[Sentinel lymph node detection by preoperative lymphoscintigraphy and intraoperative gamma probe guidance in malignant melanoma].
OBJECTIVE
The purpose of this work was to prove the clinical significance of nuclear medical procedures in pre- and intraoperative detection of the SLN.


METHODS
In the past 4 years, we did preoperative lymphoscintigraphy in 214 patients (pts.). Intraoperative localisation of the SLN with a hand-held gamma probe followed in 150 pts.


RESULTS
In 214 pts. 247 lymphatic draining regions were found by preoperative scintigraphy. In 3 pts. with melanoma of the cheek no lymphatics/lymph nodes could be detected. 14 pts. showed interval lymph nodes. In 150 pts. gamma probe guided SLNE was done. In 2 pts. with supraclavicular primary tumor 4 SLN had been defined by preoperative scintigraphy but only 2 could be found intraoperatively. In all other cases (98.7%) the sentinel node was detected correctly by the gamma probe and then removed. In 19 of 150 pts. (12.7%) metastases were detected in the pathologic specimen. The incidence of lymph node metastases showed a continuous increase from 0% at tumor stage pT1 to 44% at stage pT4.


CONCLUSIONS
SLNE is an accurate method to determine nodal involvement in melanoma and minimizes operative invasiveness in melanoma surgery.
Klinik für Nuklearmedizin, Zentralklinikum Augsburg, Deutschland.
H
H
Vogt
D
D
Bachter
H K
HK
Büchels
H
H
Wengenmair
R
R
Dorn
P
P
Heidenreich
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015902:Gamma Cameras; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging*; D008297:Male; D008545:Melanoma / Q000000981:diagnostic imaging* / Q000601:surgery*; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D011877:Radionuclide Imaging; D012878:Skin Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*
Nachweis des Sentinel-Lymphknotens mittels präoperativer Lymphszintigraphie und intraoperativer Gammasondenmessung bei malignem Melanom.