Sentinel Node Mapping in Patients with Malignant Melanoma Using Melanoma Tc-99m Colloidal Rhenium Sulfide

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Abstract
The aim of the study was to localize the sentinel lymph node using lymphoscintigraphy aided by Tc-99m colloidal rhenium sulfide. Thirty consecutive patients with histologically proved melanoma, but no clinical evidence of metastases, were examined before operation by injecting 20 to 40 MBq (0.5 to 1.1 mCi) Tc-99m colloidal rhenium sulfide with a mean particle size of 100 nm (range, 50 to 200 nm) intradermally around the lesion. Lymphoscintigraphy was performed immediately after injection. In addition, blue dye was injected before operation. A hand-held gamma probe guided the sentinel node biopsy. Lymphoscintigraphy revealed hot spots in all patients. During surgery, the sentinel node was identified in all 30 patients. The number of sentinel nodes per patient ranged from 1 to 4 (mean, 1.9). Histologic examination confirmed the metastatic involvement of the sentinel lymph node in 11 of 30 patients. The sentinel lymph node–positive rate was 22.4%, which was comparable to findings using Tc-99m–labeled nanocolloids. The findings indicate that Tc-99m–bound colloidal rhenium sulfide is suitable for sentinel node mapping.