Sentinel node approach in prostate cancer
| Autor: | Sergi Vidal-Sicart, R.A. Valdés Olmos |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Single Photon Emission Computed Tomography Computed Tomography medicine.medical_treatment Sentinel lymph node Context (language use) Adenocarcinoma Fluorescence Injections Extended lymphadenectomy Prostate cancer Biopsy medicine Humans Radiology Nuclear Medicine and imaging Intraoperative imaging Technetium Tc 99m Aggregated Albumin Ultrasonography Interventional Neoplasm Staging General Environmental Science Intraoperative Care medicine.diagnostic_test Sentinel Lymph Node Biopsy business.industry General Engineering Prostatic Neoplasms Robotics Intraoperative navigation Sentinel node medicine.disease Occult Surgery Lymphatic system SPECT/TC Lymphatic Metastasis General Earth and Planetary Sciences Laparoscopy Lymphadenectomy Radiology Neoplasm Grading Radiopharmaceuticals Sentinel Lymph Node business Lymphoscintigraphy Forecasting |
| Zdroj: | Revista Espanola de Medicina Nuclear e Imagen Molecular, 34(6), 358-371 |
| ISSN: | 2253-654X |
| DOI: | 10.1016/j.remn.2015.07.007 |
| Popis: | In general terms, one of the main objectives of sentinel lymph node (SLN) biopsy is to identify the 20-25% of patients with occult regional metastatic involvement. This technique reduces the associated morbidity from lymphadenectomy, as well as increasing the identification rate of occult lymphatic metastases by offering the pathologist those lymph nodes with the highest probability of containing metastatic cells. Pre-surgical lymphoscintigraphy is considered a "road map" to guide the surgeon towards the sentinel nodes and to ascertain unpredictable lymphatic drainages. In prostate cancer this aspect is essential due to the multidirectional character of the lymphatic drainage in the pelvis. In this context the inclusion of SPECT/CT should be mandatory in order to improve the SLN detection rate, to clarify the location when SLNs are difficult to interpret on planar images, to achieve a better definition of them in locations close to injection site, and to provide anatomical landmarks to be recognized during operation to locate SLNs. Conventional and laparoscopic hand-held gamma probes allow the SLN technique to be applied in any kind of surgery. The introduction and combination of new tracers and devices refines this technique, and the use of intraoperative images. These aspects become of vital importance due to the recent incorporation of robot-assisted procedures for SLN biopsy. In spite of these advances various aspects of SLN biopsy in prostate cancer patients still need to be discussed, and therefore their clinical application is not widely used. |
| Databáze: | OpenAIRE |
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