Sentinel lymph node detection by SPECT-CT in patient with laryngeal carcinoma

Objective To evaluate the value of SPECT-CT lympheseintigraphy for sentinel lymph node (SLN) detection in patients with larynx neoplasms. Methods Thirty patients with cN0 laryngeal carcinoma were eligible for the study. Preoperative SPECT-CT lymphoscintigraphy was performed with laryngutracheoscopy guided injection of radioactivity isotope 99Tcm-sulfur colloid (99Tcm-SC) into the laryngeal carcinoma before surgery. The patients underwent intraoperative lympbatic mapping with a handheld gamma-detecting probe. The results of routine pathologic examination of cervical specimen were set a golden standard to assess the efficacy of SLN biopsy in evaluating the cervical lymph node status. Results Sixty-six SLNs were detected in 28 cases out of the total 30 cases (93.3%). Preoperative planar image and SPECT-CT fusion image detected 61 and 66 SLNs, respectively. With the application of intraoperative gamma probe, SLN was detected in 27/30 patients (90.0%), correlate rate was 85.7% (24/28). Six patients (20.0%) had lymph node metastasis. The sensitivity, specificity, accuracy and false negative rate of SLN detection were respectively 83.3%, 95.8%, 93.3% and 16.7%. Conclusion Preoperative SPECT-CT lymphescintigraphy can not only enables precise localization of SLN but also detect the cervical lymph node metastasis in patients with laryngeal carcinoma. Key words: Laryngeal neoplasms; Lymphatic metastasis; Tomography, emission-computed, single-photon; Tomography, X-ray computed; Sentinel lymph node