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• W3177031934 abstract "Purpose: To evaluate and compare the diagnostic efficacy of the planar lymphoscintigraphy, SPECT (SPECT/CT) and intraoperative detection with handheld gamma-probe in the identification of the sentinel lymph node (SLN) among patients with melanoma. Materia l and methods : 324 patients with cutaneous melanoma who underwent treatment at N.N. Blokhin National Medical Research Center of Oncology between 2018 and 2020, were included in this study. For SLN identification lymphoscintigraphy ( n = 324) and SPECT (SPECT/CT) ( n = 259) images were obtained preoperatively after injection of 99mTc-labeled colloid particles. Lymphatic mapping was implemented with permanent skin marker designating the anatomical landmarks of sentinel node’s location. Additionally, SLN localization was identified by handheld gamma-probe ( n = 294). The status of the remote sentinel lymph node was determined by a histological assessment considered as the gold standard. Results: SPECT (SPECT/CT) provided additional information in 67 patients (25.8 %) with planar lymphoscintigraphy: in 45 cases it revealed more SLN within the same regional lymphatic drainage basin, and in 22 (8.5 %) showed additional (lymphatic drainage) basin or unusual drainage pattern. In 10 patients (3.9 %) SPECT/CT revealed SLN not visible in the planar lymphoscintigraphy (false-negative). False SLN identification results were detected mostly in patients with head and neck melanoma. The overall rate of surgical approach modification in the total group is 10.4 % (10 patients among 259), the additional information provided by SPECT (SPECT/CT) impacted management and surgical planning in 11 (37.9 %) of 29 patients of head and neck melanoma group. Analysis of planar lymphoscintigraphic imaging, tomographic imaging (SPECT and SPECT/CT), and intraoperative detection revealed a sensitivity and PPV of 95.6, 100, 100 % and 98.7, 97.7, 96.9 %, respectively. Conclusion : Radionuclide imaging techniques are reliable and account for the current need for navigating the surgical access when performing a sentinel lymph node biopsy. SPECT and SPECT/CT visualizes more sentinel nodes than conventional images, reduces false-negative rate and improved anatomical location of sentinel nodes. The diagnostic effi of SPECT and SPECT/CT is superior to the static lymphoscintigraphy in sentinel lymph node detection due to the better sensitivity (100 and 95.6 %, respectively) with a similar positive predictive value PPV (97.7 and 98.7 %, respectively). These advantages may lead to a surgical adjustment in a considerable number of patients, especially in the head and neck melanoma." @default.
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• W3177031934 date "2021-06-22" @default.
• W3177031934 modified "2023-10-16" @default.
• W3177031934 title "The Efficacy of Radionuclide Imaging Techniques at Sentinel Node Identification in Patients with Cutaneous Melanoma" @default.
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• W3177031934 doi "https://doi.org/10.37174/2587-7593-2021-4-2-37-50" @default.
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