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European Journal of Nuclear Medicine and Molecular Imaging

, Volume 44, Issue 6, pp 998–1004

First Online: 29 January 2017Received: 28 October 2016Accepted: 02 January 2017DOI: 10.1007-s00259-017-3613-8

Cite this article as: den Toom, I.J., van Schie, A., van Weert, S. et al. Eur J Nucl Med Mol Imaging 2017 44: 998. doi:10.1007-s00259-017-3613-8


PurposeTo assess the role of single-photon emission computed tomography with computed tomography SPECT-CT for the identification of sentinel lymph nodes SLNs in patients with early stage T1–T2 oral cancer and a clinically negative neck cN0.

MethodsIn addition to planar lymphoscintigraphy, SPECT-CT was performed in 66 consecutive patients with early stage oral cancer and a clinically negative neck. The addition of SPECT-CT to planar images was retrospectively analyzed for the number of additional SLNs, more precise localization of SLNs, and importance of anatomical information by a team consisting of a nuclear physician, surgeon, and investigator.

ResultsIdentification rate for both imaging modalities combined was 98% 65-66. SPECT-CT identified 15 additional SLNs in 14 patients 22%. In 2-15 13% of these additional SLNs, the only metastasis was found, resulting in an upstaging rate of 3% 2-65. In 20% of the patients with at least one positive SLN, the only positive SLN was detected due to the addition of SPECT-CT. SPECT-CT was considered to add important anatomical information in two patients 3%. In 5-65 8% of the patients initially scored SLNs on planar lymphoscintigrams were scored as non-SLNs when SPECT-CT was added. There were four false-negative SLN biopsy procedures in this cohort.

ConclusionsThe addition of SPECT-CT to planar lymphoscintigraphy is recommended for the identification of more positive SLNs and better topographical orientation for surgery in sentinel lymph node biopsy for early stage oral cancer.

KeywordsOral cancer Sentinel lymph nodes Single-photon emission computed tomography Lymphoscintigraphy Lymphatic metastasis Presented at the 7th International Symposium on Sentinel Node Biopsy in Head and Neck Cancer, Rome 8th–9th April 2016

Presented at the 29th Annual Meeting and Refresher Course of the European Society of Head and Neck Radiology, Leiden 22nd–24th September 2016

Autor: Inne J. den Toom - Annelies van Schie - Stijn van Weert - K. Hakki Karagozoglu - Elisabeth Bloemena - Otto S. Hoekstra


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