Imprint cytology is simple and rapid, and has good sensitivity for macrometastases. The significance of poor sensitivity for micrometastases will be determined by trials investigating their natural history.

We achieved a high rate of SLN identification. SPECT/CT was most frequently helpful when the primary melanoma was located in the head, neck and trunk. Routine use of SPECT/CT during lymphoscintigraphy provides important anatomical information and may reduce the false-negative rate.

Sentinel lymph node biopsy is a crucial part of staging intermediate and thick melanoma. Lymphatic drainage from a tumor site can be highly variable, especially on the head, neck, and trunk. SPECT/CT fuses nuclear medicine and x-ray CT images to produce images with high anatomic detail. At our institution, SPECT/CT is performed routinely in addition to planar imaging. This article presents examples where SPECT/CT has proven helpful in image interpretation.