Role of SPECT-CT in sentinel lymph node biopsy in patients diagnosed with head and neck melanoma

Rev Esp Med Nucl Imagen Mol. 2016 Jan-Feb;35(1):22-8. doi: 10.1016/j.remn.2015.05.009. Epub 2015 Jul 4.
[Article in English, Spanish]

Abstract

Objective: Assess the role of SPECT-CT in sentinel lymph node (SLN) biopsy in the accurate anatomical location of the SNL in patients with cutaneous head and neck melanoma.

Material and methods: A retrospective study was conducted from February 2010 to June 2013 on 22 consecutive patients with a diagnosis of cutaneous head and neck melanoma (9 female, 13 male), with a mean age of 55 years old and who met the inclusion criteria for SLN biopsy. Patients underwent preoperative scanning after peri-scar injection of (99m)Tc-labeled-nanocolloid. Planar images of the injection-site, whole-body, and SPECT-CT scanning were acquired.

Results: Detection rate of SLN reached up to 91% (20/22 patients) by planar lymphoscintigraphy and 95.4% (21/22 patients) by SPECT-CT. SPECT-CT provided an accurate location of SLN in 14/22 patients, enabling to improve the surgical approach (clinical impact: 63.6%). SLN was positive for metastatic cells in 9.1% patients.

Conclusion: SPECT-CT provides detailed anatomical SLN location and allows detecting a higher number of SLN than planar lymphoscintigraphy. Routine use of SPECT-CT is recommended in order to optimise the SLN detection and location in patients with head and neck melanoma.

Keywords: Biopsia selectiva del ganglio centinela; Cabeza y cuello; Head and neck; Melanoma; Sentinel lymph node biopsy; Single photon emission computed Tomography/computed tomography; Tomografia por emisión de fotón Simple/tomografía computadorizada.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Head and Neck Neoplasms / diagnostic imaging*
  • Head and Neck Neoplasms / pathology
  • Humans
  • Intraoperative Care
  • Lymphatic Metastasis / diagnostic imaging*
  • Lymphoscintigraphy / methods
  • Male
  • Melanoma / diagnostic imaging*
  • Melanoma / pathology
  • Melanoma / secondary*
  • Middle Aged
  • Preoperative Care
  • Radiopharmaceuticals / analysis
  • Retrospective Studies
  • Sensitivity and Specificity
  • Sentinel Lymph Node Biopsy / methods*
  • Single Photon Emission Computed Tomography Computed Tomography*
  • Skin Neoplasms / diagnostic imaging*
  • Skin Neoplasms / pathology
  • Technetium Tc 99m Aggregated Albumin / analysis
  • Young Adult

Substances

  • Radiopharmaceuticals
  • Technetium Tc 99m Aggregated Albumin
  • technetium Tc 99m nanocolloid