title: SPECT-CT and intraoperative portable gamma-camera detection  protocol for sentinel lymph node biopsy in oral cavity squamous cell  carcinoma.
abstract: OBJECTIVE
  The aim of this study was to evaluate a multimodality approach to sentinel lymph node biopsy (SLNB) detection with lymphoscintigraphy and single-photon emission computed tomography (SPECT)/computed tomography (CT). When combined with intraoperative imaging by a portable gamma camera (PGC), improved SLNB accuracy and detection rate may result.
  
  
  METHODS
  A total of 42 patients selected for SLNB in node-negative T1 and T2 oral squamous cell carcinoma were retrospectively analyzed. The detection protocol consisted of preoperative lymphoscintigraphy and SPECT/CT performed the day before surgery. Intraoperative sentinel lymph node (SLN) detection was done with the aid of a PGC in association with hand-held gamma probe.
  
  
  RESULTS
  All SLN detected in the preoperative study could be harvested except for one case. A total of 131 SLN were resected. This number was higher than the SLN depicted on lymphoscintigraphy (119 SLNs) and SPECT/CT (123 SLNs). Sublingual SLNs were observed in two cases (4.76%). These SLNs were detected by SPECT/CT but not by lymphoscintigraphy. Five (3.8%) additional SLNs not previously visualized on lymphoscintigraphy or on SPECT/CT were detected intraoperatively with the aid of the PGC. Positive SLNs were detected in eight cases (19%). Micrometastases were detected in five cases (62%) and macrometastases in three cases (38%).
  
  
  CONCLUSIONS
  The SLNB detection protocol described contributes to more accurate study and detection.
authors.forename: Ramón
authors.initials: R
authors.lastname: Sieira-Gil
authors.forename: Pilar
authors.initials: P
authors.lastname: Paredes
authors.forename: Carles
authors.initials: C
authors.lastname: Martí-Pagés
authors.forename: Ada
authors.initials: A
authors.lastname: Ferrer-Fuertes
authors.forename: Eloy
authors.initials: E
authors.lastname: García-Díez
authors.forename: Gui Youn
authors.initials: GY
authors.lastname: Cho-Lee
authors.forename: Andres
authors.initials: A
authors.lastname: Tapias
authors.forename: Maria
authors.initials: M
authors.lastname: Mayoral
authors.forename: Sergi
authors.initials: S
authors.lastname: Vidal-Sicart
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging*; D006801:Humans; D008207:Lymphatic Metastasis; D009062:Mouth Neoplasms / Q000000981:diagnostic imaging*; D064847:Multimodal Imaging; D000071036:Sentinel Lymph Node / Q000473:pathology; D021701:Sentinel Lymph Node Biopsy / Q000295:instrumentation / Q000379:methods*; D000072098:Single Photon Emission Computed Tomography Computed Tomography / Q000295:instrumentation / Q000379:methods*