SPECT/CT for sentinel lymph node mapping in head and neck melanoma

Area of Science:

• Nuclear medicine
• Oncologic imaging
• Surgical oncology

Background:

• Sentinel lymph node biopsy is crucial for melanoma staging.
• Accurate sentinel node detection and localization are vital for accurate staging and treatment planning in head and neck melanoma.
• Conventional lymphoscintigraphy has limitations in visualizing and localizing sentinel nodes.

Purpose of the Study:

• To determine the added value of single photon emission computed tomography with CT (SPECT/CT) for sentinel node detection and localization in head and neck melanoma patients.
• To assess the impact of SPECT/CT on surgical approach and patient management.

Main Methods:

• Thirty-eight patients with head and neck melanoma underwent conventional lymphoscintigraphy followed by hybrid SPECT/CT.
• Analysis included the number of visualized sentinel nodes and the provision of anatomical information.
• Surgical approach modifications based on SPECT/CT findings were evaluated in 20 patients.

Main Results:

• SPECT/CT visualized an average of 2.6 sentinel nodes per patient.
• An additional sentinel node was detected in 16% of patients using SPECT/CT.
• SPECT/CT clearly delineated the anatomical location of sentinel nodes in all patients, leading to surgical approach adjustments in 55% of cases.

Conclusions:

• SPECT/CT enhances sentinel node visualization and provides precise anatomical localization compared to conventional imaging.
• SPECT/CT is recommended for improved management of head and neck melanoma patients due to its superior diagnostic capabilities.