Validation of single-photon emission computed tomography with computed tomography and lymphoscintigraphy for sentinel lymph node identification in cervical cancer

Int J Gynaecol Obstet. 2023 Dec;163(3):813-817. doi: 10.1002/ijgo.14917. Epub 2023 Jun 18.

Abstract

Objective: To compare single-photon emission computed tomography with computed tomography (SPECT/CT) and lymphoscintigraphy (LSG) for the detection of sentinel lymph nodes (SLNs) in patients with early-stage cervical cancer.

Methods: This hospital-based, single-center, retrospective study included 128 patients with cervical cancer (aged >18 years) treated between 2014 and 2022. Injection of 99 m Technetium-labeled phytate into the uterine cervix was used to detect pelvic SLNs. SNL identification rates and locations were analyzed for preoperative LSG and SPECT/CT.

Results: Median age and body mass index of patients were 40 years (range, 20-78 years) and 21.7 kg/m2 (range, 16-40 kg/m2 ), respectively. There was no significant difference in overall identification rates (identification of at least one SLN) of SLNs between SPECT/CT (91%) and LSG (88%). There was no significant difference in bilateral SLN identification rates between SPECT/CT (66%) and LSG (65%). A total of 219 pelvic SLNs (110 right and 109 left hemipelvis) were identified by SPECT/CT; the most frequent locations were the obturator (122 SLNs, 56%) and external iliac (67 SLNs, 30%).

Conclusion: SPECT/CT and LSG showed high SLN identification rates in patients with cervical cancer, and there was no significant difference in overall or bilateral SLN identification rates between the two techniques.

Keywords: SPECT/CT; cervical cancer; identification rate; lymphoscintigraphy; radio isotope; sentinel lymph node.

MeSH terms

  • Female
  • Humans
  • Lymph Nodes / diagnostic imaging
  • Lymph Nodes / pathology
  • Lymphoscintigraphy / methods
  • Retrospective Studies
  • Sentinel Lymph Node* / diagnostic imaging
  • Sentinel Lymph Node* / pathology
  • Tomography, Emission-Computed, Single-Photon / methods
  • Tomography, X-Ray Computed
  • Uterine Cervical Neoplasms* / pathology

Substances

  • Technetium-99