Skip to main content
SpringerLink
Log in

Role of intraoperative sentinel node imaging in head and neck cancer

  • Review Article
  • Published:
Clinical and Translational Imaging Aims and scope Submit manuscript

An Erratum to this article was published on 22 September 2016

Abstract

At the present time, there is a dilemma concerning the best management of the neck in patients presenting with early head and neck squamous cell carcinoma (HNSCC). Occult cervical metastasis is found in up to a quarter of HNSCC patients with radiologically N0 necks, and for this reason, conventional treatment includes elective neck dissection (END) alongside tumour excision. Sentinel node biopsy (SNB) offers an alternative accurate and minimally invasive method of staging the neck, which has been safely applied to oral cancer. SNB is a patient-specific procedure which has an enhanced recovery compared to END but is currently not widely offered to patients. There are exciting developments in the technology supporting SNB, improving the accuracy and ease of the procedure and opening up the technique to new tumour types. We describe our experiences in using a novel intraoperative navigation device for sentinel node retrieval and review other advances in SNB practice which have the potential to change the standard management for patients with early HNSCC.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Thiele OC et al (2012) The role of elective supraomohyoidal neck dissection in the treatment of early, node-negative oral squamous cell carcinoma (OSCC): a retrospective analysis of 122 cases. J Craniomaxillofac Surg 40(1):67–70

    Article  PubMed  Google Scholar 

  2. O’Connor R et al (2013) The relative cost of sentinel lymph node biopsy in early oral cancer. J Craniomaxillofac Surg 41(8):721–727

    Article  PubMed  Google Scholar 

  3. Psychogios G et al (2013) Incidence of occult cervical metastasis in head and neck carcinomas: development over time. J Surg Oncol 107(4):384–387

    Article  PubMed  Google Scholar 

  4. Ferris RL, Kraus DH (2012) Sentinel lymph node biopsy versus selective neck dissection for detection of metastatic oral squamous cell carcinoma. Clin Exp Metastasis 29(7):693–698

    Article  PubMed  Google Scholar 

  5. Civantos FJ et al (2010) Sentinel lymph node biopsy accurately stages the regional lymph nodes for T1-T2 oral squamous cell carcinomas: results of a prospective multi-institutional trial. J Clin Oncol 28(8):1395–1400

    Article  PubMed  PubMed Central  Google Scholar 

  6. Ross GL et al (2004) Sentinel node biopsy in head and neck cancer: preliminary results of a multicenter trial. Ann Surg Oncol 11(7):690–696

    Article  PubMed  Google Scholar 

  7. Alkureishi LW et al (2009) Joint practice guidelines for radionuclide lymphoscintigraphy for sentinel node localization in oral/oropharyngeal squamous cell carcinoma. Ann Surg Oncol 16(11):3190–3210

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Bluemel C, Herrmann K, Kübler A, Buck AK, Geissinger E, Wild V, Hartmann S, Lapa C, Linz C, Müller-Richter U (2014) Intraoperative 3-D imaging improves sentinel lymph node biopsy in oral cancer. Eur J Nucl Med Mol Imaging 41(12):2257–2264. doi:10.1007/s00259-014-2870-z

    Article  CAS  PubMed  Google Scholar 

  9. Bilde A et al (2006) The role of SPECT-CT in the lymphoscintigraphic identification of sentinel nodes in patients with oral cancer. Acta Otolaryngol 126(10):1096–1103

    Article  PubMed  Google Scholar 

  10. Haerle SK et al (2009) Is there an additional value of SPECT/CT over planar lymphoscintigraphy for sentinel node mapping in oral/oropharyngeal squamous cell carcinoma? Ann Surg Oncol 16(11):3118–3124

    Article  PubMed  Google Scholar 

  11. Schilling C, Gnanasegaran G, McGurk M (2014) Three-dimensional imaging and navigated sentinel node biopsy for primary parotid malignancy: new application in parotid cancer management. Head Neck 36(9):E91–E93

    PubMed  Google Scholar 

  12. Bluemel C et al (2013) Freehand SPECT for image-guided sentinel lymph node biopsy in breast cancer. Eur J Nucl Med Mol Imaging 40(11):1656–1661

    Article  PubMed  Google Scholar 

  13. Mihaljevic AL et al (2014) Transferring innovative freehand SPECT to the operating room: first experiences with sentinel lymph node biopsy in malignant melanoma. Eur J Surg Oncol 40(1):42–48

    Article  CAS  PubMed  Google Scholar 

  14. Heuveling DA et al (2012) Sentinel node biopsy using 3D lymphatic mapping by freehand SPECT in early stage oral cancer: a new technique. Clin Otolaryngol 37(1):89–90

    Article  CAS  PubMed  Google Scholar 

  15. Mandapathil M et al (2014) Freehand SPECT for sentinel lymph node detection in patients with head and neck cancer: first experiences. Acta Otolaryngol 134(1):100–104

    Article  PubMed  Google Scholar 

  16. Bluemel C, Herrmann K, Müller-Richter U, Lapa C, Higuchi T, Wild V, Buck AK, Kübler A, Linz C (2014) Freehand SPECT-guided sentinel lymph node biopsy in early oral squamous cell carcinoma. Head Neck 36(11):E112–E116. doi:10.1002/hed.23596

    Article  PubMed  Google Scholar 

  17. Den Toom IJ, Heuveling DA, Flach GB, van Weert S, Karagozoglu KH, van Schie A, Bloemena E, Leemans CR, de Bree R (2015) Sentinel node biopsy for early-stage oral cavity cancer: the VU University Medical Center experience. Head Neck 37(4):573–578. doi:10.1002/hed.23632

    Article  Google Scholar 

  18. Heuveling DA et al (2015) Evaluation of the use of freehand SPECT for sentinel node biopsy in early stage oral carcinoma. Oral Oncol 51(3):287–290

    Article  PubMed  Google Scholar 

  19. Wendler T et al (2007) Towards intra-operative 3D nuclear imaging: reconstruction of 3D radioactive distributions using tracked gamma probes. Med Image Comput Comput Assist Interv 10(Pt 2):909–917

    PubMed  Google Scholar 

  20. Wendler T et al (2010) First demonstration of 3-D lymphatic mapping in breast cancer using freehand SPECT. Eur J Nucl Med Mol Imaging 37(8):1452–1461

    Article  PubMed  Google Scholar 

  21. Stoffels I et al (2012) Radio-guided surgery: advantages of a new portable gamma-camera (Sentinella) for intraoperative real time imaging and detection of sentinel lymph nodes in cutaneous malignancies. J Eur Acad Dermatol Venereol 26(3):308–313

    Article  CAS  PubMed  Google Scholar 

  22. Borbon-Arce M et al (2014) An innovative multimodality approach for sentinel node mapping and biopsy in head and neck malignancies. Rev Esp Med Nucl Imagen Mol 33(5):274–279

    CAS  PubMed  Google Scholar 

  23. Mayoral M et al (2014) The added value of a portable gamma camera for intraoperative detection of sentinel lymph node in squamous cell carcinoma of the oral cavity: a case report. Rev Esp Med Nucl Imagen Mol 33(4):237–240

    CAS  PubMed  Google Scholar 

  24. Hellingman D et al (2015) Detecting near-the-injection-site sentinel nodes in head and neck melanomas with a high-resolution portable gamma camera. Clin Nucl Med 40(1):e11–e16

    Article  PubMed  Google Scholar 

  25. Freesmeyer M et al (2014) Real-time ultrasound and freehand-SPECT. Experiences with sentinel lymph node mapping. Nuklearmedizin 53(6):259–264

    Article  CAS  PubMed  Google Scholar 

  26. Brouwer OR et al (2012) Comparing the hybrid fluorescent-radioactive tracer indocyanine green-99mTc-nanocolloid with 99mTc-nanocolloid for sentinel node identification: a validation study using lymphoscintigraphy and SPECT/CT. J Nucl Med 53(7):1034–1040

    Article  CAS  PubMed  Google Scholar 

  27. Heuveling DA et al (2012) Nanocolloidal albumin-IRDye 800CW: a near-infrared fluorescent tracer with optimal retention in the sentinel lymph node. Eur J Nucl Med Mol Imaging 39(7):1161–1168

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Agrawal A, Civantos FJ, Brumund KT, Chepeha DB, Hall NC, Carroll WR, Smith RB, Zitsch RP, Lee WT, Shnayder Y, Cognetti DM, Pitman KT, King DW, Christman LA, Lai SY (2015) [99mTc]Tilmanocept accurately detects sentinel lymph nodes and predicts node pathology status in patients with oral squamous cell carcinoma of the head and neck: results of a phase III multi-institutional trial. Ann Surg Oncol. doi:10.1245/s10434-015-4382-x

    PubMed Central  Google Scholar 

  29. Zaknun JJ et al (2012) Changing paradigms in radioguided surgery and intraoperative imaging: the GOSTT concept. Eur J Nucl Med Mol Imaging 39(1):1–3

    Article  PubMed  Google Scholar 

  30. Valdes Olmos RA et al (2014) The GOSTT concept and hybrid mixed/virtual/augmented reality environment radioguided surgery. Q J Nucl Med Mol Imaging 58(2):207–215

    CAS  PubMed  Google Scholar 

Download references

Conflict of interest

Dr. Clare Schilling, Dr. Andrea Corrado Profeta, Dr. Gopinanth Gnanasegaran and Professor Mark McGurk declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

All patients gave consent for images reproduced in this article.

Author information

Authors and Affiliations

  1. Department of Head and Neck Surgery, Guy’s Hospital, Guy’s and St Thomas’s Hospital NHS Foundation Trust, London, SE1 9RT, UK

    Clare Schilling, Andrea Corrado & Mark McGurk

  2. Department of Nuclear Medicine, Guy’s Hospital, Guy’s and St Thomas’s Hospital NHS Foundation Trust, London, SE1 9RT, UK

    Gopinanth Gnanasegaran

Authors
  1. Clare Schilling
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Andrea Corrado
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gopinanth Gnanasegaran
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mark McGurk
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Clare Schilling.

Additional information

An erratum to this article can be found at http://dx.doi.org/10.1007/s40336-016-0208-5.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Schilling, C., Corrado, A., Gnanasegaran, G. et al. Role of intraoperative sentinel node imaging in head and neck cancer. Clin Transl Imaging 3, 217–223 (2015). https://doi.org/10.1007/s40336-015-0121-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40336-015-0121-3

Keywords

Search

Navigation