Sentinel Node Detection in Head and Neck Malignancies: Innovations in Radioguided Surgery

Table 1

Technical details of SPECT/CT in head and neck malignancies in various studies.

Study	𝑁^∗	Malignancy	Dose	Injection	Planar Imaging	Timing SPECT/CT	SPECT	Surgery	Details
Even-Sapir et al. [12]	9	3 HNM 6 OCC	74 MBq	Intradermal or submucosal injection 4 peritumoral deposits of 0.4 mL each	Sequential images within minutes after injection until visualization (up to 24 hours)	Not specified	3^∘ angle/20 s to 25 s steps Matrix: 128×128	Next day	Total number of patients: 34 (9 head and neck malignancy)
Wagner et al. [13]	30	OCC	20 MBq	Intra-mucodermal injection 2 peritumoral deposits of 0.05 mL each	Static image 60 minutes after injection	60 minutes after injection	6^∘ angle/30 s steps Matrix: 128×128	Same day	Sentinel node biopsy performed in 13/30
Lopez et al. [14]	10	OCC	22.2 MBq	4 peritumoral deposits Total volume <0.5 mL	Sequential images 4 to 24 hours after injection	Not specified	6^∘ angle/10 s steps Matrix: 128×128	Same day	Image registration performed manually by reprojection
Thomsen et al. [15]	37	OCC	20 MBq	4–6 peritumoral submucosal deposits Total volume 0.2 mL	Static images 30–60 minutes after injection	Not specified	6^∘ angle/8 s steps Matrix: 128×128	Same day	SPECT/CT in 37 out of 40 patients
Terada et al. [16]	12	OCC	18.5 MBq	4 peritumoral submucosal deposits, volume unclear	A static lymphoscintigram (anterior and bilateral oblique) was performed	After planar images	Not specified	Same day	Results of SPECT/CT are not compared to results of planar imaging
Bilde et al. [17]	34	OCC	120 MBq or 60 MBq^§	4 peritumoral submucosal deposits Total volume 0.2 mL	Dynamic imaging (lateral and anterior) during 20 minutes Static images after 30 and 90 minutes	After planar images	3^∘ angle/30 s steps Matrix: 128×128	Some the next day, some the same day
Khafif et al. [18]	20	OCC	74 MBq	Injection at the border of the primary tumor 4 deposits of 0.4 mL each	Sequential images within minutes until visualization (up to 24 hours)	Not specified	3^∘ angle / 20 s–25 s steps Matrix: 128×128	Next day
Keski-Säntti et al. [19]	15	OCC	74 MBq	Peritumoral injection in 1 or 2 deposits Total volume 0.2 mL	Planar lymphoscintigraphy with anterior and lateral projections	Not specified	Not specified	Next day
Covarelli et al. [20]	12 versus 11^±	HNM	50 MBq or 10 MBq^§	Peritumoral intradermal injection in 4 deposits In case of excision: 2 deposits around surgical scar Total volume 0.1 mL	Dynamic planar imaging for 20 minutes Sequential static images up to until 3 hours	45 minutes after injection	4^∘ angle / 30 s steps Matrix: 256×256	Some the next day, some the same day	Patients received either planar imaging or SPECT/CT

^∗number of patients with a head and neck malignancy that received SPECT/CT.
HNM: head and neck melanoma.
OCC: oral cavity carcinoma.
§ the first dose was injected if patients were operated the next day; the last dose was injected if patients were operated the same day.
± 12 patients received SPECT/CT only; 11 patients received planar imaging only.