title: Utility of hybrid SPECT/CT in primary melanoma lymphoscintigraphy: A retrospective case series.
abstract: BACKGROUND
  Sentinel lymph node (SLN) biopsy is widely accepted as an important part of staging cutaneous malignant melanoma. Hybrid single photon emission computed tomography and computed tomography (SPECT/CT) may identify additional SLN and provide important information to the surgeon performing SLN biopsy. We report our experience at a major referral centre for melanoma surgery.
  
  
  METHODS
  Retrospective case series of pre-operative sentinel node lymphoscintigraphy for primary melanoma over a consecutive 12-month period. All patients had planar imaging and hybrid SPECT/CT.
  
  
  RESULTS
  At least 1 SLN was successfully identified in 82 of 86 eligible patients (95.3%). These 82 patients had 144 SLNs (mean 1.8). There were no patients where the SLN was seen only with SPECT/CT. Additional information was provided by SPECT/CT in 32 patients (39.0%). Histology reports were available for 52 patients, 9 (17.3%) had at least 1 SLN positive for metastatic disease.
  
  
  CONCLUSIONS
  We achieved a high rate of SLN identification. SPECT/CT was most frequently helpful when the primary melanoma was located in the head, neck and trunk. Routine use of SPECT/CT during lymphoscintigraphy provides important anatomical information and may reduce the false-negative rate.
authors.affiliation: Department of Nuclear Medicine, PET & Ultrasound, Westmead Hospital, Westmead, New South Wales, Australia.
authors.forename: Khimling
authors.initials: K
authors.lastname: Tew
authors.affiliation: Department of Nuclear Medicine, PET & Ultrasound, Westmead Hospital, Westmead, New South Wales, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Farlow
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000965:Antimony; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D061305:Lymphoscintigraphy / Q000379:methods*; D008297:Male; D008545:Melanoma / Q000000981:diagnostic imaging* / Q000473:pathology*; D008875:Middle Aged; D064847:Multimodal Imaging; D009367:Neoplasm Staging; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D012878:Skin Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D017556:Technetium Compounds; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D017556:Technetium Compounds; C019096:technetium Tc 99m antimony sulfide; D000965:Antimony
keywords: 
  SPECT
  ; melanoma; sentinel lymph node biopsy