Detection of Sentinel Lymph Nodes in Gynecologic Tumours by Planar Scintigraphy and SPECT/CT

Kraft, Otakar; Havel, Martin

doi:10.4274/mirt.236

Cited by 36 publications

(5 citation statements)

References 55 publications

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“…Detection rates were not significantly different between lymphoscintigraphy and SPECT-CT in this study, but this last method was more accurate in determining the anatomic location of the SLNs compared to planar lymphoscintigraphy. Several other studies obtained similar results [ 21 – 24 ]. Nevertheless, the detection rates by planar lymphoscintigraphy were lower in these studies than in ours.…”

Section: Discussionsupporting

confidence: 79%

Feasibility and performance of lymphoscintigraphy in sentinel lymph node biopsy for early cervical cancer: results of the prospective multicenter SENTICOL study

et al. 2014

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ObjectiveTo evaluate feasibility, SLN detection rate, and SLN location of lymphoscintigraphy in sentinel lymph node (SLN) biopsy for early cervical cancer.MethodsAncillary analysis of data from the multicenter prospective SENTICOL study (January 2005–June 2007) of patients with early cervical cancer (FIGO stage IA with emboli to IB1) was conducted. Preoperative lymphoscintigraphy was performed after intracervical administration of 60 or 120 MBq of 99mTc-labeled radiocolloid on the day before (long protocol) or morning of (short protocol) surgery. SLNs were identified intraoperatively using combined radioactivity/patent blue detection. SLNs were sampled electively and routine bilateral pelvic lymphadenectomy was performed by laparoscopy. A centralized review of lymphoscintigraphies was performed to assess feasibility, detection rates, and anatomic SLN location.ResultsOf 139 patients included in the SENTICOL study, 133 received radiocolloid injection, and 131 (98.5 %) underwent preoperative lymphoscintigraphy, with the long protocol in three-fourths of cases. The lymphoscintigraphic detection rate was 87.8 %, with a median of 2 (1–4) SLNs per patient. By multivariate analysis, factors independently associated with lymphoscintigraphic SLN detection were age [odds ratio (OR) 0.91, 95 % confidence interval (95 % CI) 0.87–0.96; P < 0.001], and protocol (long vs. short; OR 8.23, 95 % CI 1.87–36.25; P = 0.005). Bilateral SLN identification by lymphoscintigraphy occurred in 67 % of cases and was independently influenced by age (OR 0.95, 95 % CI 0.92–0.98, P < 0.001) and protocol (OR 5.42, 95 % CI 2.21–13.27; P < 0.001). Although 60.5 % of preoperative SLNs were in the external iliac territory, unusual drainage patterns included the common iliac (19.6 %), para-aortic (10.8 %), and parametrial (6 %) basins.ConclusionsOur study demonstrates the feasibility and good detection rate of preoperative lymphoscintigraphy, with better detection in younger patients and with the long protocol. The high proportion of SLN basins in unexpected territories is of interest to guide intraoperative detection. Further studies are needed to better evaluate preoperative detection and to assess the contribution of lymphoscintigraphy to intraoperative detection.

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Section: Discussionsupporting

confidence: 79%

Feasibility and performance of lymphoscintigraphy in sentinel lymph node biopsy for early cervical cancer: results of the prospective multicenter SENTICOL study

et al. 2014

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“…However, the higher cost of detection and imaging equipment, inconvenience, and potential radioactive contamination limit its use ( 31 ). The cervical injection site can also stimulate gamma detectors, which makes it difficult to be distinguished from parametrial lymph nodes ( 34 ).…”

Section: The Technique Advances Of Slnmmentioning

confidence: 99%

Sentinel Lymph Node Mapping in Endometrial Cancer: A Comprehensive Review

et al. 2021

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Endometrial cancer (EC) is known as a common gynecological malignancy. The incidence rate is on the increase annually. Lymph node status plays a crucial role in evaluating the prognosis and selecting adjuvant therapy. Currently, the patients with high-risk (not comply with any of the following: (1) well-differentiated or moderately differentiated, pathological grade G1 or G2; (2) myometrial invasion< 1/2; (3) tumor diameter < 2 cm are commonly recommended for a systematic lymphadenectomy (LAD). However, conventional LAD shows high complication incidence and uncertain survival benefits. Sentinel lymph node (SLN) refers to the first lymph node that is passed by the lymphatic metastasis of the primary malignant tumor through the regional lymphatic drainage pathway and can indicate the involvement of lymph nodes across the drainage area. Mounting evidence has demonstrated a high detection rate (DR), sensitivity, and negative predictive value (NPV) in patients with early-stage lower risk EC using sentinel lymph node mapping (SLNM) with pathologic ultra-staging. Meanwhile, SLNM did not compromise the patient’s progression-free survival (PFS) and overall survival (OS) with low operative complications. However, the application of SLNM in early-stage high-risk EC patients remains controversial. As revealed by the recent studies, SLNM may also be feasible, effective, and safe in high-risk patients. This review aims at making a systematic description of the progress made in the application of SLNM in the treatment of EC and the relevant controversies, including the application of SLNM in high-risk patients.

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“…While most studies are prospective in nature, 2 of the studies included were retrospective reviews (Barlin et al [20] and Holloway et al [21]). In 1 study, by Kraft et al [22], the focus was specific to identification of sentinel nodes by SPECT/CT [(using radioisotope (RI)]. In this article, only preoperative detection rates were reported with no further information on operative or histologic findings; therefore, this study was excluded from our analysis.…”

Section: Resultsmentioning

confidence: 91%

Is Sentinel Lymph Node Dissection an Appropriate Standard of Care for Low-Stage Endometrial Cancers? A Review of the Literature

Levinson

Escobar

2013

Gynecol Obstet Invest

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Background/Aims: To review the literature and compare detection rates, false negative (FN) rates, and negative predictive values (NPVs) of sentinel lymph node (SLN) biopsy in endometrial cancer to those in breast and vulvar cancer. Secondary objectives were to evaluate techniques of SLN biopsy in endometrial cancer. Methods: The PubMed database was searched for applicable scientific articles. Detection rates, FN rates, and NPVs were calculated for all studies. Studies were stratified by techniques and compared. Results: Nineteen articles met criteria for this review. The overall detection rates ranged from 62 to 100%, the FN rate ranged from 0 to 50%, and the NPVs ranged from 95 to 100%. There is no technique that is definitively superior to any other with regard to surgical modality, injectant used, injection site, or pathologic techniques. Conclusions: Studies on SLN biopsy in endometrial cancer have a large range of detection rates and FN rates, and larger studies including more patients with metastatic disease are needed for comparison with breast and vulvar cancers. While no techniques are definitively superior to others, minimally invasive surgery, cervical injection, and pathologic analysis utilizing HE staining, immunohistochemistry, and ultrastaging may be clinically advantageous.

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Detection of Sentinel Lymph Nodes in Gynecologic Tumours by Planar Scintigraphy and SPECT/CT

Cited by 36 publications

References 55 publications

Feasibility and performance of lymphoscintigraphy in sentinel lymph node biopsy for early cervical cancer: results of the prospective multicenter SENTICOL study

Feasibility and performance of lymphoscintigraphy in sentinel lymph node biopsy for early cervical cancer: results of the prospective multicenter SENTICOL study

Sentinel Lymph Node Mapping in Endometrial Cancer: A Comprehensive Review

Is Sentinel Lymph Node Dissection an Appropriate Standard of Care for Low-Stage Endometrial Cancers? A Review of the Literature

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