99mtc nanocoll

On the afternoon of the day before surgery or the morning of surgery, the patients underwent endoscopic submucosal radiocolloid injection of 4 × 0.5 mL in total of 60 MBq ^99mTc-nanocoll (GE Healthcare Srl., Milan, Italy) peritumourally and intratumourally.
For logistical reasons, patients undergoing surgery on a Monday underwent preoperative sentinel node imaging in the week before surgery. These patients underwent a second endoscopic procedure as described above on the morning of surgery to allow for intraoperative SLN detection.

Thirty percent (20/67) of the patients underwent both preoperative and postoperative arm lymphoscintigraphy. We excluded the results from the patients without preoperative imaging to minimize bias. Both hands (between the first and second digit) were injected intradermally with 40 MBq of technetium-labeled sulfur nanocolloid (99mTc-Nanocoll; GE Healthcare Ltd, Italy) in the volume of 0.1–0.2 ml. The imaging was performed with Infinia Hawkeye single-photon emission computed tomography/computed tomography (General Electric Medical Systems, Milwaukee, Wis.) as previously explained.^{9 (link)} We used the semiquantitative transport index (TI) of the operated arm in the analysis of the results. The TI value was calculated as previously described.^{20 (link)} A TI value of over 10 was considered to be the borderline for pathological lymphatic function.