Investigating the Role of SPECT/CT in Dynamic Sentinel Lymph Node Biopsy for Penile Cancers

Overview

Journal Eur J Nucl Med Mol Imaging

Specialties Biophysics
Nuclear Medicine
Radiology

Date 2017 Feb 9

PMID 28175934

Citations 11

Authors

Ziauddin Zia Saad

Savvas Omorphos

Sofia Michopoulou

Svetislav Gacinovic

Peter Malone

Raj Nigam

Asif Muneer

Jamshed Bomanji

Affiliations

Soon will be listed here.

Abstract

Purpose: Currently, most centres use 2-D planar lymphoscintigraphy when performing dynamic sentinel lymph node biopsy in penile cancer patients with clinically impalpable inguinal nodes. This study aimed to investigate the role of SPECT/CT following 2-D planar lymphoscintigraphy (dynamic and static) in the detection and localization of sentinel lymph nodes in the groin.

Methods: A qualitative (visual) review was performed on planar followed by SPECT/CT lymphoscintigraphy in 115 consecutive patients (age 28-86 years) who underwent injection of Tc-nanocolloid followed by immediate acquisition of dynamic (20 min) and early static scans (5 min) initially and further delayed static (5 min) images at 120 min followed by SPECT/CT imaging. The lymph nodes detected in each groin on planar lymphoscintigraphy and SPECT/CT were compared.

Results: A total of 440 and 467 nodes were identified on planar scintigraphy and SPECT/CT, respectively. Overall, SPECT/CT confirmed the findings of planar imaging in 28/115 cases (24%). In the remaining 87 cases (76%), gross discrepancies were observed between planar and SPECT/CT images. SPECT/CT identified 17 instances of skin contamination (16 patients, 13%) and 36 instances of in-transit lymphatic tract activity (24 patients, 20%) that had been interpreted as tracer-avid lymph nodes on planar imaging. In addition, SPECT/CT identified 53 tracer-avid nodes in 48 patients (42%) that were not visualized on planar imaging and led to reclassification of the drainage basins (pelvic/inguinal) of 27 tracer-avid nodes.

Conclusions: The addition of SPECT/CT improved the rate of detection of true tracer-avid lymph nodes and delineated their precise (3-D) anatomic localization in drainage basins.

Citing Articles

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Li Y, Chen Y, Xie G, Li G, Yin H Front Oncol. 2025; 15:1388390.

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New EAU/ASCO guideline recommendations on sentinel node biopsy for penile cancer and remaining challenges from a nuclear medicine perspective.

Vreeburg M, Donswijk M, Albersen M, Parnham A, Ayres B, Protzel C Eur J Nucl Med Mol Imaging. 2024; 51(10):2861-2868.

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Accuracy of dynamic sentinel lymph node biopsy for inguinal lymph node staging in cN0 penile cancer.

Gebruers J, Elst L, Baldewijns M, De Wever L, Van Laere K, Albersen M EJNMMI Res. 2023; 13(1):62.

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Ah-Thiane L, Rousseau C, Aumont M, Cailleteau A, Dore M, Mervoyer A Cancers (Basel). 2023; 15(10).

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