Localisation of sentinel lymph nodes in patients with melanomas by planar lymphoscintigraphic and hybrid SPECT/CT imaging

BACKGROUND: The aim of the study was to assess the role ofplanar lymphoscintigraphy and fusion imaging of SPECT/CT in sentinellymph node (SLN) identification in patients with melanomas.MATERIAL AND METHODS: Planar and hybrid SPECT/low-doseCT lymphoscintigraphy were performed in 113 consecutive patientswith melanomas (59 men, 54 women, mean age 57.6 withrange 11–87 years, BMI 29.4 ± 12.5). The radiopharmaceuticalwas injected around the tumour (Group A, 59 patients), oraround the scar (Group B, 54 patients). Localisation of melanomas:head and neck 4, trunk 55, upper extremities 28, lowerextremities 26. Planar and SPECT/CT images were interpretedseparately by two nuclear medicine physicians. Abilities of thesetwo techniques to image SLN were compared.RESULTS: SLNs were detected on lymphoscintigraphy comprisingplanar and SPECT-CT images in 108 (95.6%) study patients;there was failure to detect SLNs in the remaining 5 (4.4%) patients. Planar images identified 253 SLNs in 100 (88.5%) pts,with a mean of 2.2 ± 1.7 (range 0–9 nodes) per patient. In theremaining 13 (11.5%) patients no SLNs were detected on planarimages. On SPECT-CT images, 334 hot nodes were detectedin 107 (94.7%) patients with a mean of 3.0 ± 2.1 (range 0–9)nodes per patient. In the remaining 6 (5.3%) patients, SPECT-CTwas negative.SPECT/CT visualised lymphatic drainage in 8 (7.1%) patientswith non-visualisation on planar imaging.CONCLUSIONS: In some patients with melanomas SPECT/CTimproves detection of sentinel lymph nodes. It can image nodesnot visible on planar scintigrams, exclude false positive uptakeand exactly localize SLNs.BACKGROUND: The aim of the study was to assess the role ofplanar lymphoscintigraphy and fusion imaging of SPECT/CT in sentinellymph node (SLN) identification in patients with melanomas.MATERIAL AND METHODS: Planar and hybrid SPECT/low-doseCT lymphoscintigraphy were performed in 113 consecutive patientswith melanomas (59 men, 54 women, mean age 57.6 withrange 11–87 years, BMI 29.4 ± 12.5). The radiopharmaceuticalwas injected around the tumour (Group A, 59 patients), oraround the scar (Group B, 54 patients). Localisation of melanomas:head and neck 4, trunk 55, upper extremities 28, lowerextremities 26. Planar and SPECT/CT images were interpretedseparately by two nuclear medicine physicians. Abilities of thesetwo techniques to image SLN were compared.RESULTS: SLNs were detected on lymphoscintigraphy comprisingplanar and SPECT-CT images in 108 (95.6%) study patients;there was failure to detect SLNs in the remaining 5 (4.4%) patients. Planar images identified 253 SLNs in 100 (88.5%) pts,with a mean of 2.2 ± 1.7 (range 0–9 nodes) per patient. In theremaining 13 (11.5%) patients no SLNs were detected on planarimages. On SPECT-CT images, 334 hot nodes were detectedin 107 (94.7%) patients with a mean of 3.0 ± 2.1 (range 0–9)nodes per patient. In the remaining 6 (5.3%) patients, SPECT-CTwas negative.SPECT/CT visualised lymphatic drainage in 8 (7.1%) patientswith non-visualisation on planar imaging.CONCLUSIONS: In some patients with melanomas SPECT/CTimproves detection of sentinel lymph nodes. It can image nodesnot visible on planar scintigrams, exclude false positive uptakeand exactly localize SLNs