Advantages of preoperative hybrid SPECT/CT in detection of sentinel lymph nodes in cutaneous head and neck malignancies

Klode, Joachim; Poeppel, Thorsten D.; Boy, Christian; Mueller, Stefan; Schadendorf, Dirk; Körber, Andreas; Stoffels, Ingo; Dissemond, Joachim

doi:10.1111/j.1468-3083.2010.03954.x

Cited by 54 publications

(28 citation statements)

References 36 publications

(45 reference statements)

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“…With the SPECT/CT-guided SLNE, we removed more SLNs (2.40 SLNs per patient) than in the standard cohort (1.87 SLNs per patient, PϽ.001), which is consistent with previous studies. 20,26,29 This finding can be explained by excised nodes near the injection site, which are more clearly visualized with SPECT/CT and the detection of SLN with a weak tracer signal. The additional SLNs excised in the SPECT/CT cohort resulted in no increase in morbidity.…”

Section: Commentmentioning

confidence: 89%

“…Our study confirms the improved identification of SLNs in overweight patients with melanoma (Table 1) 17 as well as those with tumors in the head and neck area. 20,26 In the head and neck area, we used smaller incisions as well as alternative entry points due to the exact anatomical localization of the SLN. For example, if SPECT/CT demonstrates that the SLN is not under the sternocleidomastoid muscle but on the dorsal margin of the muscle, the surgeon is able to choose a different surgical entry point (FIGURE 2).…”

Section: Commentmentioning

confidence: 99%

“…19,20 Preparation and subsequent excision of all marked lymph nodes was performed via an incision over the area with the highest activity indicated by a mobile manual scintillation measuring probe (C-Trak, Care Wise Medical Products Corporation) in the control cohort or by preoperative marking on the skin according to the additional information obtained from SPECT/CT in the SPECT/CT cohort. Surgery was terminated as soon as no further radioactive foci could be detected in the surgical field.…”

Section: Sentinel Lymph Node Excisionmentioning

confidence: 99%

See 2 more Smart Citations

Association Between Sentinel Lymph Node Excision With or Without Preoperative SPECT/CT and Metastatic Node Detection and Disease-Free Survival in Melanoma

Stoffels

Boy²,

Pöppel³

et al. 2012

JAMA

122

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Section: Commentmentioning

confidence: 89%

Section: Commentmentioning

confidence: 99%

Section: Sentinel Lymph Node Excisionmentioning

confidence: 99%

See 1 more Smart Citation

Association Between Sentinel Lymph Node Excision With or Without Preoperative SPECT/CT and Metastatic Node Detection and Disease-Free Survival in Melanoma

Stoffels

Boy²,

Pöppel³

et al. 2012

JAMA

122

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“…The superior anatomical information provided by SPECT/CT may lead to modification of the surgical approach as shown in 11 out of 38 patients (29 %) with head and neck melanoma; in six of these 38 patients, SPECT/CT detected additional SNs (16 %) [22]. In another study, SPECT/CT modified the surgical approach (more superficial incision or incision at other site) in 9 out of 34 (27 %) patients with head and neck malignancies [23]. The surgical adjustment rate due to additional information from SPECT/CT increases when SNs are located in the periparotid areas; in eight out of 14 patients (57 %) with melanoma and drainage to the parotid region on planar lymphoscintigraphy, SPECT/CT was able to distinguish SNs in level II of the neck from those located in or around the parotid [24].…”

Section: Head and Neck Malignanciesmentioning

confidence: 96%

SPECT/CT and sentinel node lymphoscintigraphy

Olmos

Rietbergen

Vidal-Sicart

2014

Clin Transl Imaging

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The use of single-photon emission computed tomography/computed tomography (SPECT/CT) for sentinel node (SN) detection has been evaluated in the majority of malignancies with predominantly superficial lymphatic drainage. In breast cancer and melanoma, important initial contributions of SPECT/CT were based on the anatomical localisation of SNs already visualised on planar images, the detection of additional SNs in aberrant basins, and the depiction of SNs in cases with no visualisation on planar images. However, more recently, the finding that SPECT/CT use is associated with a higher rate of SN detection, more metastatic SNs, and a higher rate of disease-free survival in large series of patients is leading SPECT/CT to be routinely performed in melanoma. The incorporation of SPECT/CT into the SN procedure in melanoma also appears to be cost effective and was significantly related to shorter operative times, shorter hospital stays, and fewer complications. In penile and vulvar cancer, the use of SPECT/CT has led to the detection of additional SNs. In oral cavity cancer and thyroid cancer, SPECT/CT not only appears to be useful for planar image interpretation but is also becoming an essential component of the SN procedure, providing surgeons with additional anatomical information. As regards malignancies with deep lymphatic drainage, SPECT/CT has been extensively validated in urological and gynaecological cancers. In these malignancies, SPECT/CT was able to localise SNs not only in the basins included in the area of extended pelvic lymph node dissection but also in aberrant locations. In gastrointestinal and lung malignancies, SPECT/CT has been used only incidentally. SPECT/CT must be considered complementary to planar lymphoscintigraphy for SN identification, and a combined interpretation of both modalities is necessary. With the improvement of the CT component, nuclear physicians today can also identify lymph nodes corresponding to radioactive SNs. This visual information is helpful for the intraoperative procedure and for postexcision assessment using portable devices.

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“…Overall, in 8-43 % of melanoma patients, 3D imaging identified SLNs that were missed on planar imaging [24]. Preoperative SPECT/CT imaging may also have an impact on surgical management in the complex HN area, by improving the esthetic results, reducing the operating time, and influencing patient outcome [25,26]. Stoffels et al found a higher rate of 4-year disease-free survival in melanoma patients when using SPECT/CT in addition to planar imaging [27].…”

Section: Preoperative 3d Imaging (Spect/ct)mentioning

confidence: 99%

New technologies in radioguided surgery in complex anatomic areas

Bluemel

Herrmann

2016

Clin Transl Imaging

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Sentinel lymph node biopsy (SLNB) is the most common radioguided surgery procedure and standard of care for lymph node staging in clinically node-negative patients with melanoma and breast cancer. While SLNB has also emerged as a potential alternative to lymph node dissection for staging in patients with other solid malignancies, its use for this purpose has to date not been widely accepted owing to technical limitations in complex anatomic areas such as the head and neck and the pelvic region. However, new technologies have recently been developed to overcome these limitations. This review focuses on the new technologies that improve SLN localization in complex anatomic areas, including new diagnostic tracers ( 99m Tc-tilmanocept and hybrid tracers), preoperative SPECT/CT imaging, and scintigraphic threedimensional intraoperative imaging techniques.

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Advantages of preoperative hybrid SPECT/CT in detection of sentinel lymph nodes in cutaneous head and neck malignancies

Cited by 54 publications

References 36 publications

Association Between Sentinel Lymph Node Excision With or Without Preoperative SPECT/CT and Metastatic Node Detection and Disease-Free Survival in Melanoma

Association Between Sentinel Lymph Node Excision With or Without Preoperative SPECT/CT and Metastatic Node Detection and Disease-Free Survival in Melanoma

SPECT/CT and sentinel node lymphoscintigraphy

New technologies in radioguided surgery in complex anatomic areas

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