PT - JOURNAL ARTICLE AU - Amelia Jimenez-Heffernan AU - Annare Ellmann AU - Heitor Sado AU - Dražen Huić AU - Chandrasekhar Bal AU - Ramanathapuram Parameswaran AU - Francesco Giammarile AU - Rossana Pruzzo AU - Irena Kostadinova AU - Mariza Vorster AU - Paulo Almeida AU - Jonas Santiago AU - Sanjay Gambhir AU - Sonya Sergieva AU - Alvaro Calderon AU - Gabriela Oh Young AU - Renato Valdes-Olmos AU - John Zaknun AU - Vincent Peter Magboo AU - Thomas N.B. Pascual TI - Results of a Prospective Multicenter International Atomic Energy Agency Sentinel Node Trial on the Value of SPECT/CT Over Planar Imaging in Various Malignancies AID - 10.2967/jnumed.114.153643 DP - 2015 Sep 01 TA - Journal of Nuclear Medicine PG - 1338--1344 VI - 56 IP - 9 4099 - http://jnm.snmjournals.org/content/56/9/1338.short 4100 - http://jnm.snmjournals.org/content/56/9/1338.full SO - J Nucl Med2015 Sep 01; 56 AB - We aimed to assess the additional value of SPECT/CT over planar lymphoscintigraphy (PI) in sentinel node (SN) detection in malignancies with different lymphatic drainage such as breast cancer, melanoma, and pelvic tumors. Methods: From 2010 to 2013, 1,508 patients were recruited in a multicenter study: 1,182 breast cancer, 262 melanoma, and 64 pelvic malignancies (prostate, cervix, penis, vulva). PI was followed by SPECT/CT 1–3 h after injection of 99mTc-colloid particles. Surgery was performed the same or next day. Results: Significantly more SNs were detected by SPECT/CT for breast cancer (2,165 vs. 1,892), melanoma (602 vs. 532), and pelvic cancer (195 vs. 138), all P < 0.001. The drainage basin mismatch between PI and SPECT/CT was 16.5% for breast cancer, 11.1% for melanoma, and 51.6% for pelvic cancers. Surgical adjustment was 17% for breast cancer, 37% for melanoma, and 65.6% for pelvic cancer. Conclusion: SPECT/CT detected more SNs and changed the drainage territory, leading to surgical adjustments in a considerable number of patients in all malignancies studied but especially in the pelvic cancer group because of this group's deep lymphatic drainage. We recommend SPECT/CT in all breast cancer patients with no SN visualized on PI, all patients with melanoma of the head and neck or trunk, all patients with pelvic malignancies, and those breast cancer and melanoma patients with unexpected drainage on PI.