Sentinel-Lymphknoten-Diagnostik im Kopf/Halsbereich: Indikation und aktuelle Untersuchungsprotokolle

Zusammenfassung

Die Sentinel-Lymphknoten-Biopsie ist ein wichtiges Staging-Instrument für Patienten mit Plattenepithelkarzinomen des Kopf-Hals-Bereichs und wird in vielen spezialisierten Zentren bereits erfolgreich durchgeführt. Der Nachweis bzw. Ausschluss von okkulten zervikalen Lymphknotenmetastasen ist für die Patienten von erheblicher Bedeutung, da hierdurch das operative Konzept entscheidend beeinflusst wird. Der nachfolgende Beitrag möchte einen Überblick über die Methode und eine praktische Handlungsanleitung zur Durchführung der nuklearmedizinischen Untersuchung geben, unter Berücksichtigung der aktuell gültigen Leitlinien [4] [16] [23].

Abstract

Sentinel lymph node biopsy is an important staging tool in patients with squamous cell carcinoma of the head and neck (HNSCC) and is used successfully in numerous specialized tumour centres. Proof of or exclusion of occult metastases in cervical lymph nodes is of outstanding importance to the patient as it affects the surgical procedure. The aim of this article is to give an overview on this method and to provide a standard operating procedure, allowing for the current guidelines [4] [16] [23].

Schlüsselwörter

Sentinel-Lymphknoten - SPECT/CT

Keywords

sentinel lymph nodes - SPECT/CT

• Literatur

• 1 Agrawal A, Civantos FJ, Brumund KT. et al. [(99m)Tc]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 2015; 22: 3708-3715
• 2 Alkureishi LW, Burak Z, Alvarez JA. European Association of Nuclear Medicine Oncology Committee; European Sentinel Node Biopsy Trial Committee. et al. Joint practice guidelines for radionuclide lymphoscintigraphy for sentinel node localization in oral/oropharyngeal squamous cell carcinoma. Ann Surg Oncol 2009; 16: 3190-3210
• 3 Alvarez Amézaga J, Barbier Herrero L, Pijoan del Barrio JI. et al. Diagnostic efficacy of sentinel node biopsy in oral squamous cell carcinoma. Cohort study and meta-analysis. Med Oral Patol Oral Cir Bucal 2007; 12: E235-243
• 4 Bluemel C, Herrmann K, Giammarile F. et al. EANM practice guidelines for lymphoscintigraphy and sentinel lymph node biopsy in melanoma. Eur J Nucl Med Mol Imaging 2015; 42: 1750-1766
• 5 Boeve K, Schepman KP, Schuuring E. et al. High sensitivity and negative predictive value of sentinel lymph node biopsy in a retrospective early stage oral cavity cancer cohort in the Northern Netherlands. Clin Otolaryngol 2018;
• 6 Broglie MA, Haerle SK, Huber GF. et al. Occult metastases detected by sentinel node biopsy in patients with early oral and oropharyngeal squamous cell carcinomas: impact on survival. Head Neck 2013; 35: 660-666
• 7 Burcia V, Costes V, Faillie JL. et al. Neck restaging with sentinel node biopsy in T1-T2N0 oral and oropharyngeal cancer: Why and how?. Otolaryngol Head Neck Surg 2010; 142: 592-597
• 8 Chapman BC, Gleisner A, Kwak JJ. et al. SPECT/CT Improves Detection of Metastatic Sentinel Lymph Nodes in Patients with Head and Neck Melanoma. Ann Surg Oncol 2016; 23: 2652-2657
• 9 Coughlin A, Resto VA. Oral cavity squamous cell carcinoma and the clinically n0 neck: the past, present, and future of sentinel lymph node biopsy. Curr Oncol Rep 2010; 12: 129-135
• 10 Creighton F, Bergmark R, Emerick K. Drainage Patterns to Nontraditional Nodal Regions and Level IIB in Cutaneous Head and Neck Malignancy. Otolaryngol Head Neck Surg 2016; 155: 1005-1011
• 11 D'Cruz AK, Vaish R, Kapre N. Head and Neck Disease Management Group. et al. Elective versus Therapeutic Neck Dissection in Node-Negative Oral Cancer. N Engl J Med 2015; 373: 521-529
• 12 den Toom IJ, Boeve K, van Weert S. et al. High rate of unexpected lymphatic drainage patterns and a high accuracy of the sentinel lymph node biopsy in oral cancer after previous neck treatment. Oral Oncol 2019; 94: 68-72
• 13 den ToomIJ, van Schie A, van Weert S. et al. The added value of SPECT-CT for the identification of sentinel lymph nodes in early stage oral cancer. Eur J Nucl Med Mol Imaging 2017; 44: 998-1004
• 14 Fairbairn N, Munson C, Khan ZA. et al. The role of hybrid SPECT/CT for lymphatic mapping in patients with melanoma. J Plast Reconstr Aesthet Surg 2013; 66: 1248-1255
• 15 Flach GB, Bloemena E, Klop WM. et al. Sentinel lymph node biopsy in clinically N0 T1-T2 staged oral cancer: the Dutch multicenter trial. Oral Oncol 2014; 50: 1020-1024
• 16 Giammarile F, Schilling C, Gnanasegaran G. et al. The EANM practical guidelines for sentinel lymph node localisation in oral cavity squamous cell carcinoma. Eur J Nucl Med Mol Imaging 2019; 46: 623-637
• 17 Haerle SK, Hany TF, Strobel K. et al. Is there an additional value of SPECT/CT over planar lymphoscintigraphy for sentinel node mapping in oral/oropharyngeal squamous cell carcinoma?. Ann Surg Oncol 2009; 16: 3118-3124
• 18 Klode J, Poeppel T, Boy C. et al. Advantages of preoperative hybrid SPECT/CT in detection of sentinel lymph nodes in cutaneous head and neck malignancies. J Eur Acad Dermatol Venereol 2011; 25: 1213-1221
• 19 Loree JT, Popat SR, Burke MS. et al. Sentinel lymph node biopsy for management of the N0 neck in oral cavity squamous cell carcinoma. J Surg Oncol 2019; 120: 101-108
• 20 McGregor A, Kim S, Norwich-Cavanaugh A. et al. Clinical Value of Single-photon Emission Computed Tomography Combined With Computed Tomography for Sentinel Lymph Node Identification in Melanoma. Ann Plast Surg 2019; 82: S192-S194
• 21 Riese CGU, Karstadt JA, Schramm A. et al. Validity of sentinel node biopsy in early oral and oropharyngeal carcinoma. J Craniomaxillofac Surg 2018; 46: 1748-1752
• 22 Schilling C, Stoeckli SJ, Haerle SK. et al. Sentinel European Node Trial (SENT): 3-year results of sentinel node biopsy in oral cancer. Eur J Cancer 2015; 51: 2777-2784
• 23 Schmidt M, Bares R, Brenner W. et al. DGN-Handlungsempfehlung (S1-Leitlinie) Verfahrensanweisung für die technische Durchführung der nuklearmedizinischen Wächter-Lymphknoten-Diagnostik Stand:10/2014 – AWMF-Registernummer 031-033.
• 24 Sethi RKV, Abt NB, Remenschneider A. et al. Value of SPECT/CT for Sentinel Lymph Node Localization in the Parotid and External Jugular Chain. Otolaryngol Head Neck Surg 2018; 159: 866-870
• 25 Sondak VK, King DW, Zager JS. et al. Combined analysis of phase III trials evaluating [⁹⁹mTc]tilmanocept and vital blue dye for identification of sentinel lymph nodes in clinically node-negative cutaneous melanoma. Ann Surg Oncol 2013; 20: 680-688
• 26 Stoeckli SJ, Alkureishi LW, Ross GL. Sentinel node biopsy for early oral and oropharyngeal squamous cell carcinoma. Eur Arch Otorhinolaryngol 2009; 266: 787-793
• 27 Tartaglione G, Stoeckli SJ, de Bree R. et al. Sentinel Node in Oral Cancer: The Nuclear Medicine Aspects. A Survey from the Sentinel European Node Trial. Clin Nucl Med 2016; 41: 534-542
• 28 Trinh BB, Chapman BC, Gleisner A. et al. SPECT/CT Adds Distinct Lymph Node Basins and Influences Radiologic Findings and Surgical Approach for Sentinel Lymph Node Biopsy in Head and Neck Melanoma. Ann Surg Oncol 2018; 25: 1716-1722
• 29 Vermeeren L. et al. SPECT/CT for sentinel lymph node mapping in head and neck melanoma. Head Neck 2011; 33: 1-6
• 30 Vogt H, Schmidt M, Bares R. et al. Procedure guideline for sentinel lymph node diagnosis. Nuklearmedizin 2010; 49: 167-172
• 31 Wagner T. et al. SPECT/CT in sentinel node imaging. Nucl Med Commun 2013; 34: 191-202
• 32 Wallace AM, Hoh CK, Vera DR. et al. Lymphoseek: a molecular radiopharmaceutical for sentinel node detection. Ann Surg Oncol 2003; 10: 531-538
• 33 Yang Y, Zhou J, Wu H. Diagnostic value of sentinel lymph node biopsy for cT1/T2N0 tongue squamous cell carcinoma: a meta-analysis. Eur Arch Otorhinolaryngol 2017; 274: 3843-3852