Abstract：Objective: Preoperative lymphoscintigraphy(LS) is important in localization of the sentinel lymph node(SLN). The present study evaluated the benefit of SPECT/CT in LS for the preoperative localization of the SLN. Methods: Twenty-one clinically negative patients with T1 or T2 oral squamous cell carcinoma were enrolled. LS underwent by SPECT/CT. Planar and fusion images were interpreted separately. Results: In all patients, SPECT/CT fusion images confirmed the localization obtained by planar images and skin marking. Moreover, in 9 of 21 patients, the fusion images improved or corrected the preoperative localization of the SLN on planar images: 7 nodes that had been identified only on fused images were located in basins other than or in addition to the basins identified on planar images, 1 node that was located closed to the injection site was hidden by its scattered radiation on planar imaging, and 1 node erroneously diagnosed that was also affected by injection radiation scatter. In addition, fusion images identified bilateral draining basins in 6 of the 21 patients, however planar images only in 1 of 21. The SLN were successfully revealed in planar and fused images, with a detection rate of 95.2% and 100% respectively. Histologic examination confirmed the metastatic involvement of the SLN in 4 of 21 patients, the SLN positive rate was 13.8%, and there were no false negatives. Conclusion: Our results showed the additional value of SPECT/CT fusion imaging to planar imaging and sharpen the localization of the SLN that are of clinically relevance to SLNB in patients with oral squamous cell carcinoma. And fusion images provide the topographic landmarks that may further facilitate surgical exploration.
2006, Vol. 17 
