BACKGROUND: Preoperative cutaneous lymphoscintigraphy (LS) to identify sentinel (first-tier) lymph nodes was performed in 250 consecutive melanoma patients before wide local excision only or wide local excision with sentinel node biopsy. METHODS: The location of the sentinel nodes was marked on the overlying skin in all patients. Whether or not tracer was present in second-tier lymph nodes on the delayed scans was recorded for each patient and related to the lesion site at which the tracer had initially been injected. For 100 consecutive patients the rate of tracer movement through the lymphatic channels was compared to the incidence of second-tier drainage. RESULTS: Second-tier nodes were visualized in all patients with melanomas on the leg and thigh, and in almost all patients with melanomas on the forearm and hand, but were seen less often in patients with more centrally located melanomas. There was a significant correlation between the rate of lymph flow and the incidence of demonstrable second-tier drainage. CONCLUSION: The results suggest that the physiology of the lymphatic system varies depending on the origin of the lymphatic vessel. These findings have important implications for application of the sentinel node biopsy technique in individual patients.
BACKGROUND: Preoperative cutaneous lymphoscintigraphy (LS) to identify sentinel (first-tier) lymph nodes was performed in 250 consecutive melanomapatients before wide local excision only or wide local excision with sentinel node biopsy. METHODS: The location of the sentinel nodes was marked on the overlying skin in all patients. Whether or not tracer was present in second-tier lymph nodes on the delayed scans was recorded for each patient and related to the lesion site at which the tracer had initially been injected. For 100 consecutive patients the rate of tracer movement through the lymphatic channels was compared to the incidence of second-tier drainage. RESULTS: Second-tier nodes were visualized in all patients with melanomas on the leg and thigh, and in almost all patients with melanomas on the forearm and hand, but were seen less often in patients with more centrally located melanomas. There was a significant correlation between the rate of lymph flow and the incidence of demonstrable second-tier drainage. CONCLUSION: The results suggest that the physiology of the lymphatic system varies depending on the origin of the lymphatic vessel. These findings have important implications for application of the sentinel node biopsy technique in individual patients.
Authors: Annette H Chakera; Birger Hesse; Zeynep Burak; James R Ballinger; Allan Britten; Corrado Caracò; Alistair J Cochran; Martin G Cook; Krzysztof T Drzewiecki; Richard Essner; Einat Even-Sapir; Alexander M M Eggermont; Tanja Gmeiner Stopar; Christian Ingvar; Martin C Mihm; Stanley W McCarthy; Nicola Mozzillo; Omgo E Nieweg; Richard A Scolyer; Hans Starz; John F Thompson; Giuseppe Trifirò; Giuseppe Viale; Sergi Vidal-Sicart; Roger Uren; Wendy Waddington; Arturo Chiti; Alain Spatz; Alessandro Testori Journal: Eur J Nucl Med Mol Imaging Date: 2009-10 Impact factor: 9.236
Authors: Christina Bluemel; Ken Herrmann; Francesco Giammarile; Omgo E Nieweg; Julien Dubreuil; Alessandro Testori; Riccardo A Audisio; Odysseas Zoras; Michael Lassmann; Annette H Chakera; Roger Uren; Sotirios Chondrogiannis; Patrick M Colletti; Domenico Rubello Journal: Eur J Nucl Med Mol Imaging Date: 2015-07-25 Impact factor: 9.236
Authors: A H Chakera; J Lock-Andersen; U Hesse; B M Nürnberg; B R Juhl; K H Stokholm; K T Drzewiecki; B Hesse Journal: Eur J Nucl Med Mol Imaging Date: 2009-01-20 Impact factor: 9.236