• 作者：G. Qu&eacute ; mard-Barrali^a ; ^{gwen0la@yahoo.fr} ; F. Floret^b ; B. Kantelip^c ; Z. Boulahdour^d ; H. Boulahdour^a
• 关键词：Cancer ; Cavit&eacute ; orale ; Ganglion sentinelle ; Lymphoscintigraphie ; TEMP-TDM
• 刊名：M&eacute ; decine Nucl&eacute ; aire
• 出版年：2012
• 期刊代码：219_09281258
• 类别：med
• 出版时间：May, 2012
• 卷：36
• 期：5
• 页码：257-267
• 文件大小：495 K

Objectives

We report a prospective evaluation of the sentinel lymph node identification and biopsy in oral cavity cancer in order to assess the additional value of the single photon emission computed tomography-computed tomography (SPECT-CT).

Patients and methods

Thirteen patients with T1 or T2 clinical N0 oral cavity cancer were prospectively included. They first underwent a lymphoscintigraphy with planar imaging. A SPECT-CT was performed secondly. Finally, excised sentinel lymph nodes were screened according to a specific histological processing.

Results

The scintigraphic detection rate was 100%, both with planar and SPECT/CT imaging. Dynamic and early images were predictive of the lymph node drainage territory for 11 patients (85%). An impact of SPECT/CT in 83%of cases was achieved with additional quantitative information in 58%cases and qualitative information in 58%cases. A greater sensibility was also pointed out for level 1 sentinel lymph nodes, close to the injection site. Once, an occult metastasis was revealed by the histological analysis of the sentinel lymph nodes.

Conclusion

Radioisotopic sentinel lymph node technique for oral cavity cancers allowed determining neck node status for all patients. Ninety-two percent of them were spared from a radical neck dissection or radiotherapy. Preoperative detection of sentinel lymph node is optimised in most cases by hybrid imaging procedure. Anatomical data provided by hybrid imaging are useful for surgery.