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Clinical evaluation of lymphoscintigraphy with a new technetium compound for metastatic cervical lymphadenopathy
1Department of Dental Radiology, Kagoshima University Dental School, Kagoshima, Japan.
Objectives:
To evaluate the potential usefulness of lymphoscintigraphy for the detection of metastatic cervical lymphadenopathy.
Methods:
Dynamic and static lymphoscintigraphy with 99Tcm-HSA-D was performed in 23 patients with malignant oropharyngeal tumors. The internal jugular nodes were excised and examined pathologically. The results of the lymphoscintigraphy were compared with the pathological examination and clinical palpation for accuracy.
Results:
All cases showed abnormal findings on lymphoscintigraphy. The accuracy on dynamic scintigraphy was 69% for asymmetric drainage, 69% for delayed drainage and 100% for inverse drainage. The overall accuracy for each side was 71%. With static scintigraphy, the accuracy was 69% for asymmetry, 86% for fitting defect, 67% for mottled-patchy appearance, 70% in swelling and 100% for collateral pathway. The overall accuracy for each side was 74%. The agreement between lymphoscintigraphy and palpation was 44%.
Conclusions:
Lymphoscintigraphy with 99Tcm-HSA-D was superior to palpation. The method is useful as a supplementary modality for the evaluation of metastatic cervical lymphadenopathy because of its relatively high accuracy and a low false-negative rate.