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Chandra P, Dhake S, Shah S, et al. Comparison of SPECT/CT and Planar Lympho-scintigraphy in Sentinel Node Biopsies of Oral Cavity Squamous Cell Carcinomas. Indian J Nucl Med. 2017;32(2):98-102doi: 10.4103/0972-3919.202244.
Chandra, P., Dhake, S., Shah, S., Agrawal, A., Purandare, N., & Rangarajan, V. (2017). Comparison of SPECT/CT and Planar Lympho-scintigraphy in Sentinel Node Biopsies of Oral Cavity Squamous Cell Carcinomas. Indian journal of nuclear medicine : IJNM : the official journal of the Society of Nuclear Medicine, India, 32(2), 98-102. https://doi.org/10.4103/0972-3919.202244
Chandra, Piyush, et al. "Comparison of SPECT/CT and Planar Lympho-scintigraphy in Sentinel Node Biopsies of Oral Cavity Squamous Cell Carcinomas." Indian journal of nuclear medicine : IJNM : the official journal of the Society of Nuclear Medicine, India vol. 32,2 (2017): 98-102. doi: https://doi.org/10.4103/0972-3919.202244
Chandra P, Dhake S, Shah S, Agrawal A, Purandare N, Rangarajan V. Comparison of SPECT/CT and Planar Lympho-scintigraphy in Sentinel Node Biopsies of Oral Cavity Squamous Cell Carcinomas. Indian J Nucl Med. 2017 Apr-Jun;32(2):98-102. doi: 10.4103/0972-3919.202244. PMID: 28533636; PMCID: PMC5439202.
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Indian J Nucl Med. 2017 Apr-Jun;32(2):98-102. doi: 10.4103/0972-3919.202244.

Comparison of SPECT/CT and Planar Lympho-scintigraphy in Sentinel Node Biopsies of Oral Cavity Squamous Cell Carcinomas.

Indian journal of nuclear medicine : IJNM : the official journal of the Society of Nuclear Medicine, India

Piyush Chandra, Sanket Dhake, Sneha Shah, Archi Agrawal, Nilendu Purandare, Venkatesh Rangarajan

Affiliations

  1. Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, E. Borges Road, Parel, Mumbai, India.

PMID: 28533636 PMCID: PMC5439202 DOI: 10.4103/0972-3919.202244

Abstract

INTRODUCTION: Evidence supporting the use of Sentinel node biopsy (SNB) for nodal staging of early oral squamous cell carcinomas (OSCC) appears to be very promising. Pre-operative lymphatic mapping using planar lymphoscinitigraphy (PL) with or without SPECT/CT in the SNB procedure is useful in sentinel node localization and for planning appropriate surgery. Recently, a large prospective multi-centric study evaluating SNB in cutaneous melanoma, breast and pelvic malignancies, demonstrated that adding SPECT to PL leads to surgical adjustments in a considerable number of patients. Our aim of this study was to evaluate the incremental value of additional SPECT/CT over PL alone in SNB for OSCC.

MATERIALS AND METHODS: This was a retrospective analysis of 44 patients (40- tongue, 4- buccal mucosa) with T1-T2, clinically N0 oral cavity SCC who underwent sentinel node biopsy procedure. PL and SPECT lymphoscinitigraphy images were compared for pre-operative mapping of sentinel nodes.

RESULTS: Using a handheld gamma probe, a total of 179 sentinel nodes were harvested, with a mean of 4.06 per patient. PL revealed 75 hotspots with a mean of 1.70 per patient, and SPECT/CT revealed 92 hotspots with a mean of 2.09 per patient. Additional hotpots were identified in 14 patients on SPECT/CT, which included 4 patients, where PL did not detect any sentinel nodes.

CONCLUSION: Pre-operative SPECT/CT in addition to planar lympho-scinitigraphy in sentinel node biopsies of oral cavity SCC detects more number of sentinel nodes compared to planar imaging alone. The higher sensitivity of SPECT combined with better anatomical localization using diagnostic CT may further improve the precision of SNB procedure.

Keywords: CT; OSCC; Oral squamous cell carcinoma; SNB; SPECT; SPECT/CT lymphoscinitigraphy; planar; sentinel node biopsy

Conflict of interest statement

There are no conflicts of interest

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