Comparison of lymphoscintigraphy and single photon emission computed tomography with computed tomography (SPECT/CT) for sentinel lymph node detection in endometrial cancer

2020 ◽  
Vol 30 (5) ◽  
pp. 626-630
Author(s):  
Shinichi Togami ◽  
Toshihiko Kawamura ◽  
Shintaro Yanazume ◽  
Masaki Kamio ◽  
Hiroaki Kobayashi
Keyword(s):  
Computed Tomography ◽  
Endometrial Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Lymph Node Metastasis ◽  
Detection Rate ◽  
Single Photon ◽  
Photon Emission ◽  
Single Photon Emission ◽  
Node Metastasis

BackgroundEndometrial cancer is the most common gynecologic cancer, and lymph node metastasis is one of the most important prognostic factors. Increasing evidence shows that sentinel lymph node (SLN) mapping is an effective alternative to comprehensive lymphadenectomy. Single photon emission CT with computed tomography (SPECT/CT) is associated with a high SLN detection rate.ObjectiveTo compare the clinical efficacy of SPECT/CT with that of lymphoscintigraphy in detecting SLNs in patients with endometrial cancer.MethodsBetween May 2014 and October 2018, 151 patients with endometrial cancer were enrolled in this study at the Department of Obstetrics and Gynecology of the Kagoshima University Hospital. Inclusion criteria were patients with endometrial cancer, older than 18 years, and with pre-operative International Federation of Gynecology and Obstetrics (FIGO) staging of I and II. All patients underwent pre-operative CT, and patients with suspected peritoneal dissemination and lymph node metastasis were excluded from this study. Pelvic SLNs were detected by injection of tecnetium-99m-labeled phytate into the uterine cervix. The number and locations of SLNs detected using lymphoscintigraphy and SPECT/CT were evaluated. JMP software (version 14, SAS Institute Inc., Cary, North Carolina, USA) was used for statistical analysis.ResultsA total of 151 patients who underwent pre-operative lymphoscintigraphy and SPECT/CT were included in the study. The median age was 57 years (range 24–79), and the median body mass index was 24.3 kg/m2 (range 16–40). The final pathology was as follows: 135 (89%) endometrioid carcinoma, 11 (7%) serous carcinoma, one (1%) clear cell carcinoma, and four (3%) other histotypes. Based on SPECT/CT, 204 pelvic SLNs were detected. The bilateral pelvic SLN detection rate was better for SPECT/CT (43% (65/151)) than for lymphoscintigraphy (32% (48/151)) (p<0.0001). The overall pelvic SLN detection rate (at least one pelvic SLN detected) was also better with SPECT/CT (77% (16/151)) vs lymphoscintigraphy (68% (102/151)) (p<0.0001). The distribution of SLN locations detected using SPECT/CT was as follows: external iliac, 91 (45%); obturator, 61 (30%); common iliac, 28 (14%); internal iliac, 19 (9%); para-aortic, 2 (1%); parametrium, 2 (1%), and presacral, 1 (1%). The SLN detection rate using SPECT/CT was significantly worse in patients of advanced age (p<0.0001).DiscussionOverall and bilateral SLN detection rate was better with SPECT/CT than with lymphoscintigraphy in patients with stage I/II endometrial cancer.

Usefulness of technetium-99m methoxyisobutylisonitrile single-photon emission computed tomography and computed tomography in the evaluation of cervical lymph node metastasis

2005 ◽  
Vol 119 (11) ◽  
pp. 882-887 ◽  
Author(s):  
Byung-Joo Lee ◽  
Soo-Geun Wang ◽  
Eui-Kyung Goh ◽  
Jun-Young Kim ◽  
In-Ju Kim ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Cervical Lymph Node ◽  
Single Photon ◽  
Photon Emission ◽  
Cervical Lymph Node Metastasis ◽  
Emission Computed Tomography ◽  
Node Metastasis ◽  
Mibi Spect

The aim of this study was to compare the effectiveness of technetium-99m methoxyisobutylisonitrile (99mTc-MIBI) single-photon emission computed tomography (SPECT) and computed tomography (CT) in evaluating cervical lymph node metastasis of head and neck cancer. Histopathologic results of 166 cervical lymph node levels in 31 neck-dissected patients were compared with pre-operative CT and 99mTc-MIBI SPECT findings about cervical lymph node metastasis, retrospectively. Sensitivity, specificity and predictability of CT and 99mTc-MIBI SPECT were 68.2, 93.1 and 89.8 per cent and 59.1, 87.5 and 83.7 per cent, respectively. When analysing CT and99mTc-MIBI SPECT together, sensitivity and specificity were 86.4 and 99.3 per cent, respectively. The combined use of 99mTc-MIBI SPECT and CT could increase the accuracy of cervical lymph node metastases detection, compared with separate use of either 99mTc-MIBI SPECT or CT.

Prospective evaluation of sentinel node navigation surgery in Japanese patients with low-risk endometrial cancer—safety and occurrence of lymphedema

2021 ◽  
Author(s):  
Hitoshi Niikura ◽  
Asami Toki ◽  
Tomoyuki Nagai ◽  
Satoshi Okamoto ◽  
Shogo Shigeta ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Lymph Node Metastasis ◽  
Lower Extremity ◽  
Lymph Node Biopsy ◽  
Occurrence Rate ◽  
Node Metastasis ◽  
Node Biopsy

Abstract Objective The present study aimed to clarify the occurrence rate of lymphedema and prognosis in patients with endometrial cancer according to sentinel lymph node biopsy alone with intraoperative histopathological examination. Methods The study included 45 consecutive patients with endometrial cancer treated at Tohoku University Hospital between October 2014 and August 2017. All patients had endometrial carcinoma with endometrioid histology Grade 1 or Grade 2 confirmed by biopsy and stage I on magnetic resonance imaging and/or computed tomography at their preoperative evaluation. Sentinel lymph node detection was performed by radioisotope and dye. Patients who were diagnosed intraoperatively as negative for sentinel lymph node metastasis did not undergo further systematic pelvic lymphadenectomy. The occurrence rate of lymphedema and prognosis was evaluated. Results Bilateral sentinel lymph nodes were detected in 44 of 45 patients (97%). Forty-three patients underwent sentinel lymph node biopsy alone, and only two patients underwent systematic lymphadenectomy. Sentinel lymph node metastases were detected in one patient intraoperatively and two patients postoperatively as ITCs. No patients experienced recurrence. New symptomatic lower-extremity lymphedema was identified in one of 43 patients (2.3%) who underwent sentinel lymph node biopsy alone. Conclusion Sentinel lymph node biopsy alone with intraoperative histopathological diagnosis appears to be a safe and effective strategy to detect lymph node metastasis and to reduce the number of patients with lower-extremity lymphedema among patients with endometrial cancer.

scholarly journals Technetium-Radiolabeled Mannose-Functionalized Gold Nanoparticles as Nanoprobes for Sentinel Lymph Node Detection

Molecules ◽  
2020 ◽  
Vol 25 (8) ◽  
pp. 1982 ◽  
Author(s):  
Oscar J. Estudiante-Mariquez ◽  
Andrés Rodríguez-Galván ◽  
David Ramírez-Hernández ◽  
Flavio F. Contreras-Torres ◽  
Luis A. Medina
Keyword(s):  
Computed Tomography ◽  
Gold Nanoparticles ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Lymphatic Mapping ◽  
Single Photon ◽  
Photon Emission ◽  
Physicochemical Characterization ◽  
Emission Computed Tomography ◽  
Sentinel Lymph Node Detection

Gold nanoparticles (AuNPs) are considered valuable nanomaterials for the design of radiolabeled nanoprobes for single-photon emission computed tomography (SPECT) imaging. Radiolabeled and functionalized AuNPs could improve lymphatic mapping by enhancing the radioactive signaling of individual particles in the sentinel node. In this study, an alternative method for functionalizing commercial AuNps with mannose is described. The chemical derivatization and biofunctionalization of AuNPs were performed with lipoic acid and mannose, respectively. Several levels of mannose were tested; the thiolate hydrazinonicotinamide-glycine-glycine-cysteine (HYNIC) molecule was also used for 99mTc radiolabeling. Physicochemical characterization of this system includes U-V spectroscopy, dynamic light scattering, Fourier-transform infrared spectroscopy, and transmission electron microscopy. The most stable nanoprobe, in terms of the aggregation, radiolabeling efficiency, and purity, was tested in a sentinel lymph node model in a rat by microSPECT/computed tomography (CT) imaging. The SPECT images revealed that 99mTc-radiolabeled AuNPs functionalized with mannose can track and accumulate in lymph nodes in a similar way to the commercial 99mTc-Sulfur colloid, commonly used in clinical practice for sentinel lymph node detection. These promising results support the idea that 99mTc-AuNPs-mannose could be used as a SPECT contrast agent for lymphatic mapping.

Utility of single-photon emission tomography/computed tomography for sentinel lymph node localization in breast cancer patients

2017 ◽  
Vol 38 (6) ◽  
pp. 493-499 ◽  
Author(s):  
Agnieszka Giżewska ◽  
Ewa Witkowska-Patena ◽  
Sebastian Osiecki ◽  
Andrzej Mazurek ◽  
Zofia Stembrowicz-Nowakowska ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Computed Tomography ◽  
Lymph Node ◽  
Single Photon ◽  
Photon Emission ◽  
Emission Tomography ◽  
Breast Cancer Patients ◽  
Single Photon Emission ◽  
Node Localization ◽  
Photon Emission Tomography

Is There a Place for Sentinel Technique in Treatment of Vaginal Cancer?: Feasibility, Clinical Experience, and Results

2013 ◽  
Vol 23 (9) ◽  
pp. 1692-1698 ◽  
Author(s):  
Hermann Hertel ◽  
Philipp Soergel ◽  
Johanna Muecke ◽  
Michael Schneider ◽  
Frank Papendorf ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Detection Rate ◽  
Single Photon ◽  
Photon Emission ◽  
Vaginal Cancer ◽  
Emission Computed Tomography ◽  
Single Photon Emission ◽  
Emission Computed ◽  
Single Photon Emission Computed ◽  
Photon Emission Computed Tomography

ObjectiveTo evaluate the clinical feasibility of sentinel lymph node (SLN) technique and the role of single-photon emission computed tomography with CT (SPECT/CT) compared to lymphoscintigraphy for detection of SLN in vaginal cancer.MethodsThe study was performed in a prospective, unicentric setting. Patients with vaginal carcinoma were scheduled for surgery and SLN labeling by peritumoral injection of 10-MBq technetium Tc 99m nanocolloid and patent blue. After 30 minutes, lymphoscintigraphy and SPECT/CT were carried out. We evaluated the number of SLNs in lymphoscintigraphy, SPECT/CT, and intraoperative histology of SLN and non-SLN as well as the impact of these results to therapeutic approach.ResultsBetween January 2009 and December 2012, the SLN technique was used for 7 of 11 patients treated due to vaginal cancer. Detection rate was 100% (7/7). Lymphoscintigraphy and SPECT/CT showed at least one SLN in each patient. Lymphoscintigraphy detected 2.6 SLNs (range, 2–4 SLNs) per patient compared to 4.3 SLNs (range, 2–8 SLNs) in SPECT/CT (P= 0.053). Sentinel lymph nodes were detected in all patients during surgery with a mean number of 4.3 (range, 1–5). Pelvic SLNs were detected in all 6 patients with infiltration of middle or proximal vaginal third (100%). If the distal vaginal third was additional (3/7 patients) or exclusively (1/7 patients) infiltrated, the inguinal SLN detection rate was 33% and 100%, respectively. All patients with nodal metastases had at least one SLN positive for tumor. There were no false negatives. In 2 (29%) of 7 patients, treatment approach was modified owing to affected SLN.ConclusionThe SLN technique was favorably used in vaginal cancer in this series. It assists in identifying an inguinal and/or pelvic lymphatic drainage. When performed accurately (technetium Tc 99m nanocolloid, lymphoscintigraphy and/or SPECT/CT, blue dye), this technique predicts regional nodal status. This allows tumor stage–adjusted therapy. Single photon emission computed tomography/CT improves preoperative planning and facilitates detection, thus enhancing the clinical value of the SLN technique and improving the oncologic safety of surgery.

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