Intraoperative 3-D imaging improves sentinel lymph node biopsy in oral cancer
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- 作者：Christina Bluemel (1)
Ken Herrmann (1)
Alexander Kübler (2)
Andreas K. Buck (1)
Eva Geissinger (3)
Vanessa Wild (3)
Stefan Hartmann (2)
Constantin Lapa (1)
Christian Linz (2)
Urs Müller-Richter (2) - 关键词：Sentinel lymph node biopsy ; Freehand SPECT ; fhSPECT ; Oral cancer ; Elective neck dissection ; 3D
- 刊名：European Journal of Nuclear Medicine and Molecular Imaging
- 出版年：2014
- 出版时间：December 2014
- 年：2014
- 卷：41
- 期：12
- 页码：2257-2264
- 全文大小：625 KB
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16 - 作者单位：Christina Bluemel (1)
Ken Herrmann (1)
Alexander Kübler (2)
Andreas K. Buck (1)
Eva Geissinger (3)
Vanessa Wild (3)
Stefan Hartmann (2)
Constantin Lapa (1)
Christian Linz (2)
Urs Müller-Richter (2)
1. Department of Nuclear Medicine, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany
2. Department of Oral and Maxillofacial Plastic Surgery, University Hospital Würzburg, Würzburg, Germany
3. Institute of Pathology, University Würzburg, Würzburg, Germany - ISSN：1619-7089
文摘
Purpose The aim of this study was to prospectively evaluate the feasibility and potential advantages of freehand single-photon emission computed tomography (fhSPECT) compared with conventional intraoperative localization techniques for sentinel lymph node biopsy (SLNB) in oral cancer. Methods Between November 2012 and February 2014, 23 consecutive patients with clinical T1/T2 oral squamous cell carcinoma and a cN0 neck were recruited. All patients underwent SLNB followed by elective neck dissection (END). All patients received preoperative lymphoscintigraphy. To detect the SLNs intraoperatively, fhSPECT with a combination of conventional acoustic SLN localization and 3-D visual navigation was used. Results All but one of the SLNs detected by preoperative imaging were successfully mapped intraoperatively by fhSPECT (detection rate 98?%), including those in six patients with a tumour in the floor of the mouth. A histopathology analysis revealed positive SLNs in 22?% of patients. No further metastases were found in LNs resected during END. SLNB correctly predicted the final LN stage in all patients (accuracy 100?%). Additional radioactive LNs, which were not present on preoperative lymphoscintigraphy, were observed in three patients. Conclusion FhSPECT is a feasible technology that allows the accurate identification of SLNs in oral cancer. FhSPECT overcomes the shine-through phenomenon, one of the most important limitations of SLNB, thereby confirming the importance of SLNB in patients with cN0 oral cancer.