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Related Concept Videos

Imaging Studies III: Computed Tomography01:27

Imaging Studies III: Computed Tomography

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DefinitionComputed Tomography (CT) of the genitourinary (GU) tract is a non-invasive imaging modality that utilizes X-rays and computer processing to generate detailed cross-sectional images of the urinary system, encompassing the kidneys, ureters, bladder, and adjacent structures such as the adrenal glands.PurposeCT scans of the GU tract serve several diagnostic and therapeutic purposes, including:Diagnosis of Urinary Tract Diseases: Detects kidney stones, tumors, cysts, and congenital...
902

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Related Experiment Video

Updated: May 5, 2026

The Application of 1% Methylene Blue Dye As a Single Technique in Breast Cancer Sentinel Node Biopsy
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Lymphatic mapping and sentinel lymph node biopsy in urinary bladder cancer: A SPECT/CT-based experience.

Amin Saber Tanha1, Ramin Sadeghi1, Hamidreza Ghorbani2

  • 1Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

Annals of Nuclear Medicine
|March 13, 2026
PubMed
Summary

Sentinel lymph node (SLN) mapping in bladder cancer is feasible, identifying atypical drainage and potentially improving staging. Performance varies with tumor stage, chemotherapy, and imaging, suggesting a role in tailored lymphadenectomy.

Keywords:
LymphoscintigraphyMuscle-invasive bladder cancerRadical cystectomySPECT/CTSentinel lymph node

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Area of Science:

  • Uro-oncology
  • Nuclear medicine imaging
  • Surgical oncology

Background:

  • Sentinel lymph node (SLN) mapping offers potential for improved nodal staging in bladder cancer.
  • Minimizing morbidity associated with pelvic lymph node dissection (PLND) is a key objective.
  • Feasibility, accuracy, and influencing factors of SLN mapping require further investigation.

Purpose of the Study:

  • To assess the feasibility and diagnostic accuracy of SLN mapping in bladder cancer patients.
  • To evaluate the impact of tumor stage, neoadjuvant chemotherapy (NAC), and imaging modality on SLN detection.
  • To compare SLN identification with standard PLND findings.

Main Methods:

  • Prospective study of 35 patients with urothelial carcinoma undergoing radical cystectomy.
  • Preoperative peritumoral injection of 99mTc-phytate followed by lymphoscintigraphy and SPECT/CT.
  • Intraoperative SLN detection using a handheld gamma probe, compared with PLND.

Main Results:

  • SLN mapping achieved patient-based detection rates of up to 68.6% with a gamma probe.
  • Detection rates were highest in early-stage (T1-T2) and NAC-positive patients (100% intraoperative localization).
  • A patient-based false-negative rate of 25% was observed; hemipelvis-based analysis showed no false negatives. Atypical lymphatic drainage was noted in 6% of patients.

Conclusions:

  • SLN mapping is technically feasible in bladder cancer, revealing variable lymphatic drainage.
  • Performance is influenced by tumor stage, NAC, and imaging modality.
  • SLN mapping may complement PLND for enhanced staging and potentially enable tailored lymphadenectomy.