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The sentinel node approach in gynaecological malignancies.

Angela Collarino1, Sergi Vidal-Sicart2, Germano Perotti3

  • 1Institute of Nuclear Medicine, Università Cattolica del Sacro Cuore, Largo F. Vito, 1, 00168 Rome, Italy ; Nuclear Medicine Section, Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.

Clinical and Translational Imaging
|October 15, 2016
PubMed
Summary

This review highlights advancements in sentinel lymph node mapping for gynecological cancers. New technologies like SPECT/CT and hybrid tracers improve surgical guidance for cervical, endometrial, and vulvar cancers.

Keywords:
Cervical cancerEndometrial cancerSPECT/CTSentinel lymph nodeVulvar cancer

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Area of Science:

  • Oncology
  • Surgical Innovation
  • Medical Imaging

Background:

  • Sentinel lymph node (SLN) biopsy is crucial for staging gynecological malignancies.
  • Accurate SLN identification impacts treatment decisions and patient outcomes.
  • Existing methods for SLN mapping require refinement for improved precision.

Approach:

  • A comprehensive literature search of PubMed/MEDLINE was conducted for studies on SLN procedures in gynecological cancers.
  • The review focuses on technological advancements in preoperative and intraoperative SLN mapping.
  • Analysis includes techniques such as lymphoscintigraphy, SPECT/CT, hybrid tracers, and novel surgical navigation tools.

Key Points:

  • Preoperative lymphatic mapping using lymphoscintigraphy and SPECT/CT was identified in 18 studies.
  • Hybrid tracers (e.g., ICG-99mTc-nanocolloid) offer enhanced visualization.
  • Intraoperative tools like portable gamma cameras and 3D navigation devices aid surgeons.
  • SLN procedure is integrated into guidelines for vulvar and cervical cancers.
  • SLN biopsy for endometrial cancer remains largely investigative.

Conclusions:

  • Technological advancements are enhancing the precision and efficacy of SLN mapping in gynecological oncology.
  • These innovations offer valuable guidance for surgeons, potentially improving staging accuracy.
  • Further research is needed to fully establish SLN biopsy for endometrial cancer.