Association Between Sentinel Lymph Node Excision With or Without Preoperative SPECT/CT and Metastatic Node Detection and Disease-Free Survival in Melanoma

Stoffels, Ingo; Boy, Christian; Pöppel, Thorsten; Kuhn, Jasna; Klötgen, K.; Dissemond, Joachim; Schadendorf, Dirk; Klode, Joachim

doi:10.1001/2012.jama.11030

Cited by 122 publications

(81 citation statements)

References 29 publications

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“…In the head and neck area, the procedure is more challenging because of the intricacy of lymphatic drainage patterns, the complexity of the local anatomy and the shine-through phenomenon [41,42]. However, an SLN detection rate of 95.2 % has been reported [43], which can be improved by additional dynamic lymphoscintigraphy [44] preoperative SPECT/CT and the intraoperative use of the gamma probe [45].…”

Section: Indicationsmentioning

confidence: 99%

EANM practice guidelines for lymphoscintigraphy and sentinel lymph node biopsy in melanoma

Bluemel

Herrmann

Giammarile

et al. 2015

Eur J Nucl Med Mol Imaging

118

131

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Section: Indicationsmentioning

confidence: 99%

EANM practice guidelines for lymphoscintigraphy and sentinel lymph node biopsy in melanoma

Bluemel

Herrmann

Giammarile

et al. 2015

Eur J Nucl Med Mol Imaging

118

131

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“…Recently, the global contribution of SPECT/CT in melanoma was established in a study comparing the results of 149 patients submitted to SPECT/CT with those of a group of 254 patients who did not undergo SPECT/CT. Not only did SPECT/CT detect more SNs (average 2.4 versus 1.87 without SPECT/CT) and more metastatic SNs (average 0.34 versus 0.21), its use was associated with a significantly higher rate of four-year disease-free interval (93.9 %) when compared with the group of patients not submitted to SPECT/CT (79.2 %) [10]. The same group of investigators evaluated the cost effectiveness of the use SPECT/CT in combination with planar lymphoscintigraphy.…”

Section: Cutaneous Melanomamentioning

confidence: 97%

SPECT/CT and sentinel node lymphoscintigraphy

Olmos

Rietbergen

Vidal-Sicart

2014

Clin Transl Imaging

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The use of single-photon emission computed tomography/computed tomography (SPECT/CT) for sentinel node (SN) detection has been evaluated in the majority of malignancies with predominantly superficial lymphatic drainage. In breast cancer and melanoma, important initial contributions of SPECT/CT were based on the anatomical localisation of SNs already visualised on planar images, the detection of additional SNs in aberrant basins, and the depiction of SNs in cases with no visualisation on planar images. However, more recently, the finding that SPECT/CT use is associated with a higher rate of SN detection, more metastatic SNs, and a higher rate of disease-free survival in large series of patients is leading SPECT/CT to be routinely performed in melanoma. The incorporation of SPECT/CT into the SN procedure in melanoma also appears to be cost effective and was significantly related to shorter operative times, shorter hospital stays, and fewer complications. In penile and vulvar cancer, the use of SPECT/CT has led to the detection of additional SNs. In oral cavity cancer and thyroid cancer, SPECT/CT not only appears to be useful for planar image interpretation but is also becoming an essential component of the SN procedure, providing surgeons with additional anatomical information. As regards malignancies with deep lymphatic drainage, SPECT/CT has been extensively validated in urological and gynaecological cancers. In these malignancies, SPECT/CT was able to localise SNs not only in the basins included in the area of extended pelvic lymph node dissection but also in aberrant locations. In gastrointestinal and lung malignancies, SPECT/CT has been used only incidentally. SPECT/CT must be considered complementary to planar lymphoscintigraphy for SN identification, and a combined interpretation of both modalities is necessary. With the improvement of the CT component, nuclear physicians today can also identify lymph nodes corresponding to radioactive SNs. This visual information is helpful for the intraoperative procedure and for postexcision assessment using portable devices.

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“…Stoffels ve ark. tarafından 264 hasta üzerinde yapılmış bir çalışmada malign melanom hastalarında SPECT/BT ile SLB saptanması durumunda 4 yıllık hastalıksız sağkalım konvansiyonel görüntülemeye oranla anlamlı yüksek (SPECT/BT: %93 lenfosintigrafi: %79,2) olup, bu hastalarda lokal nüks hızı %6,8 (lenfosintigrafi: %23,8) bulunmuştur (56). SPECT/BT görüntüleri enjeksiyon yerinin lenfatik drenaj bölgesine yakın olduğu durumlarda bu yüksek radyoaktivite nedeni ile maskelenen lenf bezlerinin saptanmasına yardımcıdır.…”

Section: Spectvespect/btgörüntülemeunclassified

Sentinel Lymph Node Biopsy: Actual Approaches

Tuncel¹,

Salancı²,

Bozkurt³

2017

Nts

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Öz Abstract GirişKanser yayılımında en önemli yollardan biri lenfatik yayılımdır. On yedinci yüzyılda lenfatik sistemin tanımlanması ve ardından kanserdeki rolünün saptanmaya başlaması ile bu konuda çeşitli çalışmalar yapılmıştır. Bu araştırmaların sonucunda bugün kanserin yerleştiği bölgeye bağlı olarak önce bölgesel lenf bezlerine ilerlediği ve klinik tanıdan çok daha önce bu bölgesel lenf bezlerinde mikrometastazların gerçekleştiği bilinmektedir. Bu bilgi özellikle meme kanseri ve malign melanom gibi kanserlerde sentinel lenf bezi (SLB) kavramının doğmasını sağlamıştır (1). İlk SLB tanımı Cabanas tarafından penil kanserde yapılmıştır (2). Lenfosintigrafinin SLB saptanmasında kullanılması Chiappa ve ark.'nın 1966'da testiküler kanserlerde yaptığı çalışma ile başlamıştır (3). Morton ve ark.'nın 194 malign melanom hastasında lenfosintigrafi kullanılarak lenfatik yayılımın araştırdığı çalışma SLB'nin örneklemesinin önünü açmış olup, günümüzde SLB sintigrafisi rutin uygulama kılavuzlarında yerini almıştır (4). Meme kanserlerinde de Christensen ve ark. ile başlayan çalışmalar koruyucu meme cerrahisi uygulamalarının yaygınlaşmasına ve hastaların daha az cerrahi komplikasyon ile tedavi edilmelerine olanak vermiştir (5). Son yıllarda gelişen görüntüleme ve intraoperatif deteksiyon teknolojileri sayesinde SLB biyopsisinin (SLBB) başarısı ve kullanım sıklığı

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Association Between Sentinel Lymph Node Excision With or Without Preoperative SPECT/CT and Metastatic Node Detection and Disease-Free Survival in Melanoma

Cited by 122 publications

References 29 publications

EANM practice guidelines for lymphoscintigraphy and sentinel lymph node biopsy in melanoma

EANM practice guidelines for lymphoscintigraphy and sentinel lymph node biopsy in melanoma

SPECT/CT and sentinel node lymphoscintigraphy

Sentinel Lymph Node Biopsy: Actual Approaches

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