Samine Sahbai1, Florin-Andrei Taran2, Annette Staebler3, Diethelm Wallwiener2, Christian la Fougère4, Sara Brucker2, Helmut Dittmann4. 1. Nuclear Medicine and Clinical Molecular Imaging, University Hospital Tuebingen, Otfried-Müller-Straße 14, 72076, Tübingen, Germany. sam.sahbai@gmail.com. 2. Gynecology and Obstetrics, University Hospital Tuebingen, Tuebingen, Germany. 3. Pathology, University Hospital Tuebingen, Tuebingen, Germany. 4. Nuclear Medicine and Clinical Molecular Imaging, University Hospital Tuebingen, Otfried-Müller-Straße 14, 72076, Tübingen, Germany.
Abstract
PURPOSE: SPECT/CT after pericervical injection of technetium-99 m-nanocolloid was shown to be suitable for sentinel lymph node (SLN) mapping in endometrial cancer (EC). The aim of this study was to analyze factors affecting successful SLN detection by means of SPECT/CT such as imaging findings, patient characteristics and tumor biology in a large cohort of patients. METHODS: One hundred and forty-five consecutive patients suffering from EC who received pre-surgical SLN mapping at our institution between 2011 and 2016 were included in this analysis. SPECT/CT data of abdomen and pelvis (mean 4:20 ± 1:20 h p.i.) were acquired after pericervical injection of technetium-99 m-nanocolloid (mean 230 ± 45 MBq) in all patients. Surgical staging was performed on the day after. Acquisition parameters, patient characteristics, SPECT/CT findings as well as histopathological results were collected. RESULTS: A total of 282 SLNs were identified by means of SPECT/CT. Overall, preoperative and intraoperative SLN detection rates were 86%, 76% and 74% respectively. The most important factor associated with failure to detect SLNs was the presence of high bone marrow on SPECT/CT (p = 0.005). Peritoneal/abdominal radioactivity was also associated with missed SLN detection in SPECT/CT (p = 0.02). However, the presence of liver/spleen uptake on its own was not predictive for detection failure. Low numbers of detected SLNs in SPECT/CT were slightly related with older age and lower injected activity. No significant influence was found for the parameters of tumor histology and stage, lymph node involvement and the time gap between injection and imaging. CONCLUSIONS: Venous drainage as indicated by bone marrow uptake is the most important factor associated with scintigraphic SLN detection failure. Moreover, high peritoneal and abdominal activity was also associated with detection failure. Thus, meticulous application of the radiotracer is crucial in EC.
PURPOSE: SPECT/CT after pericervical injection of technetium-99 m-nanocolloid was shown to be suitable for sentinel lymph node (SLN) mapping in endometrial cancer (EC). The aim of this study was to analyze factors affecting successful SLN detection by means of SPECT/CT such as imaging findings, patient characteristics and tumor biology in a large cohort of patients. METHODS: One hundred and forty-five consecutive patients suffering from EC who received pre-surgical SLN mapping at our institution between 2011 and 2016 were included in this analysis. SPECT/CT data of abdomen and pelvis (mean 4:20 ± 1:20 h p.i.) were acquired after pericervical injection of technetium-99 m-nanocolloid (mean 230 ± 45 MBq) in all patients. Surgical staging was performed on the day after. Acquisition parameters, patient characteristics, SPECT/CT findings as well as histopathological results were collected. RESULTS: A total of 282 SLNs were identified by means of SPECT/CT. Overall, preoperative and intraoperative SLN detection rates were 86%, 76% and 74% respectively. The most important factor associated with failure to detect SLNs was the presence of high bone marrow on SPECT/CT (p = 0.005). Peritoneal/abdominal radioactivity was also associated with missed SLN detection in SPECT/CT (p = 0.02). However, the presence of liver/spleen uptake on its own was not predictive for detection failure. Low numbers of detected SLNs in SPECT/CT were slightly related with older age and lower injected activity. No significant influence was found for the parameters of tumor histology and stage, lymph node involvement and the time gap between injection and imaging. CONCLUSIONS: Venous drainage as indicated by bone marrow uptake is the most important factor associated with scintigraphic SLN detection failure. Moreover, high peritoneal and abdominal activity was also associated with detection failure. Thus, meticulous application of the radiotracer is crucial in EC.
Authors: Samine Sahbai; Florin-Andrei Taran; Francesco Fiz; Annette Staebler; Sven Becker; Erich Solomayer; Diethelm Wallwiener; Christian la Fougère; Sara Brucker; Helmut Dittmann Journal: Clin Nucl Med Date: 2016-12 Impact factor: 7.794
Authors: J Ferlay; E Steliarova-Foucher; J Lortet-Tieulent; S Rosso; J W W Coebergh; H Comber; D Forman; F Bray Journal: Eur J Cancer Date: 2013-02-26 Impact factor: 9.162
Authors: Ane Gerda Zahl Eriksson; Jen Ducie; Narisha Ali; Michaela E McGree; Amy L Weaver; Giorgio Bogani; William A Cliby; Sean C Dowdy; Jamie N Bakkum-Gamez; Nadeem R Abu-Rustum; Andrea Mariani; Mario M Leitao Journal: Gynecol Oncol Date: 2015-12-31 Impact factor: 5.482
Authors: A Perissinotti; P Paredes; S Vidal-Sicart; A Torné; S Albela; I Navales; S Martínez-Román; J Pahisa; F Pons Journal: Gynecol Oncol Date: 2013-01-30 Impact factor: 5.482
Authors: Samine Sahbai; Francesco Fiz; Florin Taran; Sara Brucker; Diethelm Wallwiener; Juergen Kupferschlaeger; Christian La Fougère; Helmut Dittmann Journal: Diagnostics (Basel) Date: 2020-09-16
Authors: Matthias Weissinger; Stefan Kommoss; Johann Jacoby; Stephan Ursprung; Ferdinand Seith; Sascha Hoffmann; Konstantin Nikolaou; Sara Yvonne Brucker; Christian La Fougère; Helmut Dittmann Journal: J Clin Med Date: 2022-08-23 Impact factor: 4.964