Bluemel Christina, Herrmann Ken, Müller-Richter Urs, Lapa Constantin, Higuchi Takahiro, Wild Vanessa, Buck Andreas K, Kübler Alexander, Linz Christian
Department of Nuclear Medicine, University Hospital of Würzburg, Würzburg, Germany.
Head Neck. 2014 Nov;36(11):E112-6. doi: 10.1002/hed.23596. Epub 2014 Jan 17.
In oral squamous cell carcinoma (OSCC), cervical lymph node status is the most important prognostic factor. Compared to elective neck dissection, reduced morbidity and better quality of life was demonstrated for sentinel lymph node biopsy, which is controversial because of the reduced detection rate of sentinel lymph nodes in close proximity to the injection site (also known as the shine-through phenomenon).
We report the case of a 44-year-old woman with a biopsy-proven early OSCC of the anterior floor of the mouth, who received SLNB guided with freehand single-photon emission CT (fhSPECT), a system for the 3D visualization of radioactivity in the body.
One level III sentinel lymph node and 1 level I sentinel lymph node, in close proximity to the injection site, were detected and dissected. The level I sentinel lymph node contained a metastasis.
Using fhSPECT, the issue outlined was overcome, and the precise histopathological lymph node status (pN1; 1 of 49) was determined.
在口腔鳞状细胞癌（OSCC）中，颈部淋巴结状态是最重要的预后因素。与选择性颈清扫术相比，前哨淋巴结活检显示出更低的发病率和更好的生活质量，但由于靠近注射部位的前哨淋巴结检出率降低（也称为穿透现象），这一方法存在争议。
我们报告了一名44岁女性的病例，经活检证实为口腔前壁早期OSCC，她接受了徒手单光子发射CT（fhSPECT）引导下的前哨淋巴结活检，fhSPECT是一种用于体内放射性三维可视化的系统。
检测并切除了1枚Ⅲ级前哨淋巴结和1枚靠近注射部位的Ⅰ级前哨淋巴结。Ⅰ级前哨淋巴结存在转移。
使用fhSPECT，克服了上述问题，并确定了精确的组织病理学淋巴结状态（pN1；49枚中有1枚）。
