The Use of Sentinel Node Biopsy to Upstage the Clinically N0 Neck in Head and Neck Cancer

Ross, Gary; Shoaib, Taimur; Soutar, David S.; Camilleri, I.; Gray, H. W.; Bessent, R. G.; Robertson, Andrew G.; MacDonald, D.G.

doi:10.1001/archotol.128.11.1287

Cited by 106 publications

(80 citation statements)

References 20 publications

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“…Sentinel lymph node biopsy is an established and widely available procedure for breast cancer and melanoma (16)(17)(18)(19)(20)(21)(22)(23)(24)(25). It is also used for the management of head and neck cancer and other malignancies.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Efficacy of a Small CdTe γ-Camera for Sentinel Lymph Node Biopsy

Tsuchimochi¹,

Hayama²,

Oda³

et al. 2008

J Nucl Med

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We previously reported the basic performance of a prototype small cadmium telluride (CdTe) g-camera (SSGC) intended for use in radioguided surgeries. In this study, we sought to confirm the favorable previous results and to extend the preliminary findings to examine the efficacy of the SSGC in an animal study and a clinical setting for sentinel lymph node biopsy. Methods: The prototype SSGC (1,024 pixels; field of view, 44.8 · 44.8 mm), equipped with a parallel-hole collimator, was used in both animal and clinical studies. 99m Tc-phytate (18.5 MBq) was injected into the tongues and legs of 6 rabbits. In the clinical study, 74 MBq of 99m Tc-phytate was injected into peritumoral regions in 8 patients with oral cancer. The detection of hot nodes by the SSGC was compared with that by a conventional scintillation g-camera (CGC). Results: The SSGC detected 29 hot nodes in images of 6 rabbits after injection. The number of hot nodes was the same as the number seen in CGC studies, but the CGC required a longer acquisition time to produce comparable images. There were no differences between the SSGC and the CGC in terms of activity ratios and hot node-to-background ratios. The biodistribution of 99m Tc-phytate in removed tissues was evaluated by contact radiography, and radioactivity was assayed with a g-well counter. The mean 6 SD radioactivity in specimens was 0.15% 6 0.15%, with a range of 0.01%-0.62%. In the clinical study, the SSGC detected 30 hot nodes with a 5-to 60-s acquisition time at 4 h after injection. The SSGC documented all hot nodes depicted by the CGC at 4 h after injection. Conclusion: The SSGC showed significant potential for the detection of sentinel lymph nodes in lymphoscintigraphy. The results of the studies suggested that the SSGC facilitates the exploration of hot nodes in sentinel lymph node biopsy.Key Words: lymphoscintigraphy; oncology; semiconductor g-camera; CdTe; handheld g-camera; sentinel lymph node biopsy; radioguided surgery; oral cancer Radi oguided surgery has been accomplished with the use of g-probes, primarily for sentinel lymph node biopsy.However, g-probes can provide only radioactivity counts and variable-pitch audio output based on the intensity of the detected radioactivity. Allowing the surgeon to see the spatial distribution of the increased radioactivity could result in more accurate delineation of the surgical field, thus facilitating the surgery. Therefore, we developed a prototype small semiconductor g-camera (SSGC) that provides images of radioactivities for surgical use (1).For radioguided surgery, the g-camera should be miniaturized or handheld to facilitate its application in the restricted space of a surgical field. A semiconductor detector containing cadmium telluride (CdTe) or cadmium zinc telluride (CdZnTe) has shown excellent performance and quality for imaging (2-7). The semiconductor detector is considered to be the most suitable for miniaturization because it does not require the relatively massive photomultiplier tube that characterizes a traditional scintil...

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Section: Discussionmentioning

confidence: 99%

Evaluation of the Efficacy of a Small CdTe γ-Camera for Sentinel Lymph Node Biopsy

Tsuchimochi¹,

Hayama²,

Oda³

et al. 2008

J Nucl Med

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“…The method is apparently not difficult to implement and easily identifies the sentinel node. 100, 101 Ross et al 100 have established the sensitivity of the procedure as 94%, when using the lymphocyntigraphy, the dye, and the full pathologic protocol.…”

Section: Treatment-related Factorsmentioning

confidence: 99%

Oral squamous cell carcinoma: Review of prognostic and predictive factors

Massano

Regateiro

Januário

et al. 2006

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, an

548

436

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“…After Morton et al reported the usefulness of intraoperative lymphatic mapping for melanoma in the early 1990s (1), the sentinel node (SN) concept has been widely accepted for the treatment of various types of cancer, including breast, gastric and head and neck cancer (1)(2)(3)(4)(5). Sentinel node navigation surgery (SNNS) is currently a standard procedure for early-stage melanoma and breast cancer.…”

Section: Introductionmentioning

confidence: 99%

Preferentially examined sentinel nodes for sentinel node navigation surgery in gastric cancer

Yaguchi

Tsujimoto

Hiraki

et al. 2015

Molecular and Clinical Oncology

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Abstract. The intraoperative examination of the sentinel nodes (SNs) is crucial for correctly performing SN navigation surgery (SNNS). Frozen-section diagnosis is ordinarily used; however, when several SNs are being assessed in gastric cancer, which has numerous regional lymph nodes, it is difficult to examine them all correctly within the short duration of surgery. In the present study, we aimed to determine the SNs that should be preferentially examined during SNNS in gastric cancer. A total of 824 SNs were examined in 113 patients with clinically determined T1-2 gastric cancer and no apparent lymph node metastasis. We focused on the accumulation of tracers expressed by hot nodes (HNs) using the radioisotope (RI) method and green nodes (GNs) using the dye-guided method and measured the radioactivity count of the HNs (RI count). We compared these parameters between 35 metastatic and 789 non-metastatic SNs. The percentage of metastasis-positive SNs that were radioactively 'hot' and dyed green was higher compared with that of the negative SNs (89 vs. 43%, respectively; P<0.01). The RI counts of the metastasis-positive SNs were higher compared with those of the negative SNs [median (range): 361 (0-10,670) vs. 53 (0-9,931), respectively; P<0.01]. The area under the receiver operating characteristic curve of the RI count was 0.69 (95% CI: 0.60-0.78). Therefore, when assessing several SNs, those with higher RI counts (HNs and GNs) should be preferentially examined. Further accumulation of cases is required to establish the cut-off value for the diagnosis of metastasis based on the RI count.

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The Use of Sentinel Node Biopsy to Upstage the Clinically N0 Neck in Head and Neck Cancer

Abstract: Sentinel node biopsy can be used to upstage the N0 neck in patients with early subclinical nodal disease. However, before it becomes the standard of care in head and neck squamous cell carcinoma, longer follow-up observational trials are needed.

Cited by 106 publications

References 20 publications

Evaluation of the Efficacy of a Small CdTe γ-Camera for Sentinel Lymph Node Biopsy

Evaluation of the Efficacy of a Small CdTe γ-Camera for Sentinel Lymph Node Biopsy

Oral squamous cell carcinoma: Review of prognostic and predictive factors

Preferentially examined sentinel nodes for sentinel node navigation surgery in gastric cancer

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