Hybrid SPECT/CT imaging of sentinel nodes in esophageal cancer: first results

• Published in: Acta radiologica (1987) 2013-05, Vol.54 (4), p.369-373
• Main Authors: Tsai, Jon A, Celebioglu, Fuat, Lindblad, Mats, Lörinc, Esther, Nilsson, Magnus, Olsson, Annie, Lundell, Lars, Axelsson, Rimma
• Format: Article
• Language: English
• Subjects: Aged; Esophageal Neoplasms - diagnostic imaging; Esophageal Neoplasms - pathology; Esophagoscopy; Female; Humans; Lymphatic Metastasis - pathology; Male; Middle Aged; Multimodal Imaging - methods; Neoplasm Staging; Radiographic Image Interpretation, Computer-Assisted; Radiopharmaceuticals; Sentinel Lymph Node Biopsy - methods; Technetium Tc 99m Aggregated Albumin; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed
• ISSN: 0284-1851; 1600-0455
• DOI: 10.1177/0284185113475924

Background Sentinel node (SN) biopsy in esophageal cancer has the potential of becoming an important tool for ruling out the presence of lymph node metastases in patients opted for less extensive surgery without neoadjuvant treatment. Purpose To investigate preoperative SN imaging in esophageal cancer using hybrid single photon emission computed tomography (SPECT)/CT. Material and Methods Eight patients with esophageal cancer scheduled for thoracoabdominal esophagectomy after neoadjuvant treatment, underwent endoscopic submucosal injection of 99mTc-nanocoll the day before surgery, followed by imaging with SPECT/CT for preoperative detection. Intraoperative detection of SNs was performed with a gamma probe. Results SNs were identified by SPECT/CT in 7/8 cases (88%) and by gamma probe in all cases. The median number of identified lymph node stations with SN in the operating field was 1 (range 0–2) for SPECT/CT and 1 (range 1–3) for gamma probe. The median distance between the perceived location of the respective SN according to SPECT/CT and the location identified with the gamma probe was