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Sentinel lymph node radiolocalization in clinically negative neck oral cancer
Akihiro Terada1, Yasuhisa Hasegawa, Mitsuo Goto
1Department of Head and Neck Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi 464-8681 Japan.
Head & Neck
|September 13, 2005
Summary
Sentinel lymph node (SLN) biopsy is a reliable method for staging oral cancer. Analyzing the three hottest SLNs accurately predicts neck status, sparing unnecessary surgeries.
Area of Science:
- Oncology
- Nuclear Medicine
- Head and Neck Surgery
Background:
- The sentinel lymph node (SLN) concept is a key area of interest in head and neck cancer treatment.
- This study evaluates the feasibility and clinical application of SLN radiolocalization and biopsy in patients with clinically negative neck oral cancer.
Purpose of the Study:
- To assess the feasibility of SLN radiolocalization and biopsy in oral cancer patients.
- To evaluate the clinical application and diagnostic accuracy of SLN biopsy in determining neck status.
Main Methods:
- Feasibility study involving 15 patients with N0 oral cancer using 99m Tc phytate tracer.
- Clinical application in 12 patients using SPECT/CT fusion imaging for intraoperative SLN biopsy (SLNB).
- Comparison of multi-slice frozen section analysis and imprint cytology for intraoperative SLNB diagnosis.
Main Results:
- SLN concept established; radioactivity accurately reflected neck status.
- Intraoperative diagnosis of the three hottest SLNs predicted neck status in 10 of 12 patients.
- Multi-slice frozen section analysis outperformed imprint cytology for intraoperative SLNB diagnosis.
Conclusions:
- SLN concept is validated in the head and neck region.
- Analysis of the three hottest SLNs is sufficient for predicting patient neck status.
- Intraoperative SLNB using SPECT/CT fusion imaging is accurate and reliable for managing oral cancer.