title: Detection of Sentinel Lymph Nodes in Gynecologic Tumours by Planar Scintigraphy and SPECT/CT.
abstract: OBJECTIVE
  Assess the role of planar lymphoscintigraphy and fusion imaging of SPECT/CT in sentinel lymph node (SLN) detection in patients with gynecologic tumours.
  
  
  METHODS
  Planar scintigraphy and hybrid modality SPECT/CT were performed in 64 consecutive women with gynecologic tumours (mean age 53.6 with range 30-77 years): 36 pts with cervical cancer (Group A), 21 pts with endometrial cancer (Group B), 7 pts with vulvar carcinoma (Group C). Planar and SPECT/CT images were interpreted separately by two nuclear medicine physicians. Efficacy of these two techniques to image SLN were compared.
  
  
  RESULTS
  Planar scintigraphy did not image SLN in 7 patients (10.9%), SPECT/CT was negative in 4 patients (6.3%). In 35 (54.7%) patients the number of SLNs captured on SPECT/CT was higher than on planar imaging. Differences in detection of SLN between planar and SPECT/CT imaging in the group of all 64 patients are statistically significant (p<0.05). Three foci of uptake (1.7% from totally visible 177 foci on planar images) in 2 patients interpreted on planar images as hot LNs were found to be false positive non-nodal sites of uptake when further assessed on SPECT/CT. SPECT/CT showed the exact anatomical location of all visualised sentinel nodes.
  
  
  CONCLUSIONS
  In some patients with gynecologic cancers SPECT/CT improves detection of sentinel lymph nodes. It can image nodes not visible on planar scintigrams, exclude false positive uptake and exactly localise pelvic and paraaortal SLNs. It improves anatomic localization of SLNs.
  
  
  BACKGROUND
  None declared.
authors.affiliation: University Hospital, Clinic of Nuclear Medicine, Ostrava, Poruba, Czech Republic ; University of Ostrava, Faculty of Medicine, Ostrava, Czech Republic.
authors.forename: Otakar
authors.initials: O
authors.lastname: Kraft
authors.forename: Martin
authors.initials: M
authors.lastname: Havel
keywords: SPECT; Sentinel lymph node biopsy; X-Ray computed; gamma camera Imaging; gynecologic neoplasms; scintigraphy; tomography