Purpose. We aimed to evaluate the results of sentinel lymph node mapping according to injection time (preoperative vs. intraoperative) of technetium-99m neomannosyl human serum albumin ( 99mTc-MSA) in patients with lung cancer. Methods. Data of 82 patients (55 men; mean age 62.9 ± 9.3 years) who were candidates for lobectomy with mediastinal lymph node dissection for clinical stage I non-small cell lung cancer were retrospectively reviewed. 99mTc-MSA was administered at the peritumoral region under chest computed tomographic guidance, 1 to 2 h before surgery (preoperation group, n = 48) or soon after thoracotomy (intraoperation group, n = 34). Results. Patients' demographic data, except type of operation, did not differ between the two groups. Sentinel lymph nodes were detected in 46 patients (95.8%) in the preoperation group and 33 patients (97.1%) in the intraoperation group (P = .243). The mean number of sentinel nodes per patient was 2.1 in the preoperation group and 2.6 in the intraoperation group (P = .068). No falsely negative sentinel nodes were detected in any of the 17 patients with N1 or N2 disease (0%) in either group. Administration of the intraoperative injection could save additional cost (US$607) and time (70 min) in each patient. Conclusions. Sentinel node identification using 99mTc-MSA appears to provide similar excellent results in both preoperative and intraoperative injection. Therefore, intraoperative injection of 99mTc-MSA may be preferred as a result of lower cost and less waste of time.
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