Isabel Roca MD, PhD, Presenter: Nothing to Disclose

Sergi Vidal-Sicart MD, Abstract Co-Author: Nothing to Disclose

Jordi Fuertes, Abstract Co-Author: Nothing to Disclose

Carles Lorenzo MD, Abstract Co-Author: Nothing to Disclose

Amparo Garcia-Burillo MD, Abstract Co-Author: Nothing to Disclose

Tomas C. Franquet MD, Abstract Co-Author: Nothing to Disclose

Dolors Sabadell, Abstract Co-Author: Nothing to Disclose

Manel Saez MD, Abstract Co-Author: Nothing to Disclose

Ramon Medel, Abstract Co-Author: Nothing to Disclose

Antonio Gil, Abstract Co-Author: Nothing to Disclose

Josep Maria Martinez-Palones, Abstract Co-Author: Nothing to Disclose

Josep Vives, Abstract Co-Author: Nothing to Disclose

Josep Argiles, Abstract Co-Author: Nothing to Disclose

Santiago Aguade MD, Abstract Co-Author: Nothing to Disclose

Carlos Alexander, Abstract Co-Author: Nothing to Disclose

Joan Castell MD, PhD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

To describe the feasibility and usefulness of sentinel lymph node lymphoscintigraphy with SPECT-CT (SLN-SPECT-CT) in several malignancies: breast, head and neck, vulvar and cervical cancer.

36 consecutive patients (33 females) have been submitted to a SLN-SPECT-CT 8-24 hours before surgery (25 breast cancer, 5 malignant melanoma (MM), 4 maxilofacial carcinoma, 2 cervical cancer). In 17 cases hybrid systems were used (Hawk-Eye, GE). In the remaining 19 cases, patients have been studied in separate CT and gammacamera systems (3 landmarks registration procedure)(Infinia+Light Speed GE or Ecam+Volum Acces Siemens, Image Registration GE).

35/36 patients drained (68 SLN, median 1.9/patient, 1 breast cancer without drainage but positive axila). Surgery: 64 SLN (median 1.8/patient). 4 SLN not resected (2 patients): 1 intramamary SLN and 3 axila SLN (MM). PROBE subjective evaluation: - 27/64 (42%) easy / limited value SLN-SPECT-CT - 20/64 (31%) feasible /easier with SLN-SPECT-CT - 16/64 (25%) difficult / high value SLN-SPECT-CT In 24/64 cases (38%) the SLN were located deeply (costal area, obese women) or in atypical areas (low axila, posterior yugular area). SURGEON subjective evaluation: - 25/36 (69%) useful or very useful (easier surgical approach, less surgical time) - 35/36 (97%) improvement in presurgical information (compared to the planar images). Disadvantages: 1. increase in dosimetry (CT). 2. more exploration time. 3. cost increase.

Excellent results have been observed in this series of 36 patients with malignancies affecting different lymphatic basins. SPECT-CT lymphoscintigraphy provides useful information to the surgeon (better information about SN location and less surgical time to find SN, specially in case of deep or atypical SN and in obese patients). It is important to emphasize the improved satisfaction of the surgeon with the technique. The main disadvantages refer to the higher dosimetry (CT) and cost.

SPECT-CT is an emerging technique which improves the SN surgery with a potential high clinical impact: improved SN location, surgical time reduction, surgeon confidence increase.

Roca, I, Vidal-Sicart, S, Fuertes, J, Lorenzo, C, Garcia-Burillo, A, Franquet, T, Sabadell, D, Saez, M, Medel, R, Gil, A, Martinez-Palones, J, Vives, J, Argiles, J, Aguade, S, Alexander, C, Castell, J, et al, , et al, , SPECT-CT for Sentinel Node Detection: Feasibility and Usefulness.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5002782.html