BACKGROUND: Lymphatic mapping for sentinel node biopsy (SNB) has been shown to be crucial for detection of sentinel lymph nodes (SLN). Previous reports suggested a benefit of single photon emission computed tomography with CT (SPECT/CT) over dynamic planar lymphoscintigraphy (LS) alone. The aim was to assess whether there is an additional value of SPECT/CT over LS alone for lymphatic mapping of SLNs in oral/oropharyngeal SCC. METHODS: A consecutive cohort of 58 patients was evaluated using SNB with additional SPECT/CT to preoperative LS. RESULTS: In the entire cohort of 58 patients undergoing LS and SPECT/CT, hot spots could be revealed in all but 4 cases. The guidance of the handheld gamma probe was able to reveal 9 additional SLNs within 3 patients not detected by either modality. Lymphoscintigraphy showed full concordance with SPECT/CT in 81% of the cases. SPECT/CT was able to detect additional HS in 11 patients, in 1 case even with additional metastatic disease. The false negative rate for SNB was 6%, and the negative predictive value 98%. CONCLUSIONS: SPECT/CT has the potential to detect more SLNs, which might harbor occult disease, than LS alone. With regard to the excellent results achieved with LS and the intraoperative use of the gamma probe, SPECT/CT is not indispensable for successful SNB. Both imaging modalities have difficulties in detecting level I sentinel nodes close to the injection site.
BACKGROUND: Lymphatic mapping for sentinel node biopsy (SNB) has been shown to be crucial for detection of sentinel lymph nodes (SLN). Previous reports suggested a benefit of single photon emission computed tomography with CT (SPECT/CT) over dynamic planar lymphoscintigraphy (LS) alone. The aim was to assess whether there is an additional value of SPECT/CT over LS alone for lymphatic mapping of SLNs in oral/oropharyngeal SCC. METHODS: A consecutive cohort of 58 patients was evaluated using SNB with additional SPECT/CT to preoperative LS. RESULTS: In the entire cohort of 58 patients undergoing LS and SPECT/CT, hot spots could be revealed in all but 4 cases. The guidance of the handheld gamma probe was able to reveal 9 additional SLNs within 3 patients not detected by either modality. Lymphoscintigraphy showed full concordance with SPECT/CT in 81% of the cases. SPECT/CT was able to detect additional HS in 11 patients, in 1 case even with additional metastatic disease. The false negative rate for SNB was 6%, and the negative predictive value 98%. CONCLUSIONS: SPECT/CT has the potential to detect more SLNs, which might harbor occult disease, than LS alone. With regard to the excellent results achieved with LS and the intraoperative use of the gamma probe, SPECT/CT is not indispensable for successful SNB. Both imaging modalities have difficulties in detecting level I sentinel nodes close to the injection site.
Authors: Pieter D de Veij Mestdagh; Marcel C J Jonker; Wouter V Vogel; Willem H Schreuder; Maarten L Donswijk; W Martin C Klop; Abrahim Al-Mamgani Journal: Eur Arch Otorhinolaryngol Date: 2018-06-28 Impact factor: 2.503
Authors: Christina Bluemel; Domenico Rubello; Patrick M Colletti; Remco de Bree; Ken Herrmann Journal: Eur J Nucl Med Mol Imaging Date: 2015-04-28 Impact factor: 9.236
Authors: Ralph Crott; Georges Lawson; Marie-Cécile Nollevaux; Annick Castiaux; Bruno Krug Journal: Eur Arch Otorhinolaryngol Date: 2016-05-12 Impact factor: 2.503
Authors: C M Meerwein; T Sekine; P Veit-Haibach; M G Bredell; G F Huber; M W Huellner Journal: Eur Arch Otorhinolaryngol Date: 2016-11-11 Impact factor: 2.503
Authors: Inne J den Toom; Annelies van Schie; Stijn van Weert; K Hakki Karagozoglu; Elisabeth Bloemena; Otto S Hoekstra; Remco de Bree Journal: Eur J Nucl Med Mol Imaging Date: 2017-01-29 Impact factor: 9.236