Ces radiol. 2010, 64(3):198-202

Reliability of the radioguided sentinel lymph node biopsy in patients with malignant melanoma - a clinical follow-upOriginal article

Pavel Koranda1, Petr Beneš2, Martin Molitor3, Ladislava Kučerová4, Milan Dočkal1, Jaroslav Hirňák$3. Miroslav Mysliveček1
1 Klinika nukleární medicíny LF UP a FN, Olomouc
2 Onkologická klinika LF UP a FN, Olomouc
3 Oddělení plastické a estetické chirurgie LF UP a FN, Olomouc
4 Ústav patologie LF UP a FN, Olomouc

Aim: To evaluate the reliability of detection of lymph node metastases using sentinel lymph node biopsy (SLNB) in patients with malignant melanoma by means of a clinical follow-up.

Methods: 167 consecutive patients with malignant melanoma MM underwent lymphoscintigraphy and radioguided SLNB and subsequently were followed at the Dept. of Oncology. Localization of MM: 91 trunk, 66 extremities, 10 head and neck. pT staging: 4 pTiS, 48 pT1, 65 pT2, 31 pT3, 17 pT4. The mean follow-up time: 2.7 years (0.6-5.8, median 2.5). In all patients 50 MBq of 99mTc-nanocolloid in 0.5 ml was injected intracutaneously in 6-8 small portions around the tumor. The scintigraphic procedure consists of a dynamic scintigraphy, early static scintigrams and delayed scans. All scans were performed using a dual-head gamma-camera equipped with HR collimator. Radioguided SLNB was started 2-5 hours after scintigraphy.

Results: SLNB detected sentinel lymph nodes (SLNs) in all patients. Local recurrences of the MM developed in 2 patients. It was not possible to decide if the lymph node metastases originated from primary tumor or recurrence, therefore a total of 165 patients were studied. Histological examination of excised SLNs detected MM metastases in 25 (15%) patients. Additional metastases in adjacent lymphatic basin were revealed during the subsequent clinical follow-up in 1 patient (sensitivity of SLNB 96.2 %, the negative predictive value being 99.2%). Haematogenous dissemination of MM was detected in 3 patients.

Conclusion: Radioguided SLNB is a reliable procedure even though clinical assessment during the follow-up is applied as a reference parameter. The sensitivity of SLNB detecting lymphatic metastases is high, which is extremely important for early treatment initiation.

Keywords: malignant melanoma, scintigraphy, Tc-99m-nanocolloid, sentinel lymph node biopsy

Accepted: May 25, 2010; Published: September 1, 2010  Show citation

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Koranda P, Beneš P, Molitor M, Kučerová L, Dočkal M, Mysliveček JHM. Reliability of the radioguided sentinel lymph node biopsy in patients with malignant melanoma - a clinical follow-up. Ces radiol. 2010;64(3):198-202.
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