Intraoperative radiolymphoscintigraphy for detection of occult nodal metastasis in patients with head and neck squamous cell carcinoma.
OBJECTIVE
We sought to determine the feasibility and utility of intraoperative radiolymphoscintigraphy as a screening procedure for the detection of occult metastatic disease in selected cases of head and neck squamous cell carcinoma (HNSCC).


METHODS
Patients with accessible primary HNSCC and no evidence of metastatic disease who were already undergoing planned surgical resection of the primary tumor and elective neck dissection met the inclusion criteria. Before resection, a hand-held gamma probe was used to find the radiolabeled sentinel lymph node (SLN). The neck specimen was examined ex vivo by using the gamma probe; the SLN or SLNs were dissected free from the specimen and sent separately for histopathologic examination.


RESULTS
At least one SLN was identified in all patients enrolled thus far. Four patients had microscopic carcinoma found in the SLN. Two of these had cancer only in the SLN, and two had disease both in the SLN and the remaining specimen.


CONCLUSIONS
Intraoperative radiolymphoscintigraphy appears to be a feasible and promising procedure to aid the surgeon in more accurately detecting occult metastatic HNSCC.
Zitsch
R P
RP
University of Missouri Health Science Center, Columbia, USA.
Todd
D W
DW
Renner
G J
GJ
Singh
A
A
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery*; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D009333:Neck; D009959:Oropharyngeal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D011446:Prospective Studies; D011877:Radionuclide Imaging