[Sentinel node biopsy and lymphatic mapping from a nuclear medicine perspective: principles, methods and experiences...

To summarise the principles, indications, radiopharmaceuticals, preoperative imaging and intraoperative detection methods of sentinel node biopsy (SNB) and lymphatic mapping, and to present the experience of the Department of Nuclear Medicine and Theranostics, University of Szeged.

This review is based on current EANM/SNMMI guidelines, the relevant international literature and institutional data.

SNB has become an accepted component of oncological care in melanoma, breast cancer, gynaecological, urological and head-and-neck malignancies. Lymphoscintigraphy combined with SPECT/CT is mandatory in numerous indications. At the University of Szeged, preoperative isotope-guided sentinel node localisation combined with intraoperative gamma probe-assisted sentinel node biopsy has been performed in nearly 6,000 patients since 1999.

SNB is a multidisciplinary procedure requiring nuclear medicine, surgery and pathology. Hybrid tracers and multimodal intraoperative detection further improve detection rates and reduce false-negative results.