Usefulness of lymphoscintigraphy and intraoperative gamma probe detection in the identification of sentinel nodes in cervical cancer.
The aim of our study was to prospectively assess the clinical usefulness of sentinel lymphoscintigraphy and intraoperative gamma probe detection in identifying sentinel nodes (SNs) in patients with early cervical carcinoma. Between 6 and 24 h before radical hysterectomy, lymphoscintigrams were obtained following peritumoural injection of technetium-99m antimony sulphur colloid in 26 patients (mean age 45 years, range 32-71 years) with cervical cancer (FIGO I-IIa). Scanning for radioactive nodes was performed using a hand-held collimated gamma-detecting probe in the initial stages of the main operation, during and before exposure of the retroperitoneal spaces. After separation and removal of radioactive, blue nodes, specimens were submitted for pathological evaluation. SNs were successfully localised using a combination of lymphoscintigraphy and intraoperative gamma probe detection in all 26 cases. However, in two of the 26 cases, SNs were only localisable using the gamma-detecting probe. A histologically positive SN was found in only one case. It is concluded that, in cervical cancer, lymphoscintigraphy and SN biopsy using a gamma-detecting probe are easy and reliable methods for the detection of SNs and are of value in defining the necessity and extent of node dissection.
Chung
Yong An
YA
Department of Nuclear Medicine, Catholic University of Korea Medical College, #505 Banpo-Dong, 137-040, Seocho-Gu, Seoul, Korea.
Kim
Sung Hoon
SH
Sohn
Hyung Sun
HS
Chung
Soo Kyo
SK
Rhim
Chae Chun
CC
Namkoong
Sung Eun
SE
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008207:Lymphatic Metastasis; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D011877:Radionuclide Imaging / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D014055:Tomography, Emission-Computed; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*