Investigating the role of SPECT/CT in dynamic sentinel lymph node biopsy for penile cancers
Investigating the role of SPECT/CT in dynamic sentinel lymph node biopsy for penile cancers
Purpose: currently, most centres use 2-D planar lymphoscintigraphy when performing dynamic sentinel lymph node biopsy in penile cancer patients with clinically impalpable inguinal nodes. This study aimed to investigate the role of SPECT/CT following 2-D planar lymphoscintigraphy (dynamic and static) in the detection and localization of sentinel lymph nodes in the groin.
Methods: a qualitative (visual) review was performed on planar followed by SPECT/CT lymphoscintigraphy in 115 consecutive patients (age 28–86 years) who underwent injection of 99mTc-nanocolloid followed by immediate acquisition of dynamic (20 min) and early static scans (5 min) initially and further delayed static (5 min) images at 120 min followed by SPECT/CT imaging. The lymph nodes detected in each groin on planar lymphoscintigraphy and SPECT/CT were compared.
Results: a total of 440 and 467 nodes were identified on planar scintigraphy and SPECT/CT, respectively. Overall, SPECT/CT confirmed the findings of planar imaging in 28/115 cases (24%). In the remaining 87 cases (76%), gross discrepancies were observed between planar and SPECT/CT images. SPECT/CT identified 17 instances of skin contamination (16 patients, 13%) and 36 instances of in-transit lymphatic tract activity (24 patients, 20%) that had been interpreted as tracer-avid lymph nodes on planar imaging. In addition, SPECT/CT identified 53 tracer-avid nodes in 48 patients (42%) that were not visualized on planar imaging and led to reclassification of the drainage basins (pelvic/inguinal) of 27 tracer-avid nodes.
Conclusions: the addition of SPECT/CT improved the rate of detection of true tracer-avid lymph nodes and delineated their precise (3-D) anatomic localization in drainage basins.
Cancer of the penis, Drainage basin, Planar lymphoscintigraphy, SPECT/CT lymphoscintigraphy, Sentinel node
1176-1184
Saad, Ziauddin Zia
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Omorphos, Savvas
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Michopoulou, Sofia
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Gacinovic, Svetislav
043a071f-cf91-48d8-bdae-e5b890e10b7b
Malone, Peter
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Nigam, Raj
de4a4767-a4d2-4eb9-8b22-f4583b2a09bf
Muneer, Asif
a78d14a3-2efc-4cf2-a52b-c39eeb1c05a8
Bomanji, Jamshed
ae51c005-7cac-41b6-a6ff-095782ee7692
7 February 2017
Saad, Ziauddin Zia
ba209635-a4b9-4ae0-b076-d6804ed3b7df
Omorphos, Savvas
ae834126-f5ab-4cb2-8b0a-107a424b72cb
Michopoulou, Sofia
f21ba2a3-f5d3-4998-801f-1ae72ff5d92c
Gacinovic, Svetislav
043a071f-cf91-48d8-bdae-e5b890e10b7b
Malone, Peter
28e638fd-3eab-49b7-9cf0-6846c665f0a9
Nigam, Raj
de4a4767-a4d2-4eb9-8b22-f4583b2a09bf
Muneer, Asif
a78d14a3-2efc-4cf2-a52b-c39eeb1c05a8
Bomanji, Jamshed
ae51c005-7cac-41b6-a6ff-095782ee7692
Saad, Ziauddin Zia, Omorphos, Savvas, Michopoulou, Sofia, Gacinovic, Svetislav, Malone, Peter, Nigam, Raj, Muneer, Asif and Bomanji, Jamshed
(2017)
Investigating the role of SPECT/CT in dynamic sentinel lymph node biopsy for penile cancers.
European Journal of Nuclear Medicine and Molecular Imaging, 44 (7), .
(doi:10.1007/s00259-017-3636-1).
Abstract
Purpose: currently, most centres use 2-D planar lymphoscintigraphy when performing dynamic sentinel lymph node biopsy in penile cancer patients with clinically impalpable inguinal nodes. This study aimed to investigate the role of SPECT/CT following 2-D planar lymphoscintigraphy (dynamic and static) in the detection and localization of sentinel lymph nodes in the groin.
Methods: a qualitative (visual) review was performed on planar followed by SPECT/CT lymphoscintigraphy in 115 consecutive patients (age 28–86 years) who underwent injection of 99mTc-nanocolloid followed by immediate acquisition of dynamic (20 min) and early static scans (5 min) initially and further delayed static (5 min) images at 120 min followed by SPECT/CT imaging. The lymph nodes detected in each groin on planar lymphoscintigraphy and SPECT/CT were compared.
Results: a total of 440 and 467 nodes were identified on planar scintigraphy and SPECT/CT, respectively. Overall, SPECT/CT confirmed the findings of planar imaging in 28/115 cases (24%). In the remaining 87 cases (76%), gross discrepancies were observed between planar and SPECT/CT images. SPECT/CT identified 17 instances of skin contamination (16 patients, 13%) and 36 instances of in-transit lymphatic tract activity (24 patients, 20%) that had been interpreted as tracer-avid lymph nodes on planar imaging. In addition, SPECT/CT identified 53 tracer-avid nodes in 48 patients (42%) that were not visualized on planar imaging and led to reclassification of the drainage basins (pelvic/inguinal) of 27 tracer-avid nodes.
Conclusions: the addition of SPECT/CT improved the rate of detection of true tracer-avid lymph nodes and delineated their precise (3-D) anatomic localization in drainage basins.
Text
s00259-017-3636-1
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Accepted/In Press date: 17 January 2017
Published date: 7 February 2017
Keywords:
Cancer of the penis, Drainage basin, Planar lymphoscintigraphy, SPECT/CT lymphoscintigraphy, Sentinel node
Identifiers
Local EPrints ID: 487896
URI: http://eprints.soton.ac.uk/id/eprint/487896
ISSN: 1619-7070
PURE UUID: af768894-d789-44bc-8fc1-b0875660355d
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Date deposited: 08 Mar 2024 17:53
Last modified: 17 Mar 2024 07:57
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Contributors
Author:
Ziauddin Zia Saad
Author:
Savvas Omorphos
Author:
Sofia Michopoulou
Author:
Svetislav Gacinovic
Author:
Peter Malone
Author:
Raj Nigam
Author:
Asif Muneer
Author:
Jamshed Bomanji
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