OBJECTIVES: Pre-operative staging of the clinically N(0) neck in patients with oral squamous cell carcinoma is hindered by the relatively high false negative/positive rates of conventional imaging techniques. The aim of this study is to evaluate the utility of (18)F-fluoro-deoxy-glucose (FDG) positron emission tomography (PET) and sentinel lymph node (SLN) imaging and biopsy to determine the true disease status of the loco-regional lymphatics. METHODS: Nineteen patients with biopsy proven disease without palpable or radiological evidence of neck metastases underwent pre-operative (18)F-FDG PET and SLN imaging. All patients underwent whole-body FDG PET and a single view of the head and neck. SLN technique was performed using four peri-tumoural injections of (99m)Tc labeled albumin colloid each of 10 MBq. Dynamic and static imaging followed in the antero-posterior and lateral projections. At operation 1 ml of 2.5% Patent Blue Dye and a hand held gamma probe (Neoprobe 1500) were used in combination to identify and remove the SLN. Surgery then continued along conventional lines including a neck dissection. Histology of the resultant specimen was correlated with that of the SLN and pre-operative imaging. RESULTS: In all patients SLN harvesting was feasible. In 15/19 patients the SLN(s) and the residual neck dissection were -ve for tumour. In 3/19 patients the SLN(s) were +ve for tumour as were other neck nodes. In 1/19 patients the SLN was -ve but another single tumour +ve node was identified in the neck. This patient occurred early in our series with a SLN close to the primary tumour. (18)F-FDG PET failed to identify nodal disease in all four patients with histologically proven lymph node metastases. The size of these nodes ranged from 12 mm x 10 mm x 3 mm to 25 mm x 15 mm x 10 mm. CONCLUSION: SLN imaging and biopsy with probe and Patent Blue Dye guided harvest is feasible in patients with oral squamous cell carcinoma and can predict cervical nodal status. (18)F-FDG PET may be less useful. Copyright 2003 Elsevier Science Ltd.
OBJECTIVES: Pre-operative staging of the clinically N(0) neck in patients with oral squamous cell carcinoma is hindered by the relatively high false negative/positive rates of conventional imaging techniques. The aim of this study is to evaluate the utility of (18)F-fluoro-deoxy-glucose (FDG) positron emission tomography (PET) and sentinel lymph node (SLN) imaging and biopsy to determine the true disease status of the loco-regional lymphatics. METHODS: Nineteen patients with biopsy proven disease without palpable or radiological evidence of neck metastases underwent pre-operative (18)F-FDG PET and SLN imaging. All patients underwent whole-body FDG PET and a single view of the head and neck. SLN technique was performed using four peri-tumoural injections of (99m)Tc labeled albumin colloid each of 10 MBq. Dynamic and static imaging followed in the antero-posterior and lateral projections. At operation 1 ml of 2.5% Patent Blue Dye and a hand held gamma probe (Neoprobe 1500) were used in combination to identify and remove the SLN. Surgery then continued along conventional lines including a neck dissection. Histology of the resultant specimen was correlated with that of the SLN and pre-operative imaging. RESULTS: In all patients SLN harvesting was feasible. In 15/19 patients the SLN(s) and the residual neck dissection were -ve for tumour. In 3/19 patients the SLN(s) were +ve for tumour as were other neck nodes. In 1/19 patients the SLN was -ve but another single tumour +ve node was identified in the neck. This patient occurred early in our series with a SLN close to the primary tumour. (18)F-FDG PET failed to identify nodal disease in all four patients with histologically proven lymph node metastases. The size of these nodes ranged from 12 mm x 10 mm x 3 mm to 25 mm x 15 mm x 10 mm. CONCLUSION: SLN imaging and biopsy with probe and Patent Blue Dye guided harvest is feasible in patients with oral squamous cell carcinoma and can predict cervical nodal status. (18)F-FDG PET may be less useful. Copyright 2003 Elsevier Science Ltd.
Authors: Robert L Ferris; Liqiang Xi; Raja R Seethala; Jon Chan; Shaun Desai; Benjamin Hoch; William Gooding; Tony E Godfrey Journal: Clin Cancer Res Date: 2011-02-25 Impact factor: 12.531
Authors: Jolijn Brouwer; Remco de Bree; Emile F I Comans; Jonas A Castelijns; Otto S Hoekstra; C René Leemans Journal: Eur Arch Otorhinolaryngol Date: 2003-12-17 Impact factor: 2.503
Authors: Hubert Vermeersch; David Loose; Hamphrey Ham; Andreas Otte; Christophe Van de Wiele Journal: Eur J Nucl Med Mol Imaging Date: 2003-10-22 Impact factor: 9.236
Authors: L W T Alkureishi; Z Burak; J A Alvarez; J Ballinger; A Bilde; A J Britten; L Calabrese; C Chiesa; A Chiti; R de Bree; H W Gray; K Hunter; A F Kovacs; M Lassmann; C R Leemans; G Mamelle; M McGurk; J Mortensen; T Poli; T Shoaib; P Sloan; J A Sorensen; S J Stoeckli; J B Thomsen; G Trifiro; J Werner; G L Ross Journal: Ann Surg Oncol Date: 2009-11 Impact factor: 5.344
Authors: Lee W T Alkureishi; Zeynep Burak; Julio A Alvarez; James Ballinger; Anders Bilde; Alan J Britten; Luca Calabrese; Carlo Chiesa; Arturo Chiti; Remco de Bree; Harry W Gray; Keith Hunter; Adorjan F Kovacs; Michael Lassmann; C Rene Leemans; Gerard Mamelle; Mark McGurk; Jann Mortensen; Tito Poli; Taimur Shoaib; Philip Sloan; Jens A Sorensen; Sandro J Stoeckli; Jorn B Thomsen; Giusepe Trifiro; Jochen Werner; Gary L Ross Journal: Eur J Nucl Med Mol Imaging Date: 2009-11 Impact factor: 9.236