SPECT-CT and intraoperative portable gamma-camera detection protocol for sentinel lymph node biopsy in oral cavity squamous cell carcinoma. Issue 10 (December 2015)

• Record Type: Journal Article
• Authors: Sieira-Gil, Ramón; Paredes, Pilar; Martí-Pagès, Carles; Ferrer-Fuertes, Ada; García-Díez, Eloy; Cho-Lee, Gui Youn; Tapias, Andres; Mayoral, Maria; Vidal-Sicart, Sergi
• Is Part Of: Journal of cranio-maxillofacial surgery. Volume 43:Issue 10(2016:Mar.)
• Page Start: 2205
• Page End: 2213
• Publication Date: 2015-12
• Subjects: Sentinel lymph node biopsy -- Radioguided surgery -- SPECT/CT -- Portable gamma camera -- Lymphoscintigraphy -- Oral cavity squamous cell carcinoma -- Neck metastases; Skull -- Surgery -- Periodicals; Maxilla -- Surgery -- Periodicals; Face -- Surgery -- Periodicals; Surgery, Plastic -- Periodicals; Maxilla -- surgery -- Periodicals; Face -- surgery -- Periodicals; Skull -- surgery -- Periodicals; Oral Surgical Procedures -- Periodicals; Reconstructive Surgical Procedures -- Periodicals; Surgery, Plastic -- Periodicals; Surgery, Oral -- Periodicals; Electronic journals; 617.514
• DOI: 10.1016/j.jcms.2015.10.006
• Languages: English
• ISSNs: 1010-5182

Abstract

Abstract: Objective: The aim of this study was to evaluate a multimodality approach to sentinel lymph node biopsy (SLNB) detection with lymphoscintigraphy and single-photon emission computed tomography (SPECT)/computed tomography (CT). When combined with intraoperative imaging by a portable gamma camera (PGC), improved SLNB accuracy and detection rate may result. Material and methods: A total of 42 patients selected for SLNB in node-negative T1 and T2 oral squamous cell carcinoma were retrospectively analyzed. The detection protocol consisted of preoperative lymphoscintigraphy and SPECT/CT performed the day before surgery. Intraoperative sentinel lymph node (SLN) detection was done with the aid of a PGC in association with hand-held gamma probe. Results: All SLN detected in the preoperative study could be harvested except for one case. A total of 131 SLN were resected. This number was higher than the SLN depicted on lymphoscintigraphy (119 SLNs) and SPECT/CT (123 SLNs). Sublingual SLNs were observed in two cases (4.76%). These SLNs were detected by SPECT/CT but not by lymphoscintigraphy. Five (3.8%) additional SLNs not previously visualized on lymphoscintigraphy or on SPECT/CT were detected intraoperatively with the aid of the PGC. Positive SLNs were detected in eight cases (19%). Micrometastases were detected in five cases (62%) and macrometastases in three cases (38%). Conclusion: The SLNB detection protocol described contributes to more accurate study and detection.