Article Figures & Data
Figures
- FIGURE 1.
Patient with cutaneous malignant melanoma in chest wall. SN hidden by scattered radiation of injection site. Multiprojection planar lymphoscintigraphy failed to identify SN (top images: selected planar images in anterior and lateral projections). On fused SPECT/CT images, hot node was identified in axilla (bottom images: transaxial and sagittal slices).
- FIGURE 2.
Patient with cutaneous malignant melanoma in right upper back. SNs in multiple basins. Multiprojection planar images identified hot node in axilla (bottom right image: anterior projection). Fused SPECT/CT images identified additional supraclavicular and low jugular nodes (top: transaxial slices; bottom left: coronal slices).
- FIGURE 3.
Patient with melanoma in back. Anterior (bottom left) and lateral (bottom right) planar images detect multiple nodes. Transaxial SPECT/CT images (top) localize nodes in anterior axilla and in aberrant superficial location.
Tables
- TABLE 1
Scintigraphic and Histopathologic Findings in Patients with Tumor Localized in Head and Neck Region
Patient no. Age (y) Sex Tumor type and location Planar imaging* Localization of nodes seen on planar imaging SPECT/CT imaging Surgical and histopathologic results First nodes detected Additional nodes Single vs. multiple basins Additional nodes† Single vs. multiple basins Clinically relevant added value‡ 1 70 M SCC, tongue Midjugular Supraclavicular Unclear Mid- and lower jugular chain + jugulo-digastric (hidden) Multiple + Positive SN (cervical) 2 50 F SCC, tongue High jugular 4 along jugular chain Single Jugular chain + submental (hidden) Single + Negative 3 43 M SCC, tongue High jugular 1 midjugular Single Jugular chain − Single − Positive SN (cervical) 4 72 M SCC, tongue Supraclavicular, suspected submandibular − Unclear Supraclavicular Second node was ruled out (injection site) Single + Positive SN (supraclavicular) 5 27 M SCC, tongue High jugular 3 along jugular chain Single Jugular chain + posterior cervical triangle Multiple + Multiple involved nodes 6 54 M SCC, oral mucosa High jugular 4 along jugular chain Single Jugular chain − Single − Negative 7 81 M MM, head 2 preauricular 2 submandibular Unclear 2 preauricular, 1 submandibular, 1 jugulodigastric − Unclear − Negative 8 67 M MM, scalp Faint occipital − Single Posterior cervical triangle − Single − Multiple involved nodes 9 55 M MM, scalp High jugular, contralateral occipital 1 cervical Multiple 2 jugular, 2 contralateral occipital − Multiple − Negative ↵* Including images obtained with 57Co flood source.
↵† Additional nodes detected on SPECT/CT only. Hidden = hidden by scatter radiation of injection site.
↵‡ SPECT/CT added data were considered clinically relevant if they guided surgeon to SNs that were undetected on planar images or to SNs in another basin.
MM = malignant melanoma.
- TABLE 2
Scintigraphic and Histopathologic Findings in Patients with Malignant Melanoma of Trunk
Patient no. Age (y) Sex Tumor type and location Planar imaging* Localization of nodes seen on planar imaging SPECT/CT imaging Surgical and histopathologic results First nodes detected Additional nodes Single vs. multiple basins Additional nodes† Single vs. multiple basins Clinically relevant added value‡ 1 52 M L shoulder L axilla − Single L axilla, central − Single − Negative 2 24 M R shoulder R axilla − Single Apical, R axilla + (IT) Single + Negative 3 73 M Midupper back L axilla 2 L axilla, 1 R axilla Multiple In L axilla, 1 subscapular node and 1 central node + pectoral node Multiple + Negative 4 61 M L upper back L axilla 2 L axilla Unclear 2 central, 1 pectoral axillary node + prescapular (IT) Multiple + Negative 5 71 M R upper back R axilla 2 R axilla Single Central axillary nodes − Single − Negative 6 67 M Midupper back L jugular chain, 2 nodes L axilla, L occipital Multiple L jugular, axillary, and occipital nodes − Multiple − Negative 7 59 F Midupper back L axilla L axilla Single Central axillary nodes − Single − 1 positive SN node (axillary) 8 52 F Midupper back R axilla, 2 nodes L axilla, 2 nodes Multiple Bilateral central axillary nodes − Multiple − Negative 9 60 M R upper back R axilla − Single 1 axillary central node + supraclavicular node, low jugular node Multiple + Negative 10 55 M Midlower back L axilla L groin Multiple L central axilla node, L groin node − Multiple − 1 positive node (groin) 11 62 M Chest wall − − − − + 1 central axillary node (hidden) Single + Negative 12 26 F Abdominal wall L groin, aberrant uptake − Unclear L groin + (?) parailiac nodes, aberrant uptake Unclear − Negative (parailiac nodes and aberrant uptake not examined) ↵* Including images obtained with 57Co flood source.
↵† Additional nodes detected on SPECT/CT only. Hidden = hidden by scatter radiation of injection site; IT = in-transit.
↵‡ SPECT/CT added data were considered clinically relevant if they guided surgeon to SNs that were undetected on planar images or to SNs in another basin.
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