Document Detail

Integration of Hybrid Single-Photon Emission Computed Tomography/Computed Tomography in the Preoperative Assessment of Sentinel Node in Patients With Cervical and Endometrial Cancer: Our Experience and Literature Review.
MedLine Citation:
PMID:  22617479     Owner:  NLM     Status:  Publisher    
OBJECTIVE: The purpose of this study was to assess whether there is an additional value of single-photon emission computed tomography/computed tomography (SPECT/CT) over lymphoscintigraphy (LSG) alone for sentinel node (SN) mapping in endometrial and cervical cancer. METHODS: Ten women with clinically cervical stage IA2 to stage IB1 and 25 women with stage I endometrial cancer underwent preoperative LSG for SN mapping. Technetium Tc 99m albumin nanocolloid was injected submucosally at 4 points of the cervix. Patients underwent SPECT/CT emission-transmission study at least 3 hours after standard planar images. Methylene blue was injected into the cervix just before surgery under general anesthesia. All patients underwent hysterectomy, bilateral salpingo-oophorectomy, and radical regional nodal dissection. Hot and/or blue nodes were labeled as SNs. RESULTS: Conventional planar imaging detection rate was 50%, whereas the detection rate of at least one SN with SPECT/CT was 91% (32/35); bilateral detection was achieved in 7 (39%) of 18 women in planar and in 17 (53%) of 32 women in SPECT/CT imaging, respectively. Bilateral detection was achieved in 57% of women (20/35). Sentinel nodes were located in external and internal iliac nodes (66%), obturator nodes (5%), internal iliac nodes (11%), common iliac nodes (9%), and presacral nodes (9%). Lymph node involvement was identified in 5 patients (14%). Sentinel node correctly predicted lymph node involvement in all node-positive patients. Sentinel node sensitivity and negative predictive value of SPECT/CT were 100%. CONCLUSIONS: Single photon emission computed tomography/computed tomography seems to improve intraoperative identification of SNs and provides additional useful information about the anatomic location of SNs compared to planar LSG in cervical and endometrial cancer.
Alessandro Buda; Federica Elisei; Maurizio Arosio; Carlotta Dolci; Mauro Signorelli; Patrizia Perego; Daniela Giuliani; Dario Recalcati; Giorgio Cattoretti; Rodolfo Milani; Cristina Messa
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-5-20
Journal Detail:
Title:  International journal of gynecological cancer : official journal of the International Gynecological Cancer Society     Volume:  -     ISSN:  1525-1438     ISO Abbreviation:  -     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-5-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9111626     Medline TA:  Int J Gynecol Cancer     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Departments of *Obstetrics and Gynecology, †Nuclear Medicine, Bioimaging Molecular Centre, and ‡Pathology, University of Milano-Bicocca, San Gerardo Hospital, Monza; and §Fondazione Tecnomed, University of Milano-Bicocca, IBFM-CNR, Monza, Italy.
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