Background: As the first sentinel lymph nodes (SLN) in lung cancer are most likely to harbor metastasis, their non-invasive identification could have a significant role in future treatments. We investigated the feasibility of adding an SLN procedure to a diagnostic navigation bronchoscopy.Methods: Thirty-one patients were included for injection of99mTc-nanocolloid and an iodinated contrast agent intra-/peritumorally and assessment of tracer dissipation via SPECT and CBCT imaging. Injections were performed endobronchially using a multi-modal catheter (Pioneer Plus), combining radial ultrasound and an angulated retractable needle to place injections under fluoroscopy and real-time ultrasound.Results: The injection of an imaging tracer was feasible in all cases using the catheter. Ultrasound visualized 29/30 tumors, and tracer injection was performed in 100% of patients. An SLN was subsequently identified in 10 out of 31 cases (32.3%) via SPECT/CT imaging. Iodinated contrast agent injection under CBCT imaging prior to99mTc nanocolloid injection visualized dissipation pathways and enabled needle relocation for subsequent99mTc-nanocolloid injection.Conclusions: Performing imaging tracer injections with a multi-modal catheter provided safe and local depot placement immediately following diagnostic navigation bronchoscopy. SPECT/CT imaging using99mTc-nanocolloid showed inconsistent results for SLN identification.
背景：作为肺癌的首个前哨淋巴结（SLN），其最可能发生转移，因此对其进行无创识别在未来的治疗中可能具有重要作用。本研究探讨了在诊断性导航支气管镜检查中增加SLN定位程序的可行性。 方法：纳入31例患者，瘤内/瘤周注射99mTc-纳米胶体及碘对比剂，并通过SPECT和CBCT成像评估示踪剂弥散情况。注射采用多模态导管（Pioneer Plus）经支气管内实施，该导管结合径向超声和可成角伸缩针，可在透视和实时超声引导下完成注射。 结果：使用该导管进行成像示踪剂注射在所有病例中均可行。超声成功显示29/30个肿瘤，所有患者均完成示踪剂注射。通过SPECT/CT成像，31例中有10例（32.3%）成功识别出SLN。在注射99mTc-纳米胶体前，通过CBCT成像注射碘对比剂可显示弥散路径，并能为后续99mTc-纳米胶体注射调整针头位置。 结论：采用多模态导管进行成像示踪剂注射，可在诊断性导航支气管镜检查后立即实现安全、局部的药物沉积。使用99mTc-纳米胶体的SPECT/CT成像在SLN识别方面结果不一致。
肿瘤(癌症)患者之家