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Khimling Tew, David Farlow
Sentinel lymph node biopsy is a crucial part of staging intermediate and thick melanoma. Lymphatic drainage from a tumor site can be highly variable, especially on the head, neck, and trunk. SPECT/CT fuses nuclear medicine and x-ray CT images to produce images with high anatomic detail. At our institution, SPECT/CT is performed routinely in addition to planar imaging. This article presents examples where SPECT/CT has proven helpful in image interpretation.
October 5, 2016: Clinical Nuclear Medicine
Elisa Tardelli, Sara Mazzarri, Domenico Rubello, Marta Gennaro, Lorenzo Fantechi, Valerio Duce, Antonella Romanini, Sotirios Chondrogiannis, Duccio Volterrani, Patrick M Colletti, Gianpiero Manca
Melanoma is an important public health problem, and its incidence is increasing worldwide. The disease status of regional lymph nodes is the most important prognostic factor in early-stage melanoma patients. Sentinel lymph node biopsy (SLNB) was introduced in the early 1990s as a less invasive procedure than complete lymph node dissection to allow histopathologic evaluation of the "sentinel lymph node" (SLN), which is the first node along the lymphatic pathway from a primary tumor. Sentinel lymph node biopsy has minimal complication risks compared with standard complete lymph node dissection...
October 5, 2016: Clinical Nuclear Medicine
Ana Barić, Vinko Marković, Adela Arapović, Sandra Prgomet, Marijan Saraga
Lymphoscintigraphy is not considered as a first line diagnostic procedure in abdominal or thoracic lymphorrhea of various origin. We report a patient with lymphangiectasia in whom posttraumatic lymphorrhea was diagnosed by lymphoscintigraphy only after third attempt when we applied pushups exercise with the aim to raise venous pressure and thus provoke lymph backflow in ductus thoracicus and enteric lymphytics. Lymphorrhea was clearly visible in colon ascendens and colon transversum on 9h planar scintigram...
October 5, 2016: Clinical Nuclear Medicine
Angela Collarino, Sergi Vidal-Sicart, Germano Perotti, Renato A Valdés Olmos
This review discusses the state-of-the-art of sentinel lymph node mapping in gynaecological malignancies, including cervical cancer, endometrial cancer, and vulvar cancer, with an emphasis on new technological advances. For this objective, PubMed/MEDLINE was searched for relevant studies about the sentinel lymph node procedure in gynaecology. In particular, the use of preoperative lymphatic mapping with lymphoscintigraphy and single photon emission tomography/computed tomography (SPECT/CT) was identified in 18 studies...
2016: Clinical and Translational Imaging: Reviews in Nuclear Medicine and Molecular Imaging
Hilary Watt, Davinder Singh-Grewal, Orli Wargon, Susan Adams
AIM: To define the clinical characteristics, investigations, management and outcomes of lymphoedema in a paediatric cohort. METHODS: A retrospective chart review of children with lymphoedema seen at two tertiary paediatric hospitals since 1998. Telephone interviews with parents were performed when information was missing. Information recorded included demographic data, features of diagnosis and clinical presentation, symptoms, complications and treatment. RESULTS: A total of 86 patients with lymphoedema were identified...
October 4, 2016: Journal of Paediatrics and Child Health
Ahmed El Muntasar, Deems Oudit
BACKGROUND AND PURPOSE: Malignant melanoma (MM) on the trunk, because of its anatomical location, has multiple potential lymphatic basins to which to drain. The aim of this study is to map the location of the sentinel lymph node (SLN) on the basis of the anatomical location of the primary malignant melanoma on the trunk. METHODS: Patients diagnosed with MM on the trunk who had undergone a SLN biopsy from January 2006 to March 2015 were identified in the Christie NHS Foundation Trust through a computer database search...
September 10, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Matthew P Doepker, Maki Yamamoto, Matthew A Applebaum, Nupur U Patel, M Jaime Montilla-Soler, Amod A Sarnaik, C Wayne Cruse, Vernon K Sondak, Jonathan S Zager
BACKGROUND: Accurate preoperative lymphoscintigraphy is vital to performing sentinel lymph node biopsy (SLNB) for cutaneous malignancies. Potential advantages of single-photon emission computed tomography with integrated computed tomography (SPECT/CT) include the ability to readily identify aberrant drainage patterns as well as provide the surgeon with three-dimensional anatomic landmarks not seen on conventional planar lymphoscintigraphy (PLS). METHODS: Patients with cutaneous malignancies who underwent SLNB with preoperative imaging using both SPECT/CT and PLS from 2011 to 2014 were identified...
September 22, 2016: Annals of Surgical Oncology
Elizabeth A Andraska, Danielle C Horne, Danielle N Campbell, Jonathan L Eliason, Thomas W Wakefield, Dawn M Coleman
BACKGROUND: The spectrum of chronic venous disease (CVD) is well documented in adults; clinical guidelines standardize diagnosis and treatment. There is a paucity of data published commenting on pediatric CVD exclusive of Klippel-Trénaunay syndrome (KTS) and post-thrombotic syndrome. METHODS: This study aimed to define patterns of pediatric venous disease. All venous reflux studies performed on patients <18 years of age between January 2012 and June 2014 were reviewed...
October 2016: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Jonathan G Hiller, Hilmy M Ismail, Michael S Hofman, Kailash Narayan, Shakher Ramdave, Bernhard J Riedel
Dilation of lymphatic vessels may contribute to iatrogenic dissemination of cancer cells during surgery. We sought to determine whether neuraxial anesthesia reduces regional lymphatic flow. Using nuclear lymphoscintigraphy, 5 participants receiving spinal anesthesia for brachytherapy had lower extremity lymph flow at rest compared with flow under conditions of spinal anesthesia. Six limbs were analyzed. Four limbs were excluded because of failure to demonstrate lymph flow (1 patient, 2 limbs), colloid injection error (1 limb), and undiagnosed deep vein thrombosis (1 limb)...
September 15, 2016: Anesthesia and Analgesia
Kate H Dinh, Ariana F Harris, Jennifer LaFemina, Giles F Whalen, Mary Sullivan, Robert Licho, Thomas Hill, Laura A Lambert
BACKGROUND AND OBJECTIVES: Lymphatic mapping (LM) and blue dye injections are essential to identification of sentinel lymph nodes (SLN) for melanoma. LM is performed the day before (DB) or the same day (SD) of surgery, but the optimal timing is unknown. Similarly, methylene blue (MB), used during SLN biopsy (SLNB), is administered diluted (dMB) or undiluted (uMB), but the relative efficacies are unknown. METHODS: Patients who underwent SLNB for melanoma from 2009 to 2013 at our institution were evaluated...
September 16, 2016: Journal of Surgical Oncology
Malihe Hassanzadeh, Elham Hosseini Farahabadi, Zohreh Yousefi, Sima Kadkhodayan, Leili Zarifmahmoudi, Ramin Sadeghi
BACKGROUND: Experience on sentinel node mapping in ovarian tumors is very limited. We evaluated the sentinel node concept in ovarian tumors using intra-operativeTc-99m-Phytate injection and lymphoscintigraphy imaging. METHODS: Thirty-five patients with a pelvic mass due to an ovarian pathology were included in the study. The radiotracer was injected just after laparotomy and before removal of the tumor either beneath the normal cortex (10 patients) or in the utero-ovarian and suspensory ligaments of the ovary just beneath the peritoneum two injections of the radiotracer (25 patients)...
2016: Journal of Ovarian Research
Linda Zetterlund, Stefan Gabrielson, Rimma Axelsson, Jana de Boniface, Jan Frisell, Annie Olsson, Fuat Celebioglu
BACKGROUND: Earlier studies have shown conflicting results regarding the accuracy of sentinel lymph node biopsy after previous breast surgery, especially after a surgical biopsy. PURPOSE: To compare lymph drainage patterns before and after a diagnostic unilateral surgical biopsy using the exact anatomical localisation of sentinel lymph nodes defined by SPECT/CT. MATERIAL AND METHODS: Thirty-seven women planned for unilateral surgical excision of an unsuspicious breast lesion were prospectively examined between September 2011 and January 2015...
September 2, 2016: Breast: Official Journal of the European Society of Mastology
S Vignes
Lymphedema results from impaired lymphatic transport with increased limb volume. Lymphedema are divided in primary and secondary forms. Upper-limb lymphedema secondary to breast cancer treatment is the most frequent in France. Primary lymphedema is sporadic, rarely familial or associated with complex malformative or genetic disorders. Diagnosis of lymphedema is mainly clinical and lymphoscintigraphy is useful in primary form to assess precisely the lymphatic function of the two limbs. Erysipelas (cellulitis) is the main complication, but psychological or functional discomfort may occur throughout the course of lymphedema...
August 31, 2016: La Revue de Médecine Interne
Homaira Rahimi, Richard Bell, Echoe M Bouta, Ronald W Wood, Lianping Xing, Christopher T Ritchlin, Edward M Schwarz
UNLABELLED: Proliferation of draining lymphatic vessels coupled with dynamic changes in lymph node volume and flow are characteristic features in rheumatoid arthritis (RA). Furthermore, impaired lymph egress from inflamed synovium is associated with joint flare in murine models of inflammatory-erosive arthritis. Unfortunately, advances towards a greater understanding of lymphatic changes in RA pathogenesis have been slow due to the absence of outcome measures to quantify lymphatic function in vivo...
2016: Arthritis Research & Therapy
Vincenzo Frusciante, Artor Niccoli Asabella, Gaetano Castriotta, Michele Guerra, Roberto Murgo, Luigi Ciuffreda, Valentina Lavelli, Cristina Ferrari, Giuseppe Rubini
UNLABELLED: The aim of the study was to assess the diagnostic contribution of hybrid SPECT/CT lymphoscintigraphy compared to planar imaging for the correct identification of sentinel lymph nodes (SLN) in breast cancer (BC) patients. MATERIALS AND METHODS: 73 planar and SPECT/CT lymphoscintigraphies were performed in 70 consecutive patients with BC (70 women, mean age 55.7±12.0 years, range 26-84) for pre-surgical SLNs research. Cohen'K was performed to evaluate the agreement between both techniques; their diagnostic capability was evaluated by the Student's t-test for paired data...
August 2016: Recenti Progressi in Medicina
C Gillard, P Franken, J Darcourt, E Barranger
OBJECTIVE: Sentinel lymph node biopsy (SLNB) is a standard for patients with early breast cancer. Using a gamma-detecting probe connected to an infrared camera, the Declipse freehand SPECT (FhSPECT) system (Surgiceye(®)) is able to detect and locate any radioactive source in 3D. The objective of this study was to evaluate the potential interest of FhSPECT imaging for real-time guidance SLNB in breast cancer. METHODS: A prospective single-center clinical study assessed sensitivity and usability of FhSPECT for SLN detection and surgical guidance in breast cancer patients...
September 2016: Gynécologie, Obstétrique & Fertilité
Rossi Matteo, Grassi Rita, Costa Renato, Di Rosa Luigi, DʼArpa Salvatore, Moschella Francesco, Cordova Adriana
BACKGROUND: Current research on the upper limb lymphatic system mainly studies breast cancer patients with unilateral lymphedema. Without a preoperative lymphoscintigraphy, the contralateral limb is used as control, assuming that is functionally intact. Criteria for lymphatic dysfunction include asymmetric and delayed (>10-30') radiotracer transportation time. Few lymphoscintigraphic studies investigate patients before any axillary surgery. The purpose of this study is to evaluate, through lymphoscintigraphy, the preoperative condition of the upper limb lymphatic system in melanoma patients and healthy controls...
August 15, 2016: Plastic and Reconstructive Surgery
Mariana Maia Freire de Oliveira, Maria Salete Costa Gurgel, Maria Teresa Pace do Amaral, Bárbara Juarez Amorim, Celso Darío Ramos, José Geraldo Almeida Filho, Laura Ferreira de Rezende, Luís Otávio Zanatta Sarian
OBJECTIVE: To evaluate manual lymphatic drainage (MLD) and active exercise effects on lymphatic alterations of the upper limb (UL), range of motion (ROM) of shoulder, and scar complications after breast cancer surgery. DESIGN: Clinical trial. SETTING: Health care center. PARTICIPANTS: Women (N=105) undergoing radical breast cancer surgery who were matched for staging, age, and body mass index. INTERVENTIONS: Women (n=52) were submitted to MLD and 53 to active exercises for UL for 1 month and followed up...
August 9, 2016: Archives of Physical Medicine and Rehabilitation
Philippe Rauch, Jean-Louis Merlin, Lea Leufflen, Julia Salleron, Alexandre Harlé, Pierre Olivier, Frédéric Marchal
BACKGROUND: Although morbidity is reduced when sentinel lymph node (SLN) biopsy is performed with dual isotopic and blue dye identification, the effectiveness of adding blue dye to radioisotope remains debated because side effects including anaphylactic reactions. PATIENTS AND METHODS: Using data from a prospectively maintained database, 1884 lymph node-negative breast cancer patients who underwent partial mastectomy with SLN mapping by a dual-tracer using patent blue dye (PBD) and radioisotope were retrospectively studied between January 2000 and July 2013...
September 2016: International Journal of Surgery
Norbertus A Ipenburg, Omgo E Nieweg, Roger F Uren, John F Thompson
BACKGROUND: At our institution, a planned sentinel node biopsy (SNB) procedure is occasionally canceled after preoperative lymphoscintigraphy. This study reports the frequency of this, the reasons, and the management and outcomes of these patients. METHODS: All patients with clinically localized cutaneous melanoma treated at Melanoma Institute Australia between 2000 and 2009 whose planned SNB procedure was not undertaken after lymphoscintigraphy were included in this retrospective study...
August 1, 2016: Annals of Surgical Oncology
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