Review Article

SPECT/CT for Lymphatic Mapping of Sentinel Nodes in Early Squamous Cell Carcinoma of the Oral Cavity and Oropharynx

Table 1

An overview of various studies using SPECT/CT in the context of lymphatic mapping for SNB in OSCC.

Study groupNumber of patients (n)SPECT/CT and the reported detection of SLN’sThe value of SPECT/CT according to the authors

Even-Sapir et al. [15]63 additional nodes detected in 6 patients compared to lymphoscintigraphy aloneSPECT/CT adds data that is of clinical relevance to SNB in patients with mucosal HNSCC

Lopez et al. [16]10100% visualization of the SLN’s by SPECT/CTSPECT/CT is shown to be an effective method for anatomic localization of the SLN’s in N0 OSCC

Wagner et al. [17]3011 additional nodes out of 49 SLNs detected compared to lymphoscintigraphy aloneSPECT/CT adds additional information regarding nodes that are adjacent to the primary lesion

Thomsen et al. [18]40SPECT/CT and/or added oblique images revealed extra nodes in 15/40 patients.SPECT/CT has added information which could not have been obtained from planar lymphoscintigraphy

Terada et al. [19]15100% visualization of the SLN’s by SPECT/CTSPECT/CT proved to be an easy, accurate, and reliable method

Khafif et al. [20]20SPECT/CT improved SLN identification and/or localization compared with planar images in 6 patients (30%)SPECT/CT provides additional preoperative data of clinical relevance to SNB in patients with OSCC

Bilde et al. [21]34SPECT/CT demonstrated extra SLN’s compared to planar imaging in 15 out of 32 patients (47%)SPECT/CT detects more SLN’s than lymphoscintigraphy and provides additional anatomical and spatial information about their localization.

Keski-Säntti et al. [22]151 additional SLN located in the jugular chain detected compared to lymphoscintigraphy aloneSPECT/CT enables more accurate localization of the SLN’s, but it rarely reveals SLN’s, that are not detected on planar images.

Haerle et al. [23]5811 additional hot spots could be revealed by SPECT/CT compared to lymphoscintigraphy alone. In one case even with additional occult disease.SPECT/CT has the potential to detect more SLN’s, which might harbour occult disease, than lymphoscintigraphy alone.

SNB: sentinel node biopsy; OSCC: oral/oropharyngeal squamous cell carcinoma; HNSCC: head and neck squamous cell carcinoma; SLN: sentinel lymph node.