Sentinel Node Mapping in Ovarian Tumors: A Study Using Lymphoscintigraphy and SPECT/CT

Area of Science:

• Oncology
• Nuclear Medicine
• Surgical Pathology

Background:

• Early-stage ovarian cancer necessitates comprehensive surgical staging, often involving radical lymphadenectomy.
• Radical lymphadenectomy carries inherent risks of morbidity and complications.
• Sentinel lymph node (SLN) mapping aims to mitigate these risks by identifying key lymphatic drainage points.

Purpose of the Study:

• To evaluate the feasibility of SLN mapping in patients with ovarian tumors.
• To assess the utility of intraoperative Technetium-99m-Phytate and postoperative SPECT/CT lymphoscintigraphy for SLN identification.

Main Methods:

• Thirty-two patients with ovarian masses underwent intraoperative radiotracer injection.
• SPECT/CT lymphoscintigraphy was performed postoperatively to identify SLNs.
• Histopathological examination assessed lymph node involvement in malignant cases.

Main Results:

• SLNs were identified in various locations, including pelvic and para-aortic regions.
• Unusual SLN locations (perirenal, intergluteal) were noted in three patients.
• The study could not determine the false negative rate due to a lack of positive lymph node cases.

Conclusions:

• Intraoperative radiotracer injection for SLN mapping is safe and feasible in ovarian tumor patients.
• Larger studies with more malignant cases are required to validate the sensitivity of SLN mapping for ovarian cancer staging.