Dynamic Sentinel Lymph Node Biopsy (DSNB) in Penile Cancer: A Practical Guide for Clinical Implementation

Reliable dynamic sentinel lymph node biopsy (DSNB) requires a standardised multidisciplinary workflow and specific expertise in nuclear medicine and radioguided surgery. This practical guide provides the minimum technical requirements for implementing DSNB in penile cancer, including patient selection, radioactive tracer administration, preoperative lymphatic mapping, and intraoperative sentinel node (SN) detection. Complementary detection modalities are discussed separately. PATIENT SUMMARY: Dynamic sentinel lymph node (LN) biopsy helps surgeons identify and remove only the LN(s) most likely to contain cancer cells in patients with penile cancer. Careful imaging and surgical techniques are essential to accurately locate these nodes while avoiding unnecessary removal of other LNs.