Sentinel lymph node detection by SPECT-CT in patient with laryngeal carcinoma

Objective To evaluate the value of SPECT-CT lymphoscintigraphy for sentinel lymph node (SLN) detection in patients with larynx neoplasms.Methods Thirty patients with cN₀ laryngeal carcinoma were eligible for the study.Preoperative SPECT-CT lymphoscintigraphy was performed with laryngotracheoscopy guided injection of radioactivity isotope ⁹⁹Tc^m-sulfur colloid (⁹⁹Tc^m-SC) into the laryngeal carcinoma before surgery.The patients underwent intraoperative lymphatic mapping with a handheld gamma-detecting probe.The results of routine pathologic examination of cervical specimen were set a golden standard to assess the efficacy of SLN biopsy in evaluating the cervical lymph node status.Results Sixty-six SLNs were detected in 28 cases out of the total 30 cases (93.3%).Preoperative planar image and SPECT-CT fusion image detected 61 and 66 SLNs, respectively.With the application of intraoperative gamma probe, SLN was detected in 27/30 patients (90.0%), correlate rate was 85.7% (24/28).Six patients (20.0%) had lymph node metastasis.The sensitivity, specificity, accuracy and false negative rate of SLN detection were respectively 83.3%, 95.8%, 93.3% and 16.7%.Conclusion Preoperative SPECT-CT lymphoscintigraphy can not only enables precise localization of SLN but also detect the cervical lymph node metastasis in patients with laryngeal carcinoma.