PURPOSE: The purpose of this study was to analyse the incidence and cause of non-visualization of sentinel lymph nodes on preoperative lymphoscintigrams for penile cancer and its implications for further management. METHODS: Preoperative lymphoscintigraphy was performed after injection of (99m)Tc-labelled nanocolloid in 123 clinically node-negative penile carcinoma patients. Anterior dynamic lymphoscintigraphy was performed during 20 min immediately after tracer injection. Subsequently, 5-min anterior and lateral static images were obtained 30 min and 2 h post injection. RESULTS: Lymphatic drainage to both groins was seen in 98 patients (79%), unilateral drainage in 23 patients (19%) and no drainage at all in two patients (2%). Thus, in 27 (11%) of 246 groins, no sentinel node was visualized. The amount of administered tracer dose was associated with non-visualization (p=0.01). Unilateral drainage was initially interpreted as a normal physiological phenomenon. After the occurrence of a tumour-positive node in a non-visualized groin, we explore non-visualized groins by blue dye mapping and intraoperative palpation. Sentinel nodes were retrieved in four out of eight such groins, of which one contained metastasis. CONCLUSION: In penile carcinoma patients, preoperative lymphoscintigraphy visualizes a sentinel node in 89% of groins. Visualization depends on the administered tracer dose. It is worthwhile to explore non-visualized groins. Sentinel nodes can be intraoperatively identified in more than half of these cases.
PURPOSE: The purpose of this study was to analyse the incidence and cause of non-visualization of sentinel lymph nodes on preoperative lymphoscintigrams for penile cancer and its implications for further management. METHODS: Preoperative lymphoscintigraphy was performed after injection of (99m)Tc-labelled nanocolloid in 123 clinically node-negative penile carcinomapatients. Anterior dynamic lymphoscintigraphy was performed during 20 min immediately after tracer injection. Subsequently, 5-min anterior and lateral static images were obtained 30 min and 2 h post injection. RESULTS: Lymphatic drainage to both groins was seen in 98 patients (79%), unilateral drainage in 23 patients (19%) and no drainage at all in two patients (2%). Thus, in 27 (11%) of 246 groins, no sentinel node was visualized. The amount of administered tracer dose was associated with non-visualization (p=0.01). Unilateral drainage was initially interpreted as a normal physiological phenomenon. After the occurrence of a tumour-positive node in a non-visualized groin, we explore non-visualized groins by blue dye mapping and intraoperative palpation. Sentinel nodes were retrieved in four out of eight such groins, of which one contained metastasis. CONCLUSION: In penile carcinomapatients, preoperative lymphoscintigraphy visualizes a sentinel node in 89% of groins. Visualization depends on the administered tracer dose. It is worthwhile to explore non-visualized groins. Sentinel nodes can be intraoperatively identified in more than half of these cases.
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Authors: P J Tanis; J W van Sandick; O E Nieweg; R A Valdés Olmos; E J T Rutgers; C A Hoefnagel; B B R Kroon Journal: Eur J Nucl Med Mol Imaging Date: 2002-03 Impact factor: 9.236
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Authors: J C Soria; K Fizazi; D Piron; A Kramar; A Gerbaulet; C Haie-Meder; J L Perrin; B Court; P Wibault; C Théodore Journal: Ann Oncol Date: 1997-11 Impact factor: 32.976
Authors: Jonathan S O'Brien; Jiasian Teh; Brian D Kelly; Kenneth Chen; Todd Manning; Marc Furrer; Justin Chee; Nathan Lawrentschuk Journal: Front Surg Date: 2022-05-18
Authors: Iris M C van der Ploeg; Renato A Valdés Olmos; Bin B R Kroon; Emiel J T Rutgers; Omgo E Nieweg Journal: Eur J Nucl Med Mol Imaging Date: 2008-08-20 Impact factor: 9.236
Authors: Teele Kuusk; Maarten L Donswijk; Renato A Valdés Olmos; Roderick E De Bruijn; Oscar R Brouwer; Kees Hendricksen; Simon Horenblas; Katarzyna Jóźwiak; Warner Prevoo; Henk G Van Der Poel; Bas W G Van Rhijn; Esther M Wit; Axel Bex Journal: EJNMMI Res Date: 2018-12-03 Impact factor: 3.138