BACKGROUND: The hybrid single-photon emission computed tomography camera with integrated CT (SPECT/CT) fuses tomographic lymphoscintigrams with anatomical CT data. SPECT/CT shows the exact anatomical location of a sentinel node and may detect additional drainage. The purpose of this study was to explore its potential in patients with melanoma. METHODS: We studied 85 patients with melanoma with conventional lymphoscintigrams that were difficult to interpret (51 patients), that showed an unusual drainage pattern (33 patients), or with nonvisualization (1 patient). Forty-one patients had melanoma on an extremity, 31 on the trunk, and 14 in the head and neck region. SPECT/CT was performed following late conventional imaging without reinjection of the radiopharmaceutical. RESULTS: Conventional imaging suggested 214 sentinel nodes in 84 of the 85 patients (99%). SPECT/CT showed these same nodes and 12 extra sentinel nodes in seven patients (8%). Ten of these additional nodes were harvested, of which three nodes of two patients harbored metastases. There was a clear advantage of SPECT/CT in 30 patients (35%), resulting in a different incision in 17 patients, an incision at another site in 8, and an extra incision in 5 patients. The value was questionable in 19 patients (22%) in whom sentinel nodes were more clearly visualized by SPECT/CT, although the incision remained unchanged. There was no additional value of SPECT/CT in 36 patients (42%). CONCLUSIONS: SPECT/CT detects additional drainage and shows the exact anatomical location of sentinel nodes in patients with inconclusive conventional lymphoscintigrams. SPECT/CT facilitates surgical exploration in difficult cases and may improve staging.
BACKGROUND: The hybrid single-photon emission computed tomography camera with integrated CT (SPECT/CT) fuses tomographic lymphoscintigrams with anatomical CT data. SPECT/CT shows the exact anatomical location of a sentinel node and may detect additional drainage. The purpose of this study was to explore its potential in patients with melanoma. METHODS: We studied 85 patients with melanoma with conventional lymphoscintigrams that were difficult to interpret (51 patients), that showed an unusual drainage pattern (33 patients), or with nonvisualization (1 patient). Forty-one patients had melanoma on an extremity, 31 on the trunk, and 14 in the head and neck region. SPECT/CT was performed following late conventional imaging without reinjection of the radiopharmaceutical. RESULTS: Conventional imaging suggested 214 sentinel nodes in 84 of the 85 patients (99%). SPECT/CT showed these same nodes and 12 extra sentinel nodes in seven patients (8%). Ten of these additional nodes were harvested, of which three nodes of two patients harbored metastases. There was a clear advantage of SPECT/CT in 30 patients (35%), resulting in a different incision in 17 patients, an incision at another site in 8, and an extra incision in 5 patients. The value was questionable in 19 patients (22%) in whom sentinel nodes were more clearly visualized by SPECT/CT, although the incision remained unchanged. There was no additional value of SPECT/CT in 36 patients (42%). CONCLUSIONS: SPECT/CT detects additional drainage and shows the exact anatomical location of sentinel nodes in patients with inconclusive conventional lymphoscintigrams. SPECT/CT facilitates surgical exploration in difficult cases and may improve staging.
Authors: Ingo Stoffels; Markus Müller; Marie Henrike Geisel; Julia Leyh; Thorsten Pöppel; Dirk Schadendorf; Joachim Klode Journal: Eur J Nucl Med Mol Imaging Date: 2014-04-25 Impact factor: 9.236
Authors: Giuliano Mariani; Laura Bruselli; Torsten Kuwert; Edmund E Kim; Albert Flotats; Ora Israel; Maurizio Dondi; Naoyuki Watanabe Journal: Eur J Nucl Med Mol Imaging Date: 2010-02-25 Impact factor: 9.236
Authors: Axel Bex; Lenka Vermeeren; Geraldine de Windt; Warner Prevoo; Simon Horenblas; Renato A Valdés Olmos Journal: Eur J Nucl Med Mol Imaging Date: 2010-01-29 Impact factor: 9.236
Authors: Richard J Straker; Michael J Carr; Andrew J Sinnamon; Adrienne B Shannon; James Sun; Karenia Landa; Kirsten M Baecher; Christian Wood; Kevin Lynch; Harrison G Bartels; Robyn Panchaud; Michael C Lowe; Craig L Slingluff; Mark J Jameson; Kenneth Tsai; Mark B Faries; Georgia M Beasley; Vernon Sondak; Giorgos C Karakousis; Jonathan S Zager; John T Miura Journal: Ann Surg Oncol Date: 2021-04-22 Impact factor: 5.344
Authors: Kristina Rue Nielsen; Annette H Chakera; Birger Hesse; Richard A Scolyer; Jonathan F Stretch; John F Thompson; Michael B Nielsen; Roger F Uren; Peter S Oturai Journal: Eur J Nucl Med Mol Imaging Date: 2011-08-17 Impact factor: 9.236
Authors: Tarik Z Belhocine; Michel Prefontaine; Dominique Lanvin; Monique Bertrand; Irina Rachinsky; Helen Ettler; Pamela Zabel; Larry W Stitt; Akira Sugimoto; Jean-Luc Urbain Journal: Am J Nucl Med Mol Imaging Date: 2013-03-08
Authors: L Vermeeren; W M C Klop; M W M van den Brekel; A J M Balm; O E Nieweg; R A Valdés Olmos Journal: J Oncol Date: 2009-11-09 Impact factor: 4.375