Dynamic lymphoscintigraphy and image fusion of SPECT and pelvic CT-scans allow mapping of aberrant pelvic sentinel lymph nodes in malignant melanoma

Kretschmer, Lutz; Altenvoerde, G.; Meller, J.; Zutt, Markus; Funke, M.; Neumann, Christine; Becker, Wolfgang

doi:10.1016/s0959-8049(02)00534-8

Cited by 56 publications

(29 citation statements)

References 15 publications

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“…There are just a few case reports and cohort studies on SPECT/CT for lymphatic mapping in patients with melanoma [29][30][31][32][33][34][35] and these are listed in Table II. The investigators of the cohort studies administered four intracutaneous deposits with a total dose of 74-185 MBq (2-5 mCi) of the radiopharmaceutical.…”

Section: Spect/ct In Patients With Melanomamentioning

confidence: 99%

“…The investigators of the cohort studies administered four intracutaneous deposits with a total dose of 74-185 MBq (2-5 mCi) of the radiopharmaceutical. Most investigators performed dynamic conventional imaging followed by sequential static imaging and subsequent SPECT/CT [31][32][33]35]. Covarelli et al only investigated patients with a head and neck melanoma and administered 10 MBq (0.3 mCi) when patients where operated on the same day and 50 MBq (1.4 mCi) if patients were operated the next day.…”

Section: Spect/ct In Patients With Melanomamentioning

confidence: 99%

“…is useful for exact localization of sentinel nodes in melanoma patients, regardless of their position, while Kretschmer et al [32] specifically mentioned its relevance for the identification of pelvic sentinel nodes in patients with a melanoma on the lower extremity. In our institution, SPECT/CT is performed only for certain indications.…”

Section: Journal Of Surgical Oncologymentioning

confidence: 99%

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SPECT/CT for preoperative sentinel node localization

Vermeeren

Ploeg

Olmos

et al. 2010

Journal of Surgical Oncology

118

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The value of SPECT/CT for detection and localization of sentinel nodes is reviewed. SPECT/CT depicts extra sentinel nodes and identifies nonnodal tracer accumulation. SPECT/CT is indicated in patients with complex lymphatic drainage as often present in patients with head, neck and scapular melanoma, breast cancer patients with extra-axillary sentinel nodes and patients with tumors draining to pelvic nodes. SPECT/CT also clarifies the drainage pattern of inconclusive conventional images (non-visualization or unclear location of the nodes).

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Section: Spect/ct In Patients With Melanomamentioning

confidence: 99%

Section: Spect/ct In Patients With Melanomamentioning

confidence: 99%

Section: Journal Of Surgical Oncologymentioning

confidence: 99%

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SPECT/CT for preoperative sentinel node localization

Vermeeren

Ploeg

Olmos

et al. 2010

Journal of Surgical Oncology

118

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“…Sentinel lymph node (SLN) was defined as the first lymph node (LN) draining the primary tumor, i. e. the first LN that is at risk from metastatic cells [1] . The histological status of the SLN has been found to be an indicator representative of the whole LN basin.…”

Section: Introductionmentioning

confidence: 99%

Detection of sentinel lymph nodes by SPECT/CT and planar scintigraphy: The influence of age, gender and BMI

Kraft

Havel

2012

JBGC

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Background: The most important prognostic factor in melanomas, breast cancers and gynecologic tumors is the state of the lymph nodes (LNs). There is not suitable pre-surgery examination procedure of detection of impacted LNs. The use of lymphatic mapping of sentinel lymph node (SLN) helps reduce the morbidity of surgery. Accurate visualization of the SLN is required for the best results. The aim is to assess the role of planar lymphoscintigraphy and fusion imaging of SPECT/CT in SLN detection in patients with various types of tumors and estimation of some factors influencing detection success -age, gender and body mass index (BMI). Methods:Planar scintigraphy and hybrid modality SPECT/CT were performed in 550 patients (pts) (mean age 58.1 ± 13.1 years): 69 pts with gynecological tumors (37 with cervical cancer, 25 pts with endometrial cancer, 7 pts with vulvar carcinoma); in 161 pts with melanomas; and in 318 women and 2 men with breast cancer. The radiopharmaceutical was injected around the tumor, subareolar or around the scar. Planar and SPECT/CT images were interpreted separately by two nuclear medicine physicians. Efficacy of these two techniques to image SLN were compared. We have estimated the influence of the age, gender and BMI on the succes rate of SLN detection. Student's paired t-test was used for comparing numbers of found SLN by both techniques; F-test, Student's t-test, and Fisher's exact test were utilized for age, gender and BMI characteristics comparisons. Values were considered significant when P<0.05. Results:Planar scintigraphy did not image SLN in 77 pts in total (14.0 %); in 8 pts with gynecologic tumors, in 23 pts with melanomas and in 46 pts with breast cancer. SPECT/CT was negative in 49 pts (8.9 %) in total; in 4 pts with gynecologic tumors, in 12 pts with melanomas and in 33 pts with breast cancer. In 199 (36.2 %) pts the number of SLNs captured on SPECT/CT was higher than on planar imaging. 35 foci of uptake (3.1 % from totally visible 1134 foci on planar images) interpreted on planar images as hot LNs were found to be false positive non-nodal sites of uptake when further assessed on SPECT/CT. Influence of the age, gender and BMI: The group of patients with higher number of detected SLN on SPECT/CT than on planar scintigraphy had lower average age than the group of patients with the same number of detected SLN on SPECT/CT and on planar scintigraphy, the difference was statistically significant (P=0.008). BMI did not differ in these two groups. There has been proportionally higher number of men than women who have had higher detected SLNs on SPECT/CT than on planar scintigrams (difference statistically significant P=0.04). It follows that gender influences the difference of detected SLNs on SPECT/CT and planar scintigraphy in favor of male gender. Conclusion:In some patients with gynecologic, including breast cancers and melanomas SPECT/CT improves detection of SLNs as compared to planar scintigraphy. It can image nodes not visible on planar scintigrams, excludes false positiv...

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“…Furthermore, corrections for attenuation and scatter have led to improved sentinel node visualization on SPECT. Several authors have reported successful introduction of the SPECT/CT technique in lymphatic mapping in several clinical situations (3)(4)(5)(6)(7)(8)(9)(10)(11)(12).…”

mentioning

confidence: 99%

The Additional Value of SPECT/CT in Lymphatic Mapping in Breast Cancer and Melanoma

Ploeg¹,

Olmos²,

Nieweg³

et al. 2007

Journal of Nuclear Medicine

110

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The recently introduced SPECT/CT integrates the physiologic data of SPECT with the anatomic data of CT into a single image. The purpose of this pilot study was to explore the additional value of SPECT/CT in breast cancer patients and melanoma patients with inconclusive planar image findings. Methods: Thirty-one patients had planar lymphoscintigrams showing unexpected lymphatic drainage, 6 had lymphoscintigrams that were difficult to interpret, and 3 showed no drainage on planar imaging. SPECT/CT was performed immediately after delayed planar imaging. Results: In 4 patients, SPECT/CT showed 6 additional sentinel nodes, of which 2 were tumor-positive and led to upstaging and tailored management in 5% of patients. SPECT/ CT depicted sentinel nodes in 3 patients whose delayed planar imaging had shown no drainage. Conclusion: SPECT/CT was of additional value in finding the exact anatomic location of sentinel nodes in patients with inconclusive planar image findings. SPECT/CT also detected sentinel nodes in addition to those found on planar images, and SPECT/CT detected sentinel nodes in patients whose planar images had shown none.

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Dynamic lymphoscintigraphy and image fusion of SPECT and pelvic CT-scans allow mapping of aberrant pelvic sentinel lymph nodes in malignant melanoma

Cited by 56 publications

References 15 publications

SPECT/CT for preoperative sentinel node localization

SPECT/CT for preoperative sentinel node localization

Detection of sentinel lymph nodes by SPECT/CT and planar scintigraphy: The influence of age, gender and BMI

The Additional Value of SPECT/CT in Lymphatic Mapping in Breast Cancer and Melanoma

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