title: Freehand SPECT for sentinel lymph node detection in patients with head and neck cancer: first experiences.
abstract: CONCLUSIONS
  Feasibility of intraoperative 3D imaging with freehand (fh) SPECT for sentinel lymph node (SLN) biopsy in head and neck cancer (HNC) could be demonstrated. Controlled clinical studies are needed to evaluate its accuracy and impact on patient morbidity.
  
  
  OBJECTIVE
  The clinical N0 neck in HNC needs improvement in management to sufficiently detect occult neck disease but to spare patients from potential morbidity by elective neck dissection. The SLN concept has potential to accurately stage the neck with low morbidity.
  
  
  METHODS
  fhSPECT is a 3D tomographic imaging modality with a gamma probe system combined with an infrared optical tracking system. Five patients with HNC and clinical N0 neck were recruited. Scanning for SLN using fhSPECT was performed before excision and selective neck dissection and specimens were analyzed histopathologically.
  
  
  RESULTS
  Preoperatively, a total of nine SLNs were located in five patients with fhSPECT. SLNs in three patients were positive for metastatic disease; in two patients the SLNs were tumor-free. No residual radioactivity was found in the neck in any of the patients after extirpation of SLNs. fhSPECT acquisitions took 2.6 ± 0.4 min. No metastatic lymph nodes were detected in any other node harvested during subsequent selective neck dissection in any patients.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery.
authors.forename: Magis
authors.initials: M
authors.lastname: Mandapathil
authors.forename: Afshin
authors.initials: A
authors.lastname: Teymoortash
authors.forename: Jochen
authors.initials: J
authors.lastname: Heinis
authors.forename: Susanne
authors.initials: S
authors.lastname: Wiegand
authors.forename: Christian
authors.initials: C
authors.lastname: Güldner
authors.forename: Stephan
authors.initials: S
authors.lastname: Hoch
authors.forename: Marion
authors.initials: M
authors.lastname: Roeßler
authors.forename: Jochen A
authors.initials: JA
authors.lastname: Werner
mesh_terms: D000328:Adult; D000368:Aged; D005240:Feasibility Studies; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging*; D006801:Humans; D007430:Intraoperative Care; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D021701:Sentinel Lymph Node Biopsy; D015899:Tomography, Emission-Computed, Single-Photon