Intraoperative sentinel node imaging versus SPECT/CT in oral cancer - A blinded comparison

European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
Clare SchillingMark McGurk

Abstract

Sentinel node biopsy (SNB) is gaining popularity as a staging tool in oral cancer. Protocol mandates radiotracer injection and pre-operative imaging (LSG ± SPECT/CT) in the nuclear medicine department. This approach limits application to accessible tumours and to centres with nuclear medicine. New technology, freehand single photon emission computed tomography (fhSPECT), has proved a useful adjunct in intraoperative imaging and localisation of sentinel nodes. This study investigates fhSPECT as an alternative to traditional imaging, an approach that would widen the remit of SNB. Fifty consecutive cT1-T2 N0 oral cancer patients received radiotracer followed by lymphoscintigraphy and SPECT/CT. Surgery was undertaken using fhSPECT by a surgeon blinded to pre-operative imaging. Prior to biopsy completion, results of pre-operative imaging were reviewed and any additional nodes removed. The accuracy of LSG, SPECT/CT and fhSPECT were compared. Nineteen patients had positive sentinel nodes. Disease free survival for sentinel node positive versus negative was significant (p < 0.005). All modalities missed positive nodes in at least one patient. The false negative rate for lymphoscintigraphy, SPECT/CT and fhSPECT was 26.3%, 15.8% and 5.3%...Continue Reading

Citations

Jul 10, 2019·Expert Review of Medical Devices·Matthias N Van OosteromFijs W B Van Leeuwen
Jan 27, 2021·The Quarterly Journal of Nuclear Medicine and Molecular Imaging : Official Publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR), [and] Section of the Society of Radiopharmaceutica·Daphne D RietbergenTessa Buckle
Apr 19, 2020·Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine·Suman B MondalSamuel Achilefu
Jun 30, 2021·European Journal of Nuclear Medicine and Molecular Imaging·Thomas WendlerMatthias N van Oosterom
Jun 10, 2021·The Quarterly Journal of Nuclear Medicine and Molecular Imaging : Official Publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR), [and] Section of the Society of Radiopharmaceutica·Imke BoekestijnMatthias N van Oosterom

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