Utility of hybrid SPECT/CT in primary melanoma lymphoscintigraphy: A retrospective case series

J Med Imaging Radiat Oncol. 2017 Apr;61(2):204-211. doi: 10.1111/1754-9485.12554. Epub 2016 Nov 14.

Abstract

Introduction: Sentinel lymph node (SLN) biopsy is widely accepted as an important part of staging cutaneous malignant melanoma. Hybrid single photon emission computed tomography and computed tomography (SPECT/CT) may identify additional SLN and provide important information to the surgeon performing SLN biopsy. We report our experience at a major referral centre for melanoma surgery.

Methods: Retrospective case series of pre-operative sentinel node lymphoscintigraphy for primary melanoma over a consecutive 12-month period. All patients had planar imaging and hybrid SPECT/CT.

Results: At least 1 SLN was successfully identified in 82 of 86 eligible patients (95.3%). These 82 patients had 144 SLNs (mean 1.8). There were no patients where the SLN was seen only with SPECT/CT. Additional information was provided by SPECT/CT in 32 patients (39.0%). Histology reports were available for 52 patients, 9 (17.3%) had at least 1 SLN positive for metastatic disease.

Conclusions: We achieved a high rate of SLN identification. SPECT/CT was most frequently helpful when the primary melanoma was located in the head, neck and trunk. Routine use of SPECT/CT during lymphoscintigraphy provides important anatomical information and may reduce the false-negative rate.

Keywords: SPECT; melanoma; sentinel lymph node biopsy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antimony
  • Female
  • Humans
  • Lymph Node Excision
  • Lymphatic Metastasis
  • Lymphoscintigraphy / methods*
  • Male
  • Melanoma / diagnostic imaging*
  • Melanoma / pathology*
  • Middle Aged
  • Multimodal Imaging*
  • Neoplasm Staging
  • Radiopharmaceuticals
  • Retrospective Studies
  • Sentinel Lymph Node Biopsy / methods*
  • Skin Neoplasms / diagnostic imaging*
  • Skin Neoplasms / pathology*
  • Technetium Compounds
  • Tomography, Emission-Computed, Single-Photon*
  • Tomography, X-Ray Computed*

Substances

  • Radiopharmaceuticals
  • Technetium Compounds
  • technetium Tc 99m antimony sulfide
  • Antimony