TY - JOUR T1 - Comparison of SPECT-CT with intraoperative mapping in cervical and uterine malignancies JF - International Journal of Gynecologic Cancer JO - Int J Gynecol Cancer SP - 679 LP - 685 DO - 10.1136/ijgc-2020-002198 VL - 31 IS - 5 AU - Anne-Sophie Navarro AU - Martina Aida Angeles AU - Federico Migliorelli AU - Claire Illac AU - Carlos Martínez-Gómez AU - Hélène Leray AU - Sarah Betrian AU - Elodie Chantalat AU - Yann Tanguy Le Gac AU - Stephanie Motton AU - Denis Querleu AU - Gwenael Ferron AU - Erwan Gabiache AU - Alejandra Martinez Y1 - 2021/05/01 UR - http://ijgc.bmj.com/content/31/5/679.abstract N2 - Introduction The objective was to evaluate whether hybrid imaging combining single photon emission tomography with computed tomography (SPECT/CT) provides additional clinical value for dectection of sentinel lymph nodes (SLNs) compared with intraoperative combined mapping in uterine and cervical malignancies.Methods This was a retrospective study of prospectively collected data from patients with stages IA–IB2 cervical cancer (International Federation of Gynecology and Obstetrics (FIGO) 2018) or stage I endometrial cancer, who underwent preoperative SPECT/CT for SLN detection. All included patients had dual injection of technetium-99m (99mTc) with patent blue or indocyanine green.Results A total of 171 patients were included with 468 SLNs detected during surgery: 146/171 patients (85.4%) had both radiotracer and blue injection whereas 25/171 patients (14.6%) had radiotracer and indocyanine green injected. The overall detection rate was 95.3%. The detection rate of SLN mapping was 74.9% for SPECT/CT, 90.6% for 99mTc, 91.8% for blue dye, and 100% for indocyanine green. Bilateral drainage was found in 140 patients (81.9%), detected by 99mTc in 105 patients (61.4%), by blue in 99 patients (67.3%), by indocyanine green in 23 patients (92%), and by SPECT/CT in 62 patients (36.4%). Atypical SLN locations were identified by SPECT/CT in 64 patients (37.4%), by 99mTc in 28 patients (16.4%), by blue in 17 patients (9.9%), and by indocyanine green in 8 patients (4.7%). Sensitivity and negative predictive value of SLN biopsy to detect lymph node metastasis using dual injection of different intraoperative combined techniques were 88.9% and 97.5%, respectively.Conclusion SPECT/CT enhanced topographic delineation of SLN and more accurately identified drainage to atypical locations. Fluorescent SLN mapping using indocyanine green offered the highest SLN detection rate. When indocyanine green was used, SPECT/CT did not increase SLN detection, and did not add further information to improve lymph node localization and removal.All data relevant to the study are included in the article or uploaded as supplementary information. ER -