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Lindsay Brammen,Jakob Nedomansky,Werner Haslik,Anton Staudenherz 대한핵의학회 2014 핵의학 분자영상 Vol.48 No.4
Abstract In melanoma patient s , preoperat i v elymphoscintigraphy has become a gold standard. The role ofsingle-photon emission computed tomography (SPECT) or itscombination with computed tomography (SPECT-CT) as partof the standard sentinel scintigraphy protocol has yet to bedetermined. A 46-year-old female patient with melanoma ofthe trunk received preoperative lymphoscintigraphy and subsequentsurgical excision. Planar imaging displayed two hotspots in the region of the primary lesion. No other lymphaticflow pathways could be appreciated. Two focal hot spots, onedorsal to the primary lesion near the left latissimus dorsimuscle and one just lateral to the primary lesion in the subcutaneoustissue, were appreciated with SPECT-CT imaging. The primary melanoma lesion, as well as the two additionallesions, which were detected by SPECT-CT, were excised andsent for histopathological examination. While the primarylesion was a superficial spreading melanoma, the lesionsappreciated in SPECT-CT revealed four sentinel lymph nodes,each of which was negative for tumor cells. Melanomas,especially of the trunk, can demonstrate multiple lymphaticdrain basins in a large percentage of patients. Given thatwithout the detailed anatomical information provided bySPECT-CT it would be very difficult to locate the diverselymphatic drain basins and their lymph nodes, we wouldsuggest routinely implementing SPECT-CT in the standardplanar sentinel imaging protocol.
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