastasis in dyed nodes. Compared with undyed nodes, the metastasis risk of dyed nodes was 19.9% versus 5.6% in compartment II, 35.0% versus 18.3% in compartment III, 37.1% versus 15.2% in compartment IV, and 14.8% versus 3.7% in compartment V. Dyed nodes were found most commonly in compartment IV, followed by compartments III, II, and then V. Per case, a median number of 6 dyed nodes were found, and dyed lymph node metastasis occurred in 33.3% of compartment II cases, 60.0% of compartment III cases, 68.8% of compartment IV cases, and 40.0% of compartment V cases, whereas they occurred at 10.2%, 31.4%, 27.5%, and 20.8%, respectively, per node.
Disclosure: For full disclosures of the study authors, visit thyroid.org.