Department of Surgery, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands.
Ann Surg Oncol. 2012 Mar;19(3):1018-23. doi: 10.1245/s10434-011-2031-6. Epub 2011 Aug 31.
To investigate whether single photon emission computed tomography camera with integrated radiographic computed tomography (SPECT/CT) is of additional value compared to conventional lymphoscintigraphy in routine lymphatic mapping in patients with melanoma.
Thirty-five unselected patients with a primary melanoma who were scheduled for wide local excision and sentinel node biopsy underwent conventional lymphoscintigraphy and subsequently SPECT/CT. We determined whether SPECT/CT showed additional sentinel nodes, whether it provided better information on the location of the sentinel nodes, and whether this additional anatomic information led to a change in the planned surgical approach.
SPECT/CT depicted the same 69 sentinel nodes as conventional lymphoscintigraphy in all 35 patients plus found eight additional sentinel nodes in seven patients (20%). In two of these patients (5.7%), an additional nodal basin had to be explored to find the extra sentinel nodes. SPECT/CT provided additional anatomic information that was helpful to the surgeon in 11 patients (31%) and led to an adjustment of the surgical approach in 10 patients (29%).
SPECT/CT provided relevant additional information in 16 (46%) of the 35 patients. Routine use of SPECT/CT in addition to conventional lymphoscintigraphy is recommended in melanoma patients undergoing lymphatic mapping.
研究与常规淋巴闪烁显像相比，集成放射学计算机断层扫描的单光子发射计算机断层扫描（SPECT/CT）在黑色素瘤患者常规淋巴作图中是否具有附加价值。
35 名拟行广泛局部切除和前哨淋巴结活检的原发性黑色素瘤患者进行了常规淋巴闪烁显像和随后的 SPECT/CT。我们确定 SPECT/CT 是否显示了额外的前哨淋巴结，是否提供了关于前哨淋巴结位置的更好信息，以及这种额外的解剖学信息是否导致了手术方式的改变。
SPECT/CT 在所有 35 名患者中均显示与常规淋巴闪烁显像相同的 69 个前哨淋巴结，并在 7 名患者（20%）中发现了另外 8 个前哨淋巴结。在其中 2 名患者（5.7%）中，需要额外探查一个淋巴结区域才能找到额外的前哨淋巴结。SPECT/CT 提供了额外的解剖学信息，这对 11 名患者（31%）的外科医生有帮助，并导致 10 名患者（29%）调整了手术方法。
在 35 名患者中，有 16 名（46%）患者获得了相关的附加信息。建议在进行淋巴作图的黑色素瘤患者中常规使用 SPECT/CT 以补充常规淋巴闪烁显像。
