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. 2012 Aug;21(2):47-55.
doi: 10.4274/Mirt.236. Epub 2012 Aug 1.

Detection of Sentinel Lymph Nodes in Gynecologic Tumours by Planar Scintigraphy and SPECT/CT

Otakar Kraft  1 , Martin Havel
Affiliations

Detection of Sentinel Lymph Nodes in Gynecologic Tumours by Planar Scintigraphy and SPECT/CT

Otakar Kraft et al. Mol Imaging Radionucl Ther. 2012 Aug.

Abstract

Objective: Assess the role of planar lymphoscintigraphy and fusion imaging of SPECT/CT in sentinel lymph node (SLN) detection in patients with gynecologic tumours.

Material and methods: Planar scintigraphy and hybrid modality SPECT/CT were performed in 64 consecutive women with gynecologic tumours (mean age 53.6 with range 30-77 years): 36 pts with cervical cancer (Group A), 21 pts with endometrial cancer (Group B), 7 pts with vulvar carcinoma (Group C). Planar and SPECT/CT images were interpreted separately by two nuclear medicine physicians. Efficacy of these two techniques to image SLN were compared.

Results: Planar scintigraphy did not image SLN in 7 patients (10.9%), SPECT/CT was negative in 4 patients (6.3%). In 35 (54.7%) patients the number of SLNs captured on SPECT/CT was higher than on planar imaging. Differences in detection of SLN between planar and SPECT/CT imaging in the group of all 64 patients are statistically significant (p<0.05). Three foci of uptake (1.7% from totally visible 177 foci on planar images) in 2 patients interpreted on planar images as hot LNs were found to be false positive non-nodal sites of uptake when further assessed on SPECT/CT. SPECT/CT showed the exact anatomical location of all visualised sentinel nodes.

Conclusion: In some patients with gynecologic cancers SPECT/CT improves detection of sentinel lymph nodes. It can image nodes not visible on planar scintigrams, exclude false positive uptake and exactly localise pelvic and paraaortal SLNs. It improves anatomic localization of SLNs.

Conflict of interest: None declared.

Keywords: SPECT; Sentinel lymph node biopsy; X-Ray computed; gamma camera Imaging; gynecologic neoplasms; scintigraphy; tomography.

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Figures

Figure 1
Figure 1. 69 year old woman with endometrial cancer. A) In the planar image in anterior projection, only one suspected deposit on the right is observed which is difficult to localize. B) The SPECT/CT fusion image shows one iliac sentinel node in the right
Figure 2
Figure 2. 73 year old woman with endometrial cancer. Planar scintigram in anterior projection (A) shows only suspected SLN on the right without possibility to localize it. Fusion of SPECT/CT (B, C) shows two SLNs on the right(B) and two SLNs on the left side (C) of the pelvis
See this image and copyright information in PMC

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