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Comparison of SPECT/CT and Planar Lympho-scintigraphy in Sentinel Node Biopsies of Oral Cavity Squamous Cell Carcinomas
INTRODUCTION: Evidence supporting the use of Sentinel node biopsy (SNB) for nodal staging of early oral squamous cell carcinomas (OSCC) appears to be very promising. Pre-operative lymphatic mapping using planar lymphoscinitigraphy (PL) with or without SPECT/CT in the SNB procedure is useful in senti...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Medknow Publications & Media Pvt Ltd
2017
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5439202/ https://www.ncbi.nlm.nih.gov/pubmed/28533636 http://dx.doi.org/10.4103/0972-3919.202244 |
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author | Chandra, Piyush Dhake, Sanket Shah, Sneha Agrawal, Archi Purandare, Nilendu Rangarajan, Venkatesh |
author_facet | Chandra, Piyush Dhake, Sanket Shah, Sneha Agrawal, Archi Purandare, Nilendu Rangarajan, Venkatesh |
author_sort | Chandra, Piyush |
collection | PubMed |
description | INTRODUCTION: Evidence supporting the use of Sentinel node biopsy (SNB) for nodal staging of early oral squamous cell carcinomas (OSCC) appears to be very promising. Pre-operative lymphatic mapping using planar lymphoscinitigraphy (PL) with or without SPECT/CT in the SNB procedure is useful in sentinel node localization and for planning appropriate surgery. Recently, a large prospective multi-centric study evaluating SNB in cutaneous melanoma, breast and pelvic malignancies, demonstrated that adding SPECT to PL leads to surgical adjustments in a considerable number of patients. Our aim of this study was to evaluate the incremental value of additional SPECT/CT over PL alone in SNB for OSCC. MATERIALS AND METHODS: This was a retrospective analysis of 44 patients (40- tongue, 4- buccal mucosa) with T1-T2, clinically N0 oral cavity SCC who underwent sentinel node biopsy procedure. PL and SPECT lymphoscinitigraphy images were compared for pre-operative mapping of sentinel nodes. RESULTS: Using a handheld gamma probe, a total of 179 sentinel nodes were harvested, with a mean of 4.06 per patient. PL revealed 75 hotspots with a mean of 1.70 per patient, and SPECT/CT revealed 92 hotspots with a mean of 2.09 per patient. Additional hotpots were identified in 14 patients on SPECT/CT, which included 4 patients, where PL did not detect any sentinel nodes. CONCLUSION: Pre-operative SPECT/CT in addition to planar lympho-scinitigraphy in sentinel node biopsies of oral cavity SCC detects more number of sentinel nodes compared to planar imaging alone. The higher sensitivity of SPECT combined with better anatomical localization using diagnostic CT may further improve the precision of SNB procedure. |
format | Online Article Text |
id | pubmed-5439202 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-54392022017-05-22 Comparison of SPECT/CT and Planar Lympho-scintigraphy in Sentinel Node Biopsies of Oral Cavity Squamous Cell Carcinomas Chandra, Piyush Dhake, Sanket Shah, Sneha Agrawal, Archi Purandare, Nilendu Rangarajan, Venkatesh Indian J Nucl Med Original Article INTRODUCTION: Evidence supporting the use of Sentinel node biopsy (SNB) for nodal staging of early oral squamous cell carcinomas (OSCC) appears to be very promising. Pre-operative lymphatic mapping using planar lymphoscinitigraphy (PL) with or without SPECT/CT in the SNB procedure is useful in sentinel node localization and for planning appropriate surgery. Recently, a large prospective multi-centric study evaluating SNB in cutaneous melanoma, breast and pelvic malignancies, demonstrated that adding SPECT to PL leads to surgical adjustments in a considerable number of patients. Our aim of this study was to evaluate the incremental value of additional SPECT/CT over PL alone in SNB for OSCC. MATERIALS AND METHODS: This was a retrospective analysis of 44 patients (40- tongue, 4- buccal mucosa) with T1-T2, clinically N0 oral cavity SCC who underwent sentinel node biopsy procedure. PL and SPECT lymphoscinitigraphy images were compared for pre-operative mapping of sentinel nodes. RESULTS: Using a handheld gamma probe, a total of 179 sentinel nodes were harvested, with a mean of 4.06 per patient. PL revealed 75 hotspots with a mean of 1.70 per patient, and SPECT/CT revealed 92 hotspots with a mean of 2.09 per patient. Additional hotpots were identified in 14 patients on SPECT/CT, which included 4 patients, where PL did not detect any sentinel nodes. CONCLUSION: Pre-operative SPECT/CT in addition to planar lympho-scinitigraphy in sentinel node biopsies of oral cavity SCC detects more number of sentinel nodes compared to planar imaging alone. The higher sensitivity of SPECT combined with better anatomical localization using diagnostic CT may further improve the precision of SNB procedure. Medknow Publications & Media Pvt Ltd 2017 /pmc/articles/PMC5439202/ /pubmed/28533636 http://dx.doi.org/10.4103/0972-3919.202244 Text en Copyright: © 2017 Indian Journal of Nuclear Medicine http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Chandra, Piyush Dhake, Sanket Shah, Sneha Agrawal, Archi Purandare, Nilendu Rangarajan, Venkatesh Comparison of SPECT/CT and Planar Lympho-scintigraphy in Sentinel Node Biopsies of Oral Cavity Squamous Cell Carcinomas |
title | Comparison of SPECT/CT and Planar Lympho-scintigraphy in Sentinel Node Biopsies of Oral Cavity Squamous Cell Carcinomas |
title_full | Comparison of SPECT/CT and Planar Lympho-scintigraphy in Sentinel Node Biopsies of Oral Cavity Squamous Cell Carcinomas |
title_fullStr | Comparison of SPECT/CT and Planar Lympho-scintigraphy in Sentinel Node Biopsies of Oral Cavity Squamous Cell Carcinomas |
title_full_unstemmed | Comparison of SPECT/CT and Planar Lympho-scintigraphy in Sentinel Node Biopsies of Oral Cavity Squamous Cell Carcinomas |
title_short | Comparison of SPECT/CT and Planar Lympho-scintigraphy in Sentinel Node Biopsies of Oral Cavity Squamous Cell Carcinomas |
title_sort | comparison of spect/ct and planar lympho-scintigraphy in sentinel node biopsies of oral cavity squamous cell carcinomas |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5439202/ https://www.ncbi.nlm.nih.gov/pubmed/28533636 http://dx.doi.org/10.4103/0972-3919.202244 |
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