Lymphoscintigraphy for sentinel lymph node mapping in Japanese patients with malignant skin neoplasms of the lower extremities: comparison with previously investigated Japanese lymphatic anatomy

Miura, Hiroyuki; Ono, Sachiko; Nagahata, Morio; Shibutani, Koichi; Kakehata, Shinya; Morimoto, Kohei; Seino, Hiroko; Kakuta, Akihisa; Aoki, Masahiko; Hatayama, Yoshiomi; Kawaguchi, Hideo; Takai, Yoshihiro; Abe, Yoshinao; Kaneko, Takahide; Sawamura, Daisuke; Hanada, Katsumi

doi:10.1007/s12149-010-0410-x

Cited by 6 publications

(15 citation statements)

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“…In cases in the lower extremities, lymphatic patterns were categorized as follows: 14 inguinal type (67%), one popliteal type (5%), and six inguinal and popliteal type (28%) (Miura et al 2010). In cases in the upper extremities, they were categorized as follows: one axillary type (25%), one cubital type (25%), and two axillary and cubital types (50%) (Figure 3).…”

Section: Resultsmentioning

confidence: 99%

“…The second hot spot visualized along the same lymph channel was considered a second echelon lymph node (Miura et al 2010). If the sentinel lymph node and second echelon lymph node existed in the same site, both were regarded as sentinel lymph nodes (Figure 1).…”

Section: Methodsmentioning

confidence: 99%

“…Patterns of lymphatic drainage from the skin of the lower extremities were categorized into three different pathways: (a) inguinal type, from the primary site to the groin (although there were plural lymphatic pathways in some cases, all paths drained into the groin, indicating that the sentinel lymph node was situated in the groin); (b) popliteal type, from the primary site to the poples; and (c) inguinal and popliteal type, from the primary site to the groin and from the primary site to the poples (Miura et al 2010). Similarly, patterns of lymphatic drainage from the skin of the upper extremities were also categorized into three different pathways: (d) axillary type, from the primary site to the axilla; (e) cubital type, from the primary site to the cubitus; and (f) the axillary and cubital type, from the primary site to axilla and cubitus (Figure 2).…”

Section: Methodsmentioning

confidence: 99%

“…This abbreviated lymph node dissection should reduce the invasiveness of the investigation. However, in some cases, there are lymphatic channels that are visualized only in early phase dynamic images immediately after tracer injection (Taylor et al 1996; Maza et al 2003; Toubert et al 2008; Miura et al 2010). If dynamic images are not observed, assessment of the sentinel lymph node might be different in these cases (Matter et al 2007; Toubert et al 2008; Miura et al 2010).…”

Section: Introductionmentioning

confidence: 99%

“…However, in some cases, there are lymphatic channels that are visualized only in early phase dynamic images immediately after tracer injection (Taylor et al 1996; Maza et al 2003; Toubert et al 2008; Miura et al 2010). If dynamic images are not observed, assessment of the sentinel lymph node might be different in these cases (Matter et al 2007; Toubert et al 2008; Miura et al 2010). Therefore, it is important to determine if the hot spot is a sentinel lymph node, as this can be closely related to the patient’s prognosis (Gennari et al 2000; Taylor et al 1996; Maza et al 2003).…”

Section: Introductionmentioning

confidence: 99%

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Contribution of dynamic sentinel lymphoscintigraphy images to the diagnosis of patients with malignant skin neoplasms in the upper and lower extremities

et al. 2014

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The aim of the present study was to confirm the contribution of dynamic images in sentinel lymphoscintigraphy in malignant skin neoplasms: precisely, to investigate if dynamic images were necessary and to observe if dynamic images could reduce the areas needed for biopsy and dissection. Twenty-five patients with malignant skin neoplasms of the lower (n = 21) and upper (n = 4) extremities were retrospectively investigated. Images were evaluated by two independent reviewers, an expert in diagnostic radiology and nuclear medicine and a diagnostic radiologist in training. Visualized hot spots were assessed to be sentinel nodes using only static planar images. Next, both static planar and dynamic images were assessed. Reviewers scored diagnostic confidence values of determined sentinel nodes as follows: 0, cannot be decided; 1, possible; 2, probable; and 3, definitive. Patterns of lymphatic drainage were categorized into six different pathways: (1) inguinal type, (2) popliteal type, (3) inguinal and popliteal type, (4) axillary type, (5) cubital type, and (6) axillary and cubital type. In cases in the lower extremities, with dynamic images, the expert reviewer changed assessment in three cases and the trainee reviewer changed it in one case. There were no cases in which a decision was changed to be the same between both reviewers. Although the average diagnostic confidence value of assessment is usually higher with dynamic images, significant differences were not present. In cases of the upper extremities, both reviewers changed their assessment in one patient. By mutual agreement, cases in which assessment was changed with dynamic images were the inguinal and popliteal type, and the axillary and cubital type. The expert reviewer noticed lymphatic channels only visualized on dynamic images and changed assessment. Determination of whether or not a lymph node is a sentinel node depends on visualization of the lymphatic network. In the present circumstances, all biopsies of hot spots determined to be lymph nodes should not be excluded. However, excessive biopsies should be avoided as much as possible. It is necessary to use dynamic images alongside skillful observation.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%