Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery
-
J Craniomaxillofac Surg · Dec 2004
SPECT-CT for topographic mapping of sentinel lymph nodes prior to gamma probe-guided biopsy in head and neck squamous cell carcinoma.
Lymphoscintigraphic planar imaging is a common procedure for sentinel lymph node imaging prior to lymph node biopsy, but fails to elucidate the specific lymphatic drainage. Composite functional/anatomical imaging (SPECT-CT) has the potential to enhance topographic orientation and diagnostic sensitivity of sentinel lymph node imaging, but has not yet been applied in the head and neck region. ⋯ Composite functional/anatomical imaging (SPECT-CT) is feasible for sentinel lymph node detection. It enhances topographic orientation and diagnostic sensitivity with more sentinel nodes being detectable than by planar lymphoscintigraphy alone. Planar imaging should be accompanied by iterative reconstructed SPECT-CT to identify lymph nodes adjacent to the primary lesion. Such nodes are easily overlooked by planar lymphoscintigraphy and intraoperative gamma probes, as the high activity at the injection site can obscure their detection.