The ability of lymphoscintigraphy to direct sentinel node biopsy in the clinically N0 neck for patients with head and neck squamous cell carcinoma

• Published in: British journal of radiology 2002-12, Vol.75 (900), p.950-958
• Main Authors: Ross, G L, Soutar, D S, Shoaib, T, Camilleri, I G, MacDonald, D G, Robertson, A G, Bessent, R G, Gray, H W
• Format: Article
• Language: English
• Subjects: Carcinoma, Squamous Cell - diagnostic imaging; Carcinoma, Squamous Cell - secondary; Head and Neck Neoplasms - pathology; Humans; Lymphatic Metastasis; Neoplasm Staging; Radionuclide Imaging; Radiopharmaceuticals; Sentinel Lymph Node Biopsy - methods; Technetium Tc 99m Sulfur Colloid
• ISSN: 0007-1285; 1748-880X
• DOI: 10.1259/bjr.75.900.750950

This study aimed to evaluate the ability of lymphoscintigraphy (LSG) to direct sentinel node biopsy (SNB) in the identification of occult metastases in the clinically N0 neck for patients with head and neck squamous cell carcinoma (HNSCC). 57 clinically N0 neck sides in 48 patients were assessed using the triple diagnostic approach of pre-operative LSG, intra-operative use of a gamma probe and blue dye. SNB was performed after radiocolloid and blue dye injection. Pre-operative LSG and the intra-operative use of a gamma probe identified radioactive sentinel nodes, and visualization of blue stained lymphatics identified blue sentinel nodes. 104 sentinel nodes were harvested from 43 patients. The identification rate was 90% (43 of 48). Of the 104 nodes harvested, 17 of 62 (27%) nodes identified as both radioactive and blue were positive for occult metastases compared with 5 of 42 (12%) nodes identified as hot or blue only (p