Value of SPECT/CT for Detection and Anatomic Localization of Sentinel Lymph Nodes Before Laparoscopic Sentinel Node Lymphadenectomy in Prostate Carcinoma

• DOI: 10.2967/jnumed.108.060673
• Publication Date: 2009-05-15T00:56:24Z
• Authors: Lenka Vermeeren; Renato A. Valdés ...; Wim Meinhardt; Axel Bex; Henk G. van der Poel; Wouter V. Vogel; Ferida Sivro; Cees A. Hoefnagel; Simon Horenblas
• Keywords: Lymphadenectomy

Laparoscopic evaluation of sentinel nodes is useful for staging prostate cancer, but preoperative localization deep abdominal with planar lymphoscintigraphy difficult. We evaluated the value SPECT/CT detecting and localizing in cancer.(99m)Tc-nanocolloid was injected peri- intratumorally, guided by transrectal ultrasonography, 46 patients cancer intermediate prognosis. Patients underwent imaging after 15 min 2 h, laparoscopic node lymphadenectomy on same day. SPECT fused CT analyzed using 2-dimensional orthogonal slicing 3-dimensional volume rendering. number extra found SPECT/CT, outside area extended pelvic lymphadenectomy, anatomic information provided SPECT/CT. Furthermore, we classified additional images into 3 categories (no advantage, presumable definite advantage) according to given whether were SPECT/CT.The had a mean age 64 y (range, 53-74 y) received dose 218 MBq 147-286 MBq). The visualization rate 91% (42 patients) 98% (45 In 29 (63%), revealed (especially lymph near injection area) not seen imaging. 7 patients, those positive metastasis (being exclusive metastatic 4 patients). Overall, (33%) nodes. Sentinel 16 (35%), whereas 56% these Performing no advantage 13% 24%, 63%. Urologic surgeons used guide their trocar insertion sites finding probe.More can be detected than alone. comparison imaging, especially reveals lymphadenectomy. modality provides about location within area, leading improved intraoperative identification.