Stéphanie C J M Speth1, Roy F P M Kruitwagen2,3, Marjolein Kleppe1, Ivo N A Pooters4, Toon Van Gorp1,3, Brigitte F M Slangen1,3, Boudewijn Brans4. 1. Department of Obstetrics and Gynaecology, Maastricht University Medical Centre, Maastricht, The Netherlands. 2. Department of Obstetrics and Gynaecology, Maastricht University Medical Centre, Maastricht, The Netherlands r.kruitwagen@mumc.nl. 3. GROW-School for Oncology and Developmental Biology, Maastricht, The Netherlands; and. 4. Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands.
Abstract
Tracer injection into ovarian ligaments has been shown to detect sentinel nodes (SNs) in patients with ovarian cancer. To determine the possibility that SNs are missed, this feasibility study compared their detection during surgery with their detection on postoperative SPECT/CT. METHODS: In 8 patients (with either ovarian or endometrial cancer), after a staging lymphadenectomy including resection of SNs related to the ovary, SPECT/CT was performed within 24 h. RESULTS: SPECT/CT identified hotspots in 4 patients at sites where SNs were resected. In 6 patients, additional sites were found, mainly in the pelvic region. CONCLUSION: Discrepancies between the γ-probe and SPECT/CT may be due to missed SNs during surgery, but with respect to pelvic hotspots, in most cases they are more probably related to remnants of tracer at injection sites. With respect to sites where SNs were resected, remaining hotspots may have been caused by residual lymphatic flow after resection.
Tracer injection into ovarian ligaments has been shown to detect sentinel nodes (SNs) in patients with ovarian cancer. To determine the possibility that SNs are missed, this feasibility study compared their detection during surgery with their detection on postoperative SPECT/CT. METHODS: In 8 patients (with either ovarian or endometrial cancer), after a staging lymphadenectomy including resection of SNs related to the ovary, SPECT/CT was performed within 24 h. RESULTS: SPECT/CT identified hotspots in 4 patients at sites where SNs were resected. In 6 patients, additional sites were found, mainly in the pelvic region. CONCLUSION: Discrepancies between the γ-probe and SPECT/CT may be due to missed SNs during surgery, but with respect to pelvic hotspots, in most cases they are more probably related to remnants of tracer at injection sites. With respect to sites where SNs were resected, remaining hotspots may have been caused by residual lymphatic flow after resection.
Authors: Nadeem R Abu-Rustum; Roberto Angioli; Arthur E Bailey; Vance Broach; Alessandro Buda; Michelle R Coriddi; Joseph H Dayan; Michael Frumovitz; Yong Man Kim; Rainer Kimmig; Mario M Leitao; Mustafa Zelal Muallem; Matt McKittrick; Babak Mehrara; Roberto Montera; Lea A Moukarzel; Raj Naik; Silvana Pedra Nobre; Marie Plante; Francesco Plotti; Oliver Zivanovic Journal: Int J Gynecol Cancer Date: 2020-03-30 Impact factor: 3.437
Authors: Pim Laven; Roy Kruitwagen; Petra Zusterzeel; Brigitte Slangen; Toon van Gorp; Jochem van der Pol; Sandrina Lambrechts Journal: J Ovarian Res Date: 2021-10-13 Impact factor: 4.234