The Evaluation of Sentinel Lymph Node Biopsy Using Radiocolloid in First Stage Endometrial Cancer/Birinci Evre Endometrial Kanserde Radyokolloid Kullanilarak Yapilan Sentinel Lenf Nodu Biyopsisinin Degerlendirilmesi

• Published in: Molecular imaging and radionuclide therapy Vol. 32; no. 2; p. 103
• Main Authors: Jankulovska, Anamarija, Stojanoski, Sinisha, Stojcevski, Sasho, Aluloski, Igor, Jovanovic, Rubens, Kunovska, Slavica Kostadinova, Tanturovski, Mile, Manevska, Nevena, Petrusevska, Gordana, Miladinova, Daniela
• Format: Journal Article
• Language: English
• Published: Galenos Yayinevi Tic. Ltd 01.06.2023
• Subjects: Development and progression; Diagnosis; Endometrial cancer; Health aspects; Lymph nodes; North Macedonia
• ISSN: 2146-1414
• DOI: 10.4274/mirt.galenos.2022.36097

Objectives: Detection of a sentinel lymph node (SLN) in patients with endometrial cancer (EC) reduces the rate of unnecessary systemic lymph dissection. The aim of this study was to assess the SLN detection rate, accuracy of the method using Tc-99m-SENTI-SCINT and the rate of metastatic nodal involvement in patients with preoperative first stage EC. Methods: A prospective study of SLN biopsy of 41 patients with stage I EC was conducted after cervical application of 4mCi Tc-99m-SENTI-SCINT. Planar lymphoscintigraphy and single-photon emission computed tomography/computed tomography (SPECT/CT) of the pelvis were performed, followed by site-specific lymphadenectomy in intermediate-risk patients if no SLN was detected per hemipelvis and pelvic lymphadenectomy in all high-risk patients. Results: Pre-operative detection rate of planar lymphoscintigraphy was 80.49 [95% confidence interval (CI): 68.36-92.62] and of SPECT/CT 95.12 (95% CI: 88.52-101.7). The total intraoperative SLN detection rate was 95.12 (95% CI: 88.52-101.7) per patient and 26.83 (95% CI: 19.91-33.75) bilaterally. The average number of SLNs removed was 1.6[+ or -]0.8. The most common anatomical location of SLN was the right external iliac region. The SLN metastatic rate was 17%. Both sensitivity and negative predictive value regarding metastatic involvement were 100%. Conclusion: The SLN detection rate, sensitivity and negative predictive value using Tc-99m-SENTI-SCINT in patients with EC in our study were high. The application of ultra-staging in the histopathological analysis of SLN increases the detection of nodal metastases and improves the staging in these patients. Keywords: Endometrial carcinoma, sentinel lymph node, ultra-staging, SPECT/CT Amac: Endometriyal kanserli (EK) hastalarda sentinel lenf nodu (SLN) saptanmasi gereksiz sistemik lenf diseksiyonu oranini azaltir. Bu calismanin amaci, preoperatif birinci evre EK'li hastalarda SLN saptama oranini, Tc-99m-SENTI-SCINT kullanilan yontemin dogrulugunu ve metastatik nodal tutulum oranini degerlendirmekti. Yontem: 4mCi Tc-99m-SENTI-SCINT'nin servikal uygulamasindan sonra evre I EK'li 41 hastanin SLN biyopsisini iceren prospektif bir calisma yapildi. Pelvisin planar lenfosintigrafisi ve tek foton emisyonlu bilgisayarli tomografisi/bilgisayarli tomografisi (SPECT/BT) cekildi, ardindan hemipelvis basina SLN saptanmadiysa orta riskli hastalarda bolgeye ozgu lenfadenektomi ve tum yuksek riskli hastalarda pelvik lenfadenektomi uygulandi. Bulgular: Planar lenfosintigrafinin ameliyat oncesi saptama orani 80,49 iken [%95 guven araligi (GA): 68,36-92,62] SPECT/BT'nin saptama orani 95,12 (%95 GA: 88,52-101,7) idi. Toplam intraoperatif SLN saptama orani hasta basina 95,12 (%95 GA: 88,52-101,7) ve bilateral olarak 26,83 (%95 GA: 19,91-33,75) idi. Cikarilan ortalama SLN sayisi 1,6[+ or -]0,8 idi. SLN'nin en yaygin anatomik yerlesim yeri sag eksternal iliak bolge idi. SLN metastatik orani %17 idi. Metastatik tutulumla ilgili hem duyarlilik hem de negatif ongoru degeri %100 idi. Sonuc: Calismamizda EK'li hastalarda Tc-99m-SENTI-SCINT kullanilarak SLN saptama oraninin ve Tc-99m-SENTI-SCINT'nin duyarliliginin ve negatif prediktif degerinin yuksek oldugu gosterildi. Ultra evrelemenin SLN'nin histopatolojik analizinde uygulanmasi nodal metastazlarin saptanmasini arttirir ve bu hastalarda evrelemeyi gelistirir. Anahtar kelimeler: Endometriyal karsinom, sentinel lenf nodu, ultra evreleme, SPECT/BT