ASO Author Reflections: Impact of SPECT/CT on Sentinel Lymph Node Biopsy in Head and Neck Melanoma

Excerpt

For early-stage melanoma, sentinel lymph node biopsy (SLNB) provides valuable prognostic information and determines the patient’s next treatment step. SLNB has had consistently higher false-negative rates in head and neck melanoma (HNM) than other locations.1 Challenges for this region include diverse and unpredictable lymphatic drainage, complex anatomy, and close proximity of tumor site to SLNs. Planar lymphoscintigraphy (PL) was first introduced in the 1990s and is still the main imaging modality used for SLNB. PL images accurately document migration of radioactivity, but provide little information on the number or anatomic location of the SLNs within the lymph node basin. Lymphoscintigraphy with single-photon emission computed tomography/computed tomography (SPECT/CT) has been shown to improve radioactive nodal detection and anatomic localization.2,3 In HNM, it has been found to increase detection of metastatic SLNs.4 Our study investigated when and how often SPECT/CT detects SLNs not identified on PL in HNM.5 We also evaluated its impact on surgical approach and oncologic outcomes. …