TY - JOUR
T1 - Sentinel Node in Oral Cancer
T2 - The Nuclear Medicine Aspects. A Survey from the Sentinel European Node Trial
AU - Tartaglione, Girolamo
AU - Stoeckli, Sandro J.
AU - De Bree, Remco
AU - Schilling, Clare
AU - Flach, Geke B.
AU - Bakholdt, Vivi
AU - Sorensen, Jens Ahm
AU - Bilde, Anders
AU - Von Buchwald, Christian
AU - Lawson, Georges
AU - Dequanter, Didier
AU - Villarreal, Pedro M.
AU - Forcelledo, Manuel Florentino Fresno
AU - Amezaga, Julio Alvarez
AU - Moreira, Augusto
AU - Poli, Tito
AU - Grandi, Cesare
AU - Vigili, Maurizio Giovanni
AU - O'Doherty, Michael
AU - Donner, Davide
AU - Bloemena, Elisabeth
AU - Rahimi, Siavash
AU - Gurney, Benjamin
AU - Haerle, Stephan K.
AU - Broglie, Martina A.
AU - Huber, Gerhard F.
AU - Krogdah, Annelise I.
AU - Sebbesen, Lars R.
AU - Odell, Edward
AU - Gutierrez, Luis Manuel Junquera
AU - Barbier, Luis
AU - Santamaria-Zuazua, Joseba
AU - Jacome, Manuel
AU - Nollevaux, Marie-Cecile
AU - Bragantini, Emma
AU - Lothaire, Philippe
AU - Silini, Enrico M.
AU - Sesenna, Enrico
AU - Dolivet, Giles
AU - Mastronicola, Romina
AU - Leroux, Agnes
AU - Sassoon, Isabel
AU - Sloan, Philip
AU - Colletti, Patrick M.
AU - Rubello, Domenico
AU - McGurk, Mark
PY - 2016/7
Y1 - 2016/7
N2 - Purpose: Nuclear imaging plays a crucial role in lymphatic mapping of oral cancer. This evaluation represents a subanalysis of the original multicenter SENT trial data set, involving 434 patientswith T1-T2, N0, and M0 oral squamous cell carcinoma. The impact of acquisition techniques, tracer injection timing relative to surgery, and causes of false-negative rate were assessed. Methods: Three to 24 hours before surgery, all patients received a dose of 99mTc-nanocolloid (10-175 MBq), followed by lymphoscintigraphy. According to institutional protocols, all patients underwent preoperative dynamic/ static scan and/or SPECT/CT. Results: Lymphoscintigraphy identified 723 lymphatic basins. 1398 sentinel lymph nodes (SNs) were biopsied (3.2 SN per patient; range, 1-10). Dynamic scan allowed the differentiation of sentinel nodes from second tier lymph nodes. SPECT/CT allowed more accurate anatomical localization and estimated SN depth more efficiently. After pathological examination, 9.9% of the SN excised (138 of 1398 SNs) showed metastases. The first neck level (NL) containing SN+ was NL I in 28.6%, NL IIa in 44.8%, NL IIb in 2.8%, NL III in 17.1%, and NL IV in 6.7% of positive patients. Approximately 96% of positive SNs were localized in the first and second lymphatic basin visualized using lymphoscintigraphy. After neck dissection, the SN+ was the only lymph node containing metastasis in approximately 80% of patients. Conclusions: Best results were observed using a dynamic scan in combination with SPECT/CT. A shorter interval between tracer injection, imaging, and surgery resulted in a lower false-negative rate. At least 2 NLs have to be harvested, as this may increase the detection of lymphatic metastases.
AB - Purpose: Nuclear imaging plays a crucial role in lymphatic mapping of oral cancer. This evaluation represents a subanalysis of the original multicenter SENT trial data set, involving 434 patientswith T1-T2, N0, and M0 oral squamous cell carcinoma. The impact of acquisition techniques, tracer injection timing relative to surgery, and causes of false-negative rate were assessed. Methods: Three to 24 hours before surgery, all patients received a dose of 99mTc-nanocolloid (10-175 MBq), followed by lymphoscintigraphy. According to institutional protocols, all patients underwent preoperative dynamic/ static scan and/or SPECT/CT. Results: Lymphoscintigraphy identified 723 lymphatic basins. 1398 sentinel lymph nodes (SNs) were biopsied (3.2 SN per patient; range, 1-10). Dynamic scan allowed the differentiation of sentinel nodes from second tier lymph nodes. SPECT/CT allowed more accurate anatomical localization and estimated SN depth more efficiently. After pathological examination, 9.9% of the SN excised (138 of 1398 SNs) showed metastases. The first neck level (NL) containing SN+ was NL I in 28.6%, NL IIa in 44.8%, NL IIb in 2.8%, NL III in 17.1%, and NL IV in 6.7% of positive patients. Approximately 96% of positive SNs were localized in the first and second lymphatic basin visualized using lymphoscintigraphy. After neck dissection, the SN+ was the only lymph node containing metastasis in approximately 80% of patients. Conclusions: Best results were observed using a dynamic scan in combination with SPECT/CT. A shorter interval between tracer injection, imaging, and surgery resulted in a lower false-negative rate. At least 2 NLs have to be harvested, as this may increase the detection of lymphatic metastases.
KW - Gamma probe
KW - Head and neck cancer
KW - Lymphatic metastasis
KW - Lymphoscintigraphy
KW - Neck dissection
KW - Sentinel lymph node biopsy
KW - Sentinel lymph nodes
KW - Single-photon emission computed tomography
KW - Squamous cell carcinoma
UR - http://www.scopus.com/inward/record.url?scp=84975706950&partnerID=8YFLogxK
UR - https://insights.ovid.com/pubmed?pmid=27088386
U2 - 10.1097/RLU.0000000000001241
DO - 10.1097/RLU.0000000000001241
M3 - Article
AN - SCOPUS:84975706950
SN - 0363-9762
VL - 41
SP - 534
EP - 542
JO - Clinical Nuclear Medicine
JF - Clinical Nuclear Medicine
IS - 7
ER -
