Objective To evaluate the value of SPECT/CT lymphoscintigraphy for sentinel lymph node (SLN) detection in patients with cN0 papillary thyroid carcinoma(PTC).

Methods From April to November 2017, 2 male and 14 female patients with cN0 PTC, with mean age of 47.0±8.4 years, and hospitalized in the first Hospital of Shanxi Medical University, were enrolled in this study. Planar and SPECT/CT SLN imaging were performed before operation. All patients underwent intraoperative lymphatic mapping with a handheld gamma probe. All specimens were sent to a pathology laboratory.

Results Among the 16 patients, 14 cases of SLN were found, with a detection rate of 87.50% (14/16). Preoperative planar and SPECT/CT fusion images showed 31 and 35 SLNs, respectively. With the application of intraoperative gamma probe, a total of 37 SLNs were detected in 13/16 patients (81.25%). The number of SLNs detected by gamma detector was inconsistent with the SPECT/CT lymphography in 4 cases and consistent in 12 cases. The coincidence rate of the two methods was 75% (12/16). Fifteen patients (93.75%) had lymph node metastasis. The sensitivity, accuracy, and false negative rate of SLN detection were 86.67%, 81.25%, and 13.33%, respectively.

Conclusion Preoperative SPECT/CT lymphoscintigraphy can not only enables precise localization of SLN but also detects the cervical lymph node metastasis in patients with cN0 papillary thyroid carcinoma.