An analysis of SPECT/CT non-visualization of sentinel lymph nodes in renal tumors
Abstract Background Sentinel lymph node biopsy (SLNB) after intratumoral injection of 99mTc labeled nanocolloid and imaging with scintigraphy and SPECT/CT in renal tumors is feasible. However, sentinel lymph node (SN) non-detection rate with scintigraphy and SPECT/CT is high. The aim of the study wa...
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doaj-e9c1f455e2504430aa8581ff5c99d9cc2020-11-25T02:31:46ZengSpringerOpenEJNMMI Research2191-219X2018-12-018111110.1186/s13550-018-0460-yAn analysis of SPECT/CT non-visualization of sentinel lymph nodes in renal tumorsTeele Kuusk0Maarten L. Donswijk1Renato A. Valdés Olmos2Roderick E. De Bruijn3Oscar R. Brouwer4Kees Hendricksen5Simon Horenblas6Katarzyna Jóźwiak7Warner Prevoo8Henk G. Van Der Poel9Bas W. G. Van Rhijn10Esther M. Wit11Axel Bex12Department of Urology, The Netherlands Cancer InstituteDepartment of Nuclear Medicine, The Netherlands Cancer InstituteDepartment of Nuclear Medicine, The Netherlands Cancer InstituteDepartment of Urology, The Netherlands Cancer InstituteDepartment of Urology, The Netherlands Cancer InstituteDepartment of Urology, The Netherlands Cancer InstituteDepartment of Urology, The Netherlands Cancer InstituteDepartment of Epidemiology and Biostatistics, The Netherlands Cancer InstituteDepartment of Radiology, The Netherlands Cancer InstituteDepartment of Urology, The Netherlands Cancer InstituteDepartment of Urology, The Netherlands Cancer InstituteDepartment of Urology, The Netherlands Cancer InstituteDepartment of Urology, The Netherlands Cancer InstituteAbstract Background Sentinel lymph node biopsy (SLNB) after intratumoral injection of 99mTc labeled nanocolloid and imaging with scintigraphy and SPECT/CT in renal tumors is feasible. However, sentinel lymph node (SN) non-detection rate with scintigraphy and SPECT/CT is high. The aim of the study was to determine factors affecting non-visualization (NV) of SN imaging in renal tumors. Seventy-eight patients with cT1–3 renal tumors received intratumoral injection of 225 MBq 99mTc-labeled nanocolloid 1 day before (partial) nephrectomy. Radiotracer injection was followed by anterioposterior and lateral scintigraphy in combination with SPECT/CT 20 min and 2–4 h after. Surgical treatment of the tumor with sentinel lymph node biopsy by aid of γ-probe and-camera was performed the next day. Scintigraphy and SPECT/CT images were evaluated and patient, tumor, and procedure characteristics were collected for 73 eligible patients used in uni- and multivariable analysis of a potential association with NV. Results A total of 80 (mean 1.1, IQR 0–2, max 6) sentinel lymph nodes in 46 patients were detected with scintigraphy and SPECT/CT. Preoperative visualization rate and intraoperative detection rate was 63% [95% CI 50–73%] and 61% [95% CI 49–72%], respectively. In uni- and multivariable analysis, the only factor associated with non-visualization was age, showing higher odds of non-visualization with higher age. Conclusion Our study demonstrated that non-visualization of SNs in renal tumors is relatively high and is associated with patient age. Furthermore, kidneys and also its tumors are highly vascularized which may cause a wash-out effect that could be identified with decreased kidney-liver ratios. However, in our data, the effect was statistically inconclusive. Further studies are needed to improve visualization and standardize the procedure of SLNB in renal tumors. The percentage of NV limits the use of SLNB for research and clinical purposes in renal cancer.http://link.springer.com/article/10.1186/s13550-018-0460-yDetection failureLymphoscintigraphyNanocolloidRenal cell carcinomaSPECT/CTSentinel lymph node |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Teele Kuusk Maarten L. Donswijk Renato A. Valdés Olmos Roderick E. De Bruijn Oscar R. Brouwer Kees Hendricksen Simon Horenblas Katarzyna Jóźwiak Warner Prevoo Henk G. Van Der Poel Bas W. G. Van Rhijn Esther M. Wit Axel Bex |
spellingShingle |
Teele Kuusk Maarten L. Donswijk Renato A. Valdés Olmos Roderick E. De Bruijn Oscar R. Brouwer Kees Hendricksen Simon Horenblas Katarzyna Jóźwiak Warner Prevoo Henk G. Van Der Poel Bas W. G. Van Rhijn Esther M. Wit Axel Bex An analysis of SPECT/CT non-visualization of sentinel lymph nodes in renal tumors EJNMMI Research Detection failure Lymphoscintigraphy Nanocolloid Renal cell carcinoma SPECT/CT Sentinel lymph node |
author_facet |
Teele Kuusk Maarten L. Donswijk Renato A. Valdés Olmos Roderick E. De Bruijn Oscar R. Brouwer Kees Hendricksen Simon Horenblas Katarzyna Jóźwiak Warner Prevoo Henk G. Van Der Poel Bas W. G. Van Rhijn Esther M. Wit Axel Bex |
author_sort |
Teele Kuusk |
title |
An analysis of SPECT/CT non-visualization of sentinel lymph nodes in renal tumors |
title_short |
An analysis of SPECT/CT non-visualization of sentinel lymph nodes in renal tumors |
title_full |
An analysis of SPECT/CT non-visualization of sentinel lymph nodes in renal tumors |
title_fullStr |
An analysis of SPECT/CT non-visualization of sentinel lymph nodes in renal tumors |
title_full_unstemmed |
An analysis of SPECT/CT non-visualization of sentinel lymph nodes in renal tumors |
title_sort |
analysis of spect/ct non-visualization of sentinel lymph nodes in renal tumors |
publisher |
SpringerOpen |
series |
EJNMMI Research |
issn |
2191-219X |
publishDate |
2018-12-01 |
description |
Abstract Background Sentinel lymph node biopsy (SLNB) after intratumoral injection of 99mTc labeled nanocolloid and imaging with scintigraphy and SPECT/CT in renal tumors is feasible. However, sentinel lymph node (SN) non-detection rate with scintigraphy and SPECT/CT is high. The aim of the study was to determine factors affecting non-visualization (NV) of SN imaging in renal tumors. Seventy-eight patients with cT1–3 renal tumors received intratumoral injection of 225 MBq 99mTc-labeled nanocolloid 1 day before (partial) nephrectomy. Radiotracer injection was followed by anterioposterior and lateral scintigraphy in combination with SPECT/CT 20 min and 2–4 h after. Surgical treatment of the tumor with sentinel lymph node biopsy by aid of γ-probe and-camera was performed the next day. Scintigraphy and SPECT/CT images were evaluated and patient, tumor, and procedure characteristics were collected for 73 eligible patients used in uni- and multivariable analysis of a potential association with NV. Results A total of 80 (mean 1.1, IQR 0–2, max 6) sentinel lymph nodes in 46 patients were detected with scintigraphy and SPECT/CT. Preoperative visualization rate and intraoperative detection rate was 63% [95% CI 50–73%] and 61% [95% CI 49–72%], respectively. In uni- and multivariable analysis, the only factor associated with non-visualization was age, showing higher odds of non-visualization with higher age. Conclusion Our study demonstrated that non-visualization of SNs in renal tumors is relatively high and is associated with patient age. Furthermore, kidneys and also its tumors are highly vascularized which may cause a wash-out effect that could be identified with decreased kidney-liver ratios. However, in our data, the effect was statistically inconclusive. Further studies are needed to improve visualization and standardize the procedure of SLNB in renal tumors. The percentage of NV limits the use of SLNB for research and clinical purposes in renal cancer. |
topic |
Detection failure Lymphoscintigraphy Nanocolloid Renal cell carcinoma SPECT/CT Sentinel lymph node |
url |
http://link.springer.com/article/10.1186/s13550-018-0460-y |
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