open access

Vol 21, No 2 (2018)
Original articles
Published online: 2018-06-08
Submitted: 2018-05-08
Accepted: 2018-05-16
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Value of planar lymphoscintigraphy (PL) versus SPECT/CT in evaluation of sentinel lymph node in trunk melanoma — one center, large series retrospective study

Małgorzata Benke, Krzysztof Wocial, Weronika Lewandowska, Piotr Rutkowski, Paweł Teterycz, Piotr Jarek, Marek Dedecjus
DOI: 10.5603/NMR.a2018.0022
·
Pubmed: 29956817
·
Nucl. Med. Rev 2018;21(2):79-84.

open access

Vol 21, No 2 (2018)
Original articles
Published online: 2018-06-08
Submitted: 2018-05-08
Accepted: 2018-05-16

Abstract

BACKGROUND: Localization and histopathological examination of sentinel lymph node is a standard of melanoma treatment. The first stage of identification of the SLN is the preoperative lymphoscintigraphy. The aim of this study was to assess and compare diagnostic value of planar lymphoscintigraphy and SPECT/CT in sentinel lymph node biopsy procedure performed in patients with cutaneous trunk melanoma.

MATERIAL AND METHODS: Between 2015 and 2016, patients with trunk melanoma (N = 255, F/M 95/160), aged from 17 to 88 after an excisional biopsy, with primary tumor ≥ pT1b (AJCC 2009, median Breslow thickness 2.0 ± 3.13) were included in the study. In all the patients PL was followed by SPECT/CT 1–3 hours after injection of 99mTc- colloid particles, and SLNB was performed the next day.

RESULTS: SPECT-CT revealed 78 (18.6%) SLN more than PL, and in 40 patients showed additional lymph drainage regions leading to surgical adjustments. In 18 patients (7.1%) SPECT-CT revealed SLN not visible in the PL (false-negative PL) and in 22 patients (8.6%), foci of uptake interpreted in PL as hot SLNs were found to be non-nodal sites of uptake when assessed on SPECT/CT (false positive PL). SPECT-CT vs. PL mismatch was observed in 31 patients (12.2%) and was the most common in patients with primary lesions located in the anterior inferior medial region (75%).

CONCLUSIONS: Results of the presented study indicates the high diagnostic value of SPECT-CT in assessment of SLNs and proved that SPECT-CT increases the sensitivity and accuracy of SLN identification as compared to PL even in very experienced hands.

Abstract

BACKGROUND: Localization and histopathological examination of sentinel lymph node is a standard of melanoma treatment. The first stage of identification of the SLN is the preoperative lymphoscintigraphy. The aim of this study was to assess and compare diagnostic value of planar lymphoscintigraphy and SPECT/CT in sentinel lymph node biopsy procedure performed in patients with cutaneous trunk melanoma.

MATERIAL AND METHODS: Between 2015 and 2016, patients with trunk melanoma (N = 255, F/M 95/160), aged from 17 to 88 after an excisional biopsy, with primary tumor ≥ pT1b (AJCC 2009, median Breslow thickness 2.0 ± 3.13) were included in the study. In all the patients PL was followed by SPECT/CT 1–3 hours after injection of 99mTc- colloid particles, and SLNB was performed the next day.

RESULTS: SPECT-CT revealed 78 (18.6%) SLN more than PL, and in 40 patients showed additional lymph drainage regions leading to surgical adjustments. In 18 patients (7.1%) SPECT-CT revealed SLN not visible in the PL (false-negative PL) and in 22 patients (8.6%), foci of uptake interpreted in PL as hot SLNs were found to be non-nodal sites of uptake when assessed on SPECT/CT (false positive PL). SPECT-CT vs. PL mismatch was observed in 31 patients (12.2%) and was the most common in patients with primary lesions located in the anterior inferior medial region (75%).

CONCLUSIONS: Results of the presented study indicates the high diagnostic value of SPECT-CT in assessment of SLNs and proved that SPECT-CT increases the sensitivity and accuracy of SLN identification as compared to PL even in very experienced hands.

Get Citation

Keywords

sentinel node, SPECT/CT, trunk melanoma, planar lymphoscintigraphy

About this article
Title

Value of planar lymphoscintigraphy (PL) versus SPECT/CT in evaluation of sentinel lymph node in trunk melanoma — one center, large series retrospective study

Journal

Nuclear Medicine Review

Issue

Vol 21, No 2 (2018)

Pages

79-84

Published online

2018-06-08

DOI

10.5603/NMR.a2018.0022

Pubmed

29956817

Bibliographic record

Nucl. Med. Rev 2018;21(2):79-84.

Keywords

sentinel node
SPECT/CT
trunk melanoma
planar lymphoscintigraphy

Authors

Małgorzata Benke
Krzysztof Wocial
Weronika Lewandowska
Piotr Rutkowski
Paweł Teterycz
Piotr Jarek
Marek Dedecjus

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