Clinical Efficacy of Sentinel Lymph Node Biopsy Using Methylene Blue Dye in Clinically Node-Negative Papillary Thyroid Carcinoma

Abstract

SLNB using methylene blue in papillary thyroid carcinoma is a safe and technically feasible procedure. However, it is of limited use in the management of clinically node-negative papillary thyroid carcinoma because of low sensitivity and a high false-negative rate.

Utility of sentinel lymph node biopsy for thyroid cancer: a comprehensive review

“…In 2012, Ji et al reported a high false-negative rate (35.1%) and low sensitivity (64.9%) with the use of methylene blue for PTC SLNB [58]. This study evaluated 114 consecutive patients with cN0 PTC, and the authors concluded that use of methylene blue for SLNB in clinically N0 PTC patients was of limited utility [58].…”

“…However, false-negatives may especially occur when relying on intraoperative frozen section diagnosis, and when evaluated by pathologists inexperienced in thyroid cancer histopathology [55,60]. In 2012, Ji et al reported a high false-negative rate (35.1%) and low sensitivity (64.9%) with the use of methylene blue for PTC SLNB [58]. This study evaluated 114 consecutive patients with cN0 PTC, and the authors concluded that use of methylene blue for SLNB in clinically N0 PTC patients was of limited utility [58].…”

Lymphoscintigraphy in Differentiated Thyroid Cancer

“…38 Preoperative diagnosis was DTC in 4 studies 20,28,29,38 and PTC in 21 studies. [13][14][15][16][17][18][19]21,22,[24][25][26][27][30][31][32][33][34][35][36][37] In 2006, Abdalla 23 studied 30 patients with a preoperative diagnosis of benign thyroid nodule. The histological diagnosis of PTC ranged between a minimum of 8 patients 22,29 and a maximum of 153 patients.…”

“…The histological diagnosis of PTC ranged between a minimum of 8 patients 22,29 and a maximum of 153 patients. 24 The authors used different vital dyes, in particular isosulfan blue in 7 studies, [13][14][15]18,23,29,31 methylene blue in 14 studies, 16,20,21,[25][26][27][28][30][31][32][33][34][35][36]38 and Patent Blue in 5 studies. 17,19,22,24,37 Injected volume ranged between 0.1 mL 13,14,16,19,22,23,28,29,36,37 and 2 mL.…”

“…25 Injection site was IT in 12 studies [13][14][15]19,[21][22][23][24]27,31,32,37 and PT in 15 studies. [16][17][18]20,22,25,26,[28][29][30][33][34][35][36]38,47 In 1 study, 22 the injection site was both IT and PT.…”