Validation of single‐photon emission computed tomography with computed tomography and lymphoscintigraphy for sentinel lymph node identification in cervical cancer

• Published in: International journal of gynecology and obstetrics 2023-12, Vol.163 (3), p.813-817
• Main Authors: Togami, Shinichi, Tokudome, Akio, Fukuda, Mika, Mizuno, Mika, Yanazume, Shintaro, Kobayashi, Hiroaki
• Format: Article
• Language: English
• Subjects: cervical cancer; identification rate; lymphoscintigraphy; radio isotope; sentinel lymph node; SPECT/CT
• ISSN: 0020-7292; 1879-3479
• DOI: 10.1002/ijgo.14917

Objective To compare single‐photon emission computed tomography with computed tomography (SPECT/CT) and lymphoscintigraphy (LSG) for the detection of sentinel lymph nodes (SLNs) in patients with early‐stage cervical cancer. Methods This hospital‐based, single‐center, retrospective study included 128 patients with cervical cancer (aged >18 years) treated between 2014 and 2022. Injection of 99 m Technetium‐labeled phytate into the uterine cervix was used to detect pelvic SLNs. SNL identification rates and locations were analyzed for preoperative LSG and SPECT/CT. Results Median age and body mass index of patients were 40 years (range, 20–78 years) and 21.7 kg/m2 (range, 16–40 kg/m2), respectively. There was no significant difference in overall identification rates (identification of at least one SLN) of SLNs between SPECT/CT (91%) and LSG (88%). There was no significant difference in bilateral SLN identification rates between SPECT/CT (66%) and LSG (65%). A total of 219 pelvic SLNs (110 right and 109 left hemipelvis) were identified by SPECT/CT; the most frequent locations were the obturator (122 SLNs, 56%) and external iliac (67 SLNs, 30%). Conclusion SPECT/CT and LSG showed high SLN identification rates in patients with cervical cancer, and there was no significant difference in overall or bilateral SLN identification rates between the two techniques. Synopsis Single‐photon emission computed tomography with computed tomography shows a high sentinel node identification rate and contributes to an improved intraoperative identification rate.