Stephan K Haerle, Sandro J Stoeckli
Department of Otolaryngology-Head and Neck Surgery, University Hospital Zurich, Frauenklinikstrasse 24, 8091 Zurich, Switzerland.
Int J Mol Imaging. 2011;2011:106068. doi: 10.1155/2011/106068. Epub 2010 Sep 6.
Adequate staging and treatment of the neck in squamous cell carcinoma of the oral cavity and oropharynx (OSCC) is of paramount importance. Elective neck dissection (END) of the clinical N0-neck is widely advocated as neck treatment. With regard to the prevalence of 20-40% of occult neck metastases found in the ND specimens, the majority of patients undergo surgery of the lymphatic drainage basin without therapeutic benefit. Sentinel node biopsy (SNB) has been shown to be a safe, reliable and accurate alternative treatment modality for selected patients. Using this technique, lymphatic mapping is crucial. Previous reports suggested a benefit of single photon emission computed tomography with CT (SPECT/CT) over dynamic planar lymphoscintigraphy (LS) alone. SPECT/CT allows the surgeon for better topographical orientation and delineation of sentinel lymph nodes (SLN's) against surrounding structures. Additionally, SPECT/CT has the potential to detect more SLN's which might harbour occult disease, than LS. SPECT/CT is recommended to be used routinely, although SPECT/CT is not indispensable for successful SNB.
口腔和口咽鳞状细胞癌（OSCC）颈部的充分分期和治疗至关重要。临床N0颈部的选择性颈清扫术（END）作为颈部治疗方法被广泛提倡。鉴于在颈清扫标本中发现20%-40%的隐匿性颈部转移的发生率，大多数患者接受了淋巴引流区的手术，但并无治疗益处。前哨淋巴结活检（SNB）已被证明是针对特定患者的一种安全、可靠且准确的替代治疗方式。使用该技术时，淋巴绘图至关重要。先前的报告表明，单光子发射计算机断层扫描与CT（SPECT/CT）比单独的动态平面淋巴闪烁造影（LS）更具优势。SPECT/CT能让外科医生更好地进行地形定位，并将前哨淋巴结（SLN）与周围结构区分开来。此外，与LS相比，SPECT/CT有可能检测到更多可能隐匿疾病的SLN。尽管SPECT/CT对于成功的SNB并非必不可少，但建议常规使用SPECT/CT。
