Ces radiol. 2011, 65(3):202-206

Lymphoscintigraphy and radioguided sentinel lymph node biopsy in patients with parotid gland carcinomasOriginal article

Pavel Koranda1, Ivo Stárek2, Vítězslav Zbořil3
1 Klinika nukleární medicíny FN a LF UP, Olomouc
2 Klinika ORL FN a LF UP, Olomouc
3 Ústav čelistní a obličejové chirurgie FN a LF UP, Olomouc

Aim: To estimate the potential impact of lymphoscintigraphy and radioguided sentinel lymph node biopsy (SLNB) in patients with parotid gland carcinomas.

Methods: 6 patients with parotid gland carcinomas (T2-4, clinically N0) underwent lymphoscintigraphy. In all patients 50 MBq of 99mTc-nanocolloid in 1,5 ml was injected peritumorally in 4-6 small portions around the tumor. The lymphoscintigraphy consisted of series of early and delayed static scintigrams. Radioguided SLNB with subsequent elective lymph node dissection was started 3-5 hours after radiopharmaceutical injection. The surgery was accomplished by the radical or conservative parotidectomy. The histopathological status of the sentinel lymph nodes was compared to that of the lymphadenectomy specimens.

Results: Sentinel lymph nodes (SLNs) were detected in all 6 patients. Standard radioguided SLNB detected SLNs in 4 patients. In one patient SLN was found using a gammaprobe in the excised tissue. SLNB was not successful in one patient with intraparotidal localization of SLN, but SLN was revealed subsequently in the extirpated parotid gland by a pathologist. Histological examination of excised SLNs detected metastases only in 2 patients in which the lymphadenectomy specimen harbored the metastases as well. SLN were detected in level V (outside the region of usual lymphadenectomy) in 3 patients - the extent of the lymphadenectomy was modified in these patients according to a lymphoscintigraphy.

Conclusion: Our pilot study seems to confirm the feasibility of radioguided SLNB in parotid gland carcinomas. It enables to individualize the extent of lymphadenectomy according to the visualized lymphatic outflow.

Keywords: parotid gland carcinoma, scintigraphy, Tc-99m-nanocolloid, sentinel lymph node biopsy

Accepted: December 15, 2010; Published: September 1, 2011  Show citation

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Koranda P, Stárek I, Zbořil V. Lymphoscintigraphy and radioguided sentinel lymph node biopsy in patients with parotid gland carcinomas. Ces radiol. 2011;65(3):202-206.
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