Comparison of 99mTc-MIBI scintigraphy and sentinel node biopsy in the detection of occult lymph node metastases from cutaneous melanoma.
99mTc-MIBI scintigraphy has been proposed as a technique that can diagnose clinically undetectable melanoma metastases. The aim of the study was to compare the sensitivity of 99mTc-MIBI with that of sentinel node biopsy (SNB) in the detection of nodal disease. Twenty-eight patients with melanoma >1.0 mm thick were enrolled. Patients underwent 99mTc-MIBI scintigraphy and a preoperative lymphoscintigraphy followed by SNB. Sentinel nodes were identified in 27/28 patients. Twelve patients had an involved sentinel node (SN), being 99mTc-MIBI positive in 10. No patient with negative SNB developed regional recurrence during the study. 99mTc-MIBI had a sensitivity of 83% and a specificity of 93%. We conclude that SNB remains the procedure of choice for detecting subclinical lymph node involvement from melanoma. 99mTc-MIBI could have an alternative role in lymph node staging of patients who are not good candidates of SNB, that needs to be tested in appropriate trials.
Alonso
Omar
O
Department of Nuclear Medicine, University of Uruguay, Av Italia s/n, Montevideo 11600, Uruguay. oalonso@hc.edu.uy
Martínez
Miguel
M
Delgado
Lucía
L
Lago
Graciela
G
Juri
Cecilia
C
Borges
Alejandra Larre
AL
Lopes de Amorim
María C
MC
de Boni
Daniela
D
Espasandín
José
J
Priario
Julio
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D017256:Technetium Tc 99m Sestamibi
D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi