scholarly journals SPECT/CT-Guided Surgical Removal of a Positive External Iliac Sentinel Node in Primary Umbilical Melanoma: Report of a Case, and Up-to-Date Review of the Literature

2022 ◽  
Vol 11 ◽  
Author(s):  
Franco Picciotto ◽  
Adriana Lesca ◽  
Luca Mastorino ◽  
Elena Califaretti ◽  
Luca Conti ◽  
...  
Keyword(s):  
Lymph Node ◽  
Single Photon ◽  
Regional Lymph Node ◽  
Photon Emission ◽  
Lymphatic Drainage ◽  
Lymph Node Biopsy ◽  
Surgical Removal ◽  
Planar Imaging ◽  
Ct Guided ◽  
Nodal Spread

Primary umbilical melanoma is rare tumor, representing about 5% of all umbilical malignancies.The lymphatic drainage from the tumor is challenging and can be to inguinal, axillary and retroperitoneal nodes. Dynamic and static lymphoscintigraphy with single-photon emission tomography/computed tomography (SPECT/CT) and sentinel lymph node biopsy (SLNB) is a widely validated technique in patients with clinically localized melanoma to search for and quantify nodal spread of cutaneous melanoma. Moreover, it offers the surgeon the preoperative information about the number and location of the sentinel lymph nodes (SLNs), which makes SLNB easier and quicker. This is the first report of an ulcerated thick melanoma of the umbilicus metastasizing only to an external iliac lymph-node without involvement of superficial inguinal SLNs. The preoperative high-resolution ultrasound (HR-US) examination of the regional lymph node field had been normal. This case-report shows how addition of SPECT/CT to planar imaging in a patient with clinically localized umbilical melanoma can help avoid incomplete SLNB when a deep SLN is not removed. A literature review of umbilical melanoma is also provided.

Breast sentinel lymph node biopsy with imaging towards minimally invasive surgery

2017 ◽  
Vol 62 (6) ◽  
pp. 547-555 ◽  
Author(s):  
Fredrick Johnson Joseph ◽  
Alexander van Oepen ◽  
Michael Friebe
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Minimally Invasive ◽  
Single Photon ◽  
Photon Emission ◽  
Lymph Node Biopsy ◽  
Emission Computed Tomography ◽  
Imaging Methods ◽  
Node Biopsy

AbstractBreast sentinel lymph nodes are still commonly assessed through complete lymph node dissections, which is a time-consuming and radical approach because the nodes are difficult to identify. To prevent false diagnosis and achieve accurate results, minimally invasive, image-guided procedures are applied and constantly improved. The purpose of this paper is to present the currently used imaging modalities ultrasound, fluorescence, single-photon emission computed tomography (SPECT), magnetic resonance imaging (MRI) and hybrid imaging methods and comparing their effectiveness for breast sentinel lymph node biopsy. A definition for an ideal imaging system combining efficient minimally invasive techniques with workflow considerations is also discussed. As a conclusion, upcoming imaging methods and their future outlook with areas of advancement are presented.

scholarly journals Contrast-Enhanced Ultrasound for Precise Sentinel Lymph Node Biopsy in Women with Early Breast Cancer: A Preliminary Study

Diagnostics ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 2104
Author(s):  
Yangyang Zhu ◽  
Xiao Fan ◽  
Dan Yang ◽  
Tiantian Dong ◽  
Yingying Jia ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Early Breast Cancer ◽  
Lymphatic Drainage ◽  
Lymph Node Biopsy ◽  
Contrast Enhanced Ultrasound ◽  
Breast Cancer Patients ◽  
Drainage Patterns ◽  
Node Biopsy ◽  
Contrast Enhanced

Background: Sentinel lymph node biopsy (SLNB), as a common method for axillary staging of early breast cancer, has gradually attracted people’s attention to the false-negative rate and postoperative complications. The aim of the study is to investigate the clinical value of preoperative contrast-enhanced ultrasound (CEUS) for intraoperative SLNB in early breast cancer patients. Methods: A total of 201 patients scheduled for SLNB from September 2018 to April 2021 were collected consecutively. Preoperative CEUS was used to identify sentinel lymph nodes (SLN) and lymphatic drainage in breast cancer patients. Results: The SLN identification rate of CEUS was 93.0% (187/201) and four lymphatic drainage patterns were found: single LC to single SLN (70.0%), multiple LCs to single SLN (8.0%), single LC to multiple SLNs (10.2%), and multiple LCs to multiple SLNs (11.8%). The Sen, Spe, PPV, NPV, AUC of CEUS, US and CEUS + US in diagnosis of SLNs were 82.7%, 80.4%, 73.8%, 87.4%, 0.815; 70.7%, 77.7%, 68.0%, 79.8%, 0.742; and 86.7%, 77.7%, 72.2%, 89.7%, 0.822, respectively. There was no statistically significant difference between the diagnostic performance of CEUS and CEUS + US (p = 0.630). Conclusions: CEUS can be used to preoperatively assess the lymphatic drainage patterns and the status of the SLNs in early breast cancer to assist precision intraoperative SLNB.

scholarly journals Sentinel Node Identification in Melanoma: Current Clinical Impact, New Emerging SPECT Radiotracers and Technological Advancements. An Update of the Last Decade

2020 ◽  
Vol 13 (1) ◽  
pp. 32-41 ◽  
Author(s):  
Natale Quartuccio ◽  
Massimiliano Siracusa ◽  
Marco Pappalardo ◽  
Annachiara Arnone ◽  
Gaspare Arnone
Keyword(s):  
Lymph Node ◽  
Single Photon ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Prognostic Information ◽  
Hybrid Techniques ◽  
Sentinel Node Identification ◽  
Anatomical Images ◽  
Metastatic Involvement ◽  
Analytical Approaches

Background: Melanoma is the most lethal skin cancer with a mortality rate of 262 cases per 100.000 cases. The sentinel lymph node (SLN) is the first lymph node draining the tumor. SLN biopsy is a widely accepted procedure in the clinical setting since it provides important prognostic information, which helps patient management, and avoids the side effects of complete lymph node dissection. The rationale of identifying and removing the SLN relies on the low probability of subsequent metastatic nodes in case of a negative histological exam performed in the SLN. Discussion: Recently, new analytical approaches, based on the evaluation of scintigraphic images are also exploring the possibility to predict the metastatic involvement of the SLN. 99mTc-labeled colloids are still the most commonly used radiotracers but new promising radiotracers, such as 99mTc- Tilmanocept, are now on the market. In the last decades, single photon emission computed tomography- computerized tomography (SPECT/CT) has gained wider diffusion in clinical departments and there is large evidence about its superior diagnostic accuracy over planar lymphoscintigraphy (PL) in the detection of SLN in patients with melanoma. Scientists are also investigating new hybrid techniques combining functional and anatomical images for the depiction of SLN but further evidence about their value is needed. Conclusion: This review examined the predictive and prognostic factors of lymphoscintigraphy for metastatic involvement of SLN, the currently available and emerging radiotracers and the evidence of the additional value of SPECT/CT over PL for the identification of SLN in patients with melanoma. Finally, the review discussed the most recent technical advances in the field.

scholarly journals Gamma Radiation Imaging System via Variable and Time-Multiplexed Pinhole Arrays

Sensors ◽  
2020 ◽  
Vol 20 (11) ◽  
pp. 3013 ◽  
Author(s):  
Ariel Schwarz ◽  
Amir Shemer ◽  
Yossef Danan ◽  
Rachel Bar-Shalom ◽  
Hemy Avraham ◽  
...  
Keyword(s):  
Gamma Radiation ◽  
Imaging System ◽  
Single Photon ◽  
Photon Emission ◽  
Three Dimensional ◽  
Medical Diagnostics ◽  
Emission Computed Tomography ◽  
Planar Imaging ◽  
Gamma Imaging ◽  
Image Capturing

Biomedical planar imaging using gamma radiation is a very important screening tool for medical diagnostics. Since lens imaging is not available in gamma imaging, the current methods use lead collimator or pinhole techniques to perform imaging. However, due to ineffective utilization of the gamma radiation emitted from the patient’s body and the radioactive dose limit in patients, poor image signal to noise ratio (SNR) and long image capturing time are evident. Furthermore, the resolution is related to the pinhole diameter, thus there is a tradeoff between SNR and resolution. Our objectives are to reduce the radioactive dose given to the patient and to preserve or improve SNR, resolution and capturing time while incorporating three-dimensional capabilities in existing gamma imaging systems. The proposed imaging system is based on super-resolved time-multiplexing methods using both variable and moving pinhole arrays. Simulations were performed both in MATLAB and GEANT4, and gamma single photon emission computed tomography (SPECT) experiments were conducted to support theory and simulations. The proposed method is able to reduce the radioactive dose and image capturing time and to improve SNR and resolution. The results and method enhance the gamma imaging capabilities that exist in current systems, while providing three-dimensional data on the object.

Frequency and prognosis of metastasis to liver, lung, bone and brain from Merkel cell carcinoma

2020 ◽  
Vol 16 (16) ◽  
pp. 1101-1113 ◽  
Author(s):  
Yi-Jun Xia ◽  
Dong-Sheng Cao ◽  
Jun Zhao ◽  
Bang-Zhong Zhu ◽  
Juan Xie
Keyword(s):  
Lymph Node ◽  
Cell Carcinoma ◽  
Merkel Cell Carcinoma ◽  
Distant Metastasis ◽  
Regional Lymph Node ◽  
Distant Metastases ◽  
Lymph Node Biopsy ◽  
Merkel Cell ◽  
Factors Affecting ◽  
Node Removal

Aim: To describe the factors affecting distant metastasis of Merkel cell carcinoma (MCC) and the prognosis of metastatic MCC. Materials & methods: The MCC patient information was downloaded from the SEER database. Logistic regression and Cox proportional hazard models were conducted to screen for significant factors. Results: A total of 3449 patients were enrolled. Surgery and chemotherapy were significantly correlated with the occurrence of distant metastasis. In the cause-specific survival rate of MCC, regional lymph node removal, sentinel lymph node biopsy, radiation and chemotherapy can significantly reduce the prognostic risk of patients with distant metastases. Conclusion: Our study screened out the factors affecting the distant metastasis and prognosis of MCC and more prospective studies are needed to verify our findings.

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