Purpose: Nuclear imaging plays a crucial role in lymphatic mapping of oral cancer. This evaluation represents a subanalysis of the original multicenter SENT trial data set, involving 434 patientswith T1-T2, N0, and M0 oral squamous cell carcinoma. The impact of acquisition techniques, tracer injection timing relative to surgery, and causes of false-negative rate were assessed. Methods: Three to 24 hours before surgery, all patients received a dose of 99mTc-nanocolloid (10-175 MBq), followed by lymphoscintigraphy. According to institutional protocols, all patients underwent preoperative dynamic/ static scan and/or SPECT/CT. Results: Lymphoscintigraphy identified 723 lymphatic basins. 1398 sentinel lymph nodes (SNs) were biopsied (3.2 SN per patient; range, 1-10). Dynamic scan allowed the differentiation of sentinel nodes from second tier lymph nodes. SPECT/CT allowed more accurate anatomical localization and estimated SN depth more efficiently. After pathological examination, 9.9% of the SN excised (138 of 1398 SNs) showed metastases. The first neck level (NL) containing SN+ was NL I in 28.6%, NL IIa in 44.8%, NL IIb in 2.8%, NL III in 17.1%, and NL IV in 6.7% of positive patients. Approximately 96% of positive SNs were localized in the first and second lymphatic basin visualized using lymphoscintigraphy. After neck dissection, the SN+ was the only lymph node containing metastasis in approximately 80% of patients. Conclusions: Best results were observed using a dynamic scan in combination with SPECT/CT. A shorter interval between tracer injection, imaging, and surgery resulted in a lower false-negative rate. At least 2 NLs have to be harvested, as this may increase the detection of lymphatic metastases.
Sentinel node in oral cancer: The nuclear medicine aspects. A survey from the sentinel European node trial / Tartaglione, Girolamo; Stoeckli, Sandro J.; De Bree, Remco; Schilling, Clare; Flach, Geke B.; Bakholdt, Vivi; Sorensen, Jens Ahm; Bilde, Anders; Von Buchwald, Christian; Lawson, Georges; Dequanter, Didier; Villarreal, Pedro M.; Forcelledo, Manuel Florentino Fresno; Amezaga, Julio Alvarez; Moreira, Augusto; Poli, Tito; Grandi, Cesare; Vigili, Maurizio Giovanni; O'Doherty, Michael; Donner, Davide; Bloemena, Elisabeth; Rahimi, Siavash; Gurney, Benjamin; Haerle, Stephan K.; Broglie, Martina A.; Huber, Gerhard F.; Krogdah, Annelise L.; Sebbesen, Lars R.; Odell, Edward; Gutierrez, Luis Manuel Junquera; Barbier, Luis; Santamaria-Zuazua, Joseba; Jacome, Manuel; Nollevaux, Marie-Cecile; Bragantini, Emma; Lothaire, Philippe; Silini, Enrico M.; Sesenna, Enrico; Dolivet, Giles; Mastronicola, Romina; Leroux, Agnes; Sassoon, Isabel; Sloan, Philip; Colletti, Patrick M.; Rubello, Domenico; Mcgurk, Mark. - In: CLINICAL NUCLEAR MEDICINE. - ISSN 0363-9762. - 41:7(2016), pp. 534-542. [10.1097/RLU.0000000000001241]
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