RT Journal Article
SR Electronic
T1 Integration of Hybrid Single-Photon Emission Computed Tomography/Computed Tomography in the Preoperative Assessment of Sentinel Node in Patients With Cervical and Endometrial Cancer: Our Experience and Literature Review
JF International Journal of Gynecologic Cancer
JO Int J Gynecol Cancer
FD BMJ Publishing Group Ltd
SP 830
OP 835
DO 10.1097/IGC.0b013e318253496f
VO 22
IS 5
A1 Alessandro Buda
A1 Federica Elisei
A1 Maurizio Arosio
A1 Carlotta Dolci
A1 Mauro Signorelli
A1 Patrizia Perego
A1 Daniela Giuliani
A1 Dario Recalcati
A1 Giorgio Cattoretti
A1 Rodolfo Milani
A1 Cristina Messa
YR 2012
UL http://ijgc.bmj.com/content/22/5/830.abstract
AB Objective The purpose of this study was to assess whether there is an additional value of single-photon emission computed tomography/computed tomography (SPECT/CT) over lymphoscintigraphy (LSG) alone for sentinel node (SN) mapping in endometrial and cervical cancer.Methods Ten women with clinically cervical stage IA2 to stage IB1 and 25 women with stage I endometrial cancer underwent preoperative LSG for SN mapping. Technetium Tc 99m albumin nanocolloid was injected submucosally at 4 points of the cervix. Patients underwent SPECT/CT emission-transmission study at least 3 hours after standard planar images. Methylene blue was injected into the cervix just before surgery under general anesthesia. All patients underwent hysterectomy, bilateral salpingo-oophorectomy, and radical regional nodal dissection. Hot and/or blue nodes were labeled as SNs.Results Conventional planar imaging detection rate was 50%, whereas the detection rate of at least one SN with SPECT/CT was 91% (32/35); bilateral detection was achieved in 7 (39%) of 18 women in planar and in 17 (53%) of 32 women in SPECT/CT imaging, respectively. Bilateral detection was achieved in 57% of women (20/35). Sentinel nodes were located in external and internal iliac nodes (66%), obturator nodes (5%), internal iliac nodes (11%), common iliac nodes (9%), and presacral nodes (9%). Lymph node involvement was identified in 5 patients (14%). Sentinel node correctly predicted lymph node involvement in all node-positive patients. Sentinel node sensitivity and negative predictive value of SPECT/CT were 100%.Conclusions Single photon emission computed tomography/computed tomography seems to improve intraoperative identification of SNs and provides additional useful information about the anatomic location of SNs compared to planar LSG in cervical and endometrial cancer.