Visualization of the sentinel node in early-stage oral cancer: limited value of late static lymphoscintigraphy
Visualization of the sentinel node in early-stage oral cancer: limited value of late static lymphoscintigraphy
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DOI：
10.1097/mnm.0b013e3283571089
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发表时间：
2012-10-01
影响因子：
1.5
通讯作者：
de Bree, Remco
中科院分区：
文献类型：
--
作者：
Heuveling, Derrek A.;Flach, Geke B.;de Bree, Remco
目的多种淋巴显像方法用于早期口腔癌前哨淋巴结（SN）的鉴别。本研究旨在评估进行额外的晚期淋巴显像的临床价值。方法回顾性分析60例早期（T1-T2, cN0）口腔癌患者行SN手术的早期（直接注射Tc-99m-Nanocoll后）和晚期（注射后2-4 h）影像学结果。晚期淋巴显像结果可分为：(a)未发现其他被认为是SNs的热点；(b)被认为是SNs的其他可见热点；(c)仅在后期成像时可见的热点。收获的SNs组织病理学结果与相应的热点相关。结果在所有患者（60例）中，淋巴显像能够显示一个被确定为SN的热点。在51/60（85%）的患者中，早期成像能够显示至少一个热点，而在9/60（15%）的患者中，大多数是口腔肿瘤，而不是活动舌和口底肿瘤，只有晚期成像能够显示热点。在14/51（27%）的患者中，晚期成像导致额外可见标记为SNs的热点，导致更广泛的手术。这些额外移除的SNs似乎没有临床相关性，因为在早期成像中识别的所有SNs都能正确预测颈部癌症是阳性还是阴性。结论本研究结果表明，只有在选定的病例中，才应进行额外的晚期淋巴显像检查。核医学通讯33:1065-1069 (C) 2012 Wolters Kluwer Health垂直bar Lippincott Williams & Wilkins。
Objective Various lymphoscintigraphic imaging protocols exist for sentinel node (SN) identification in early-stage oral cancer. This study aimed to evaluate the clinical value of performing additional late lymphoscintigraphic imaging.Methods We retrospectively analysed early (directly following injection of Tc-99m-Nanocoll) and late (2-4 h after injection) imaging results of 60 early-stage (T1-T2, cN0) oral cancer patients scheduled for SN procedure. Lymphoscintigraphic results of late imaging were categorized into: (a) no visualization of additional hotspots considered to be SNs; (b) additional hotspots visualized that are considered to be SNs and (c) hotspots visualized only during late imaging. Histopathological results of the harvested SNs were related to the corresponding hotspot.Results In all patients (n=60) lymphoscintigraphy was able to visualize a hotspot that was identified as an SN. In 51/60 (85%) patients, early imaging was able to visualize at least one hotspot, whereas in 9/60 (15%) patients, mostly with oral cavity tumours other than mobile tongue and floor-of-mouth tumours, only late imaging was able to visualize hotspots. In 14/51 (27%) patients, late imaging resulted in additionally visualized hotspots marked as SNs, resulting in a more extensive surgical procedure. These additionally removed SNs appeared to be of no clinical relevance, as all SNs identified during early imaging correctly predicted whether the neck was positive or negative for cancer.Conclusion Results of this study indicate that additional late lymphoscintigraphic imaging should be performed only in selected cases. Nucl Med Commun 33:1065-1069 (C) 2012 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.