Authors: Federica Elisei Cinzia Crivellaro Daniela Giuliani Carlotta Dolci Elena De Ponti Luca Montanelli Maria La Manna Luca Guerra Maurizio Arosio Claudio Landoni Alessandro Buda
Publish Date: 2016/11/04
Volume: 31, Issue: 1, Pages: 93-99
Abstract
40 stageI EC patients 667 ± 97 years underwent preoperative lymphoscintigraphy After about 3 h from Tc99malbumin nanocolloid cervical injection all patients underwent SPECT/CT study MBD was injected into the cervix just before surgery under general anesthesia All patients underwent SLN biopsy hysterectomy bilateral salpingooophorectomy and radical regional lymphadenectomy SPECT/CT findings were compared to those of gammaprobe and MBD techniquesIn 2 patients no nodal migration was observed neither with MBD nor radiotracer Detection rate of at least one SLN was 90 36/40 patients with SPECT/CT 88 35/40 intraoperatively with gammaprobe and 80 32/40 with MBD Only in 7/40 patients a bilateral migration was obtained with all considered modalities In particular bilateral detection was achieved in 26 patients with SPECT/CT in 24 with gammaprobe and in 10 patients with MBD The concordance site between SPECT/CT and intraoperative gammaprobe was 73 29/40 patients 2 without migration 21 bilateral and 6 monolateral SLNs while concordance site with MBD was found in 40 16/40 8 bilateral 6 monolateral SLNs 2 without SLNs Overall 628 LNs were dissected mean 18 LNs per patient The median number of SLNs removed was 2 mean 25 per patient Out of 91 SLNs 43 were “hot and blue HB” 10 were blue only and 38 were hot only LN metastases rate was 16 9/90 SLNs 7 HB 2 hot only were positive for metastases in 6 patients Four nonSLNs were found positive in 3 patients and all presented concomitant positive SLNs False negative rate was 0SPECT/CT had the highest detection rate and achieved the highest rate of bilateral mapping compared to gammaprobe and MDB SPECT/CT had moderate concordance with gammaprobe and it can help the intraoperative detection of SLNs providing important information about their anatomic location
Keywords: