title: SPECT/CT in sentinel node imaging.
abstract: Sentinel node lymphoscintigraphy and biopsy has become standard practice for lymphatic staging in early-stage breast cancer and melanoma. More recently, sentinel node lymphoscintigraphy has also been used in head and neck squamous cell cancers and other solid tumours. Single photon emission computed tomography/computed tomography (SPECT/CT) is a new tool and this article reviews its potential application in sentinel node imaging. SPECT/CT provides complementary functional and anatomical information and has been shown to be superior to planar imaging in a number of indications. The advantages include more accurate anatomical localization, identification of false positives (due to contamination or spillover from the injection site), reduction in the number of false negatives (visualization of nodes not seen on planar imaging) and alteration of the surgical approach. We thus believe that sentinel lymph node SPECT/CT can provide valuable information before sentinel lymph node biopsy and advocate its use in a range of tumours such as truncal and head and neck melanomas.
authors.affiliation: Department of Nuclear Medicine, Royal Free Hospital NHS, Trust, London, UK.
authors.forename: Thomas
authors.initials: T
authors.lastname: Wagner
authors.forename: John
authors.initials: J
authors.lastname: Buscombe
authors.forename: Gopinath
authors.initials: G
authors.lastname: Gnanasegaran
authors.forename: Shaunak
authors.initials: S
authors.lastname: Navalkissoor
mesh_terms: D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000175:diagnosis; D061305:Lymphoscintigraphy / Q000379:methods*; D008297:Male; D009369:Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology*; D015203:Reproducibility of Results; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*