Comparison of (99m)Tc-MIBI scintigraphy and sentinel node biopsy in the detection of occult lymph node metastases from cutaneous melanoma.

摘要

99mTc-MIBI scintigraphy has been proposed as a technique that can diagnose clinically undetectable melanoma metastases. The aim of the study was to compare the sensitivity of (99m)Tc-MIBI with that of sentinel node biopsy (SNB) in the detection of nodal disease. Twenty-eight patients with melanoma > 1.0 mm thick were enrolled. Patients underwent (99m)Tc-MIBI scintigraphy and a preoperative lymphoscintigraphy followed by SNB. Sentinel nodes were identified in 27/28 patients. Twelve patients had an involved sentinel node (SN), being (99m)Tc-MIBI positive in 10. No patient with negative SNB developed regional recurrence during the study. (99m)Tc-MIBI had a sensitivity of 83% and a specificity of 93%. We conclude that SNB remains the procedure of choice for detecting subclinical lymph node involvement from melanoma. (99m)Tc-MIBI could have an alternativerole in lymph node staging of patients who are not good candidates of SNB, that needs to be tested in appropriate trials. Copyright John Libbey Eurotext 2003.