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Localisation of sentinel lymph nodes in patients with melanomas by planar lymphoscintigraphic and hybrid SPECT/CT imaging
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Abstract
BACKGROUND: The aim of the study was to assess the role of
planar lymphoscintigraphy and fusion imaging of SPECT/CT in sentinel
lymph node (SLN) identification in patients with melanomas.
MATERIAL AND METHODS: Planar and hybrid SPECT/low-dose
CT lymphoscintigraphy were performed in 113 consecutive patients
with melanomas (59 men, 54 women, mean age 57.6 with
range 11–87 years, BMI 29.4 ± 12.5). The radiopharmaceutical
was injected around the tumour (Group A, 59 patients), or
around the scar (Group B, 54 patients). Localisation of melanomas:
head and neck 4, trunk 55, upper extremities 28, lower
extremities 26. Planar and SPECT/CT images were interpreted
separately by two nuclear medicine physicians. Abilities of these
two techniques to image SLN were compared.
RESULTS: SLNs were detected on lymphoscintigraphy comprising
planar and SPECT-CT images in 108 (95.6%) study patients;
there was failure to detect SLNs in the remaining 5 (4.4%) patients. Planar images identified 253 SLNs in 100 (88.5%) pts,
with a mean of 2.2 ± 1.7 (range 0–9 nodes) per patient. In the
remaining 13 (11.5%) patients no SLNs were detected on planar
images. On SPECT-CT images, 334 hot nodes were detected
in 107 (94.7%) patients with a mean of 3.0 ± 2.1 (range 0–9)
nodes per patient. In the remaining 6 (5.3%) patients, SPECT-CT
was negative.
SPECT/CT visualised lymphatic drainage in 8 (7.1%) patients
with non-visualisation on planar imaging.
CONCLUSIONS: In some patients with melanomas SPECT/CT
improves detection of sentinel lymph nodes. It can image nodes
not visible on planar scintigrams, exclude false positive uptake
and exactly localize SLNs.
Abstract
BACKGROUND: The aim of the study was to assess the role of
planar lymphoscintigraphy and fusion imaging of SPECT/CT in sentinel
lymph node (SLN) identification in patients with melanomas.
MATERIAL AND METHODS: Planar and hybrid SPECT/low-dose
CT lymphoscintigraphy were performed in 113 consecutive patients
with melanomas (59 men, 54 women, mean age 57.6 with
range 11–87 years, BMI 29.4 ± 12.5). The radiopharmaceutical
was injected around the tumour (Group A, 59 patients), or
around the scar (Group B, 54 patients). Localisation of melanomas:
head and neck 4, trunk 55, upper extremities 28, lower
extremities 26. Planar and SPECT/CT images were interpreted
separately by two nuclear medicine physicians. Abilities of these
two techniques to image SLN were compared.
RESULTS: SLNs were detected on lymphoscintigraphy comprising
planar and SPECT-CT images in 108 (95.6%) study patients;
there was failure to detect SLNs in the remaining 5 (4.4%) patients. Planar images identified 253 SLNs in 100 (88.5%) pts,
with a mean of 2.2 ± 1.7 (range 0–9 nodes) per patient. In the
remaining 13 (11.5%) patients no SLNs were detected on planar
images. On SPECT-CT images, 334 hot nodes were detected
in 107 (94.7%) patients with a mean of 3.0 ± 2.1 (range 0–9)
nodes per patient. In the remaining 6 (5.3%) patients, SPECT-CT
was negative.
SPECT/CT visualised lymphatic drainage in 8 (7.1%) patients
with non-visualisation on planar imaging.
CONCLUSIONS: In some patients with melanomas SPECT/CT
improves detection of sentinel lymph nodes. It can image nodes
not visible on planar scintigrams, exclude false positive uptake
and exactly localize SLNs.
Keywords
sentinel node, malignant melanoma, lymphoscintigraphy, planar scintigraphy, SPECT/CT
Title
Localisation of sentinel lymph nodes in patients with melanomas by planar lymphoscintigraphic and hybrid SPECT/CT imaging
Journal
Issue
Article type
Research paper
Pages
101-107
Published online
2012-08-27
Page views
1233
Article views/downloads
2437
Bibliographic record
Nucl. Med. Rev 2012;15(2):101-107.
Keywords
sentinel node
malignant melanoma
lymphoscintigraphy
planar scintigraphy
SPECT/CT
Authors
Otakar Kraft
Martin Havel