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BibTeX
Detection of lymph node metastases in pediatric and adolescent/young adult sarcoma: Sentinel lymph node biopsy versus fludeoxyglucose positron emission tomography imaging—A prospective trial
Cancer, 2017-01, Vol.123 (1), p.155-160
Wagner, Lars M.
Kremer, Nathalie
Gelfand, Michael J.
Sharp, Susan E.
Turpin, Brian K.
Nagarajan, Rajaram
Tiao, Gregory M.
Pressey, Joseph G.
Yin, Julie
Dasgupta, Roshni
2017
Details
Autor(en) / Beteiligte
Wagner, Lars M.
Kremer, Nathalie
Gelfand, Michael J.
Sharp, Susan E.
Turpin, Brian K.
Nagarajan, Rajaram
Tiao, Gregory M.
Pressey, Joseph G.
Yin, Julie
Dasgupta, Roshni
Titel
Detection of lymph node metastases in pediatric and adolescent/young adult sarcoma: Sentinel lymph node biopsy versus fludeoxyglucose positron emission tomography imaging—A prospective trial
Ist Teil von
Cancer, 2017-01, Vol.123 (1), p.155-160
Ort / Verlag
United States: Wiley Subscription Services, Inc
Erscheinungsjahr
2017
Link zum Volltext
Quelle
Free E-Journal (出版社公開部分のみ)
Beschreibungen/Notizen
BACKGROUND Lymph node metastases are an important cause of treatment failure for pediatric and adolescent/young adult (AYA) sarcoma patients. Nodal sampling is recommended for certain sarcoma subtypes that have a predilection for lymphatic spread. Sentinel lymph node biopsy (SLNB) may improve the diagnostic yield of nodal sampling, particularly when single‐photon emission computed tomography/computed tomography (SPECT‐CT) is used to facilitate anatomic localization. Functional imaging with positron emission tomography/computed tomography (PET‐CT) is increasingly used for sarcoma staging and is a less invasive alternative to SLNB. To assess the utility of these 2 staging methods, this study prospectively compared SLNB plus SPECT‐CT with PET‐CT for the identification of nodal metastases in pediatric and AYA patients. METHODS Twenty‐eight pediatric and AYA sarcoma patients underwent SLNB with SPECT‐CT. The histological findings of the excised lymph nodes were then correlated with preoperative PET‐CT imaging. RESULTS A median of 2.4 sentinel nodes were sampled per patient. No wound infections or chronic lymphedema occurred. SLNB identified tumors in 7 of the 28 patients (25%), including 3 patients who had normal PET‐CT imaging of the nodal basin. In contrast, PET‐CT demonstrated hypermetabolic regional nodes in 14 patients, and this resulted in a positive predictive value of only 29%. The sensitivity and specificity of PET‐CT for detecting histologically confirmed nodal metastases were only 57% and 52%, respectively. CONCLUSIONS SLNB can safely guide the rational selection of nodes for biopsy in pediatric and AYA sarcoma patients and can identify therapy‐changing nodal disease not appreciated with PET‐CT. Cancer 2017;155–160. © 2016 American Cancer Society. Sentinel lymph node biopsy using lymphoscintigraphy and single‐photon emission computed tomography/computed tomography for anatomic localization is a safe and effective method for identifying regional nodal metastases that may alter therapy. Positron emission tomography/computed tomography does not have sufficient sensitivity or specificity to eliminate the need for tissue sampling.
Sprache
Englisch
Identifikatoren
ISSN: 0008-543X
eISSN: 1097-0142
DOI: 10.1002/cncr.30282
Titel-ID: cdi_proquest_miscellaneous_1859483963
Format
–
Schlagworte
Adolescent
,
Adult
,
Biopsy
,
Cancer
,
Child
,
Child, Preschool
,
Computation
,
Computed tomography
,
Diagnostic systems
,
Emissions
,
Female
,
Fluorodeoxyglucose F18 - metabolism
,
Humans
,
Imaging
,
Infant
,
Invasiveness
,
Localization
,
Lymph Node Excision - methods
,
Lymph nodes
,
Lymphatic Metastasis - diagnosis
,
Lymphatic Metastasis - pathology
,
Lymphatic system
,
Lymphedema
,
lymphoscintigraphy
,
Lymphoscintigraphy - methods
,
Male
,
Medical imaging
,
Metastases
,
Metastasis
,
Neoplasm Staging - methods
,
Patients
,
pediatric sarcoma
,
Pediatrics
,
Photon emission
,
Positron emission
,
Positron emission tomography
,
positron emission tomography/computed tomography (PET‐CT)
,
Positron-Emission Tomography - methods
,
Prospective Studies
,
Sampling
,
Sarcoma
,
Sarcoma - metabolism
,
Sarcoma - pathology
,
Sarcoma - surgery
,
Sensitivity
,
Sensitivity and Specificity
,
Sentinel Lymph Node - metabolism
,
Sentinel Lymph Node - pathology
,
Sentinel Lymph Node - surgery
,
sentinel lymph node biopsy
,
Sentinel Lymph Node Biopsy - methods
,
Single photon emission computed tomography
,
single‐photon emission computed tomography/computed tomography (SPECT‐CT)
,
Therapy
,
Tomography
,
Tomography, X-Ray Computed - methods
,
Tumors
,
Wounds
,
Young Adult
,
Young adults
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