The added value of SPECT-CT for the identification of sentinel lymph nodes in early stage oral cancer.
The added value of SPECT-CT for the identification of sentinel lymph nodes in early stage oral cancer.
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DOI：
10.1007/s00259-017-3613-8
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发表时间：
2017-06
影响因子：
9.1
通讯作者：
de Bree R
中科院分区：
文献类型：
--
作者：
den Toom IJ;van Schie A;van Weert S;Karagozoglu KH;Bloemena E;Hoekstra OS;de Bree R
目的：评价单光子发射计算机断层扫描(SPECT-CT)在早期(T1-T2)口腔癌患者和临床阴性颈部(CN0)患者中识别前哨淋巴结(SLN)的作用。除了平面淋巴核素扫描外，66例临床阴性的早期口腔癌患者还接受了SPECT-CT检查。由核内科医生、外科医生和研究人员组成的团队回顾分析了SPECT-CT在平面图像中增加的SLN的数量、SLN的更精确定位以及解剖信息的重要性。两种检查方法的联合识别率为98%(65/66)。SPECT-CT发现14例患者(22%)另外15个SLN。在这些新增的SLN中，有2/15(13%)发现了唯一的转移，导致3%(2/65)的提高率。在至少有一个SLN阳性的患者中，有20%的患者由于增加了SPECT-CT而仅检出了SLN阳性。有2例患者(3%)认为SPECT-CT提供了重要的解剖信息。在65例患者中，5/65(8%)的患者在平面淋巴显像上首次获得SLN，当加入SPECT-CT时，被评为非SLN。在这个队列中，有四个假阴性的SLN活检术。在早期口腔癌前哨淋巴结活检术中，SPECT-CT结合平面淋巴显像可发现更多(阳性)的SLN和更好的定位。
To assess the role of single-photon emission computed tomography with computed tomography (SPECT-CT) for the identification of sentinel lymph nodes (SLNs) in patients with early stage (T1–T2) oral cancer and a clinically negative neck (cN0). In addition to planar lymphoscintigraphy, SPECT-CT was performed in 66 consecutive patients with early stage oral cancer and a clinically negative neck. The addition of SPECT-CT to planar images was retrospectively analyzed for the number of additional SLNs, more precise localization of SLNs, and importance of anatomical information by a team consisting of a nuclear physician, surgeon, and investigator. Identification rate for both imaging modalities combined was 98% (65/66). SPECT-CT identified 15 additional SLNs in 14 patients (22%). In 2/15 (13%) of these additional SLNs, the only metastasis was found, resulting in an upstaging rate of 3% (2/65). In 20% of the patients with at least one positive SLN, the only positive SLN was detected due to the addition of SPECT-CT. SPECT-CT was considered to add important anatomical information in two patients (3%). In 5/65 (8%) of the patients initially scored SLNs on planar lymphoscintigrams were scored as non-SLNs when SPECT-CT was added. There were four false-negative SLN biopsy procedures in this cohort. The addition of SPECT-CT to planar lymphoscintigraphy is recommended for the identification of more (positive) SLNs and better topographical orientation for surgery in sentinel lymph node biopsy for early stage oral cancer.