Radionuclide lymphoscintigraphy with technetium /sup 99m/ antimony sulfide colloid to identify lymphatic drainage of cutaneous melanoma at ambiguous sites in the head and neck and trunk
Frequently the primary lesion of high-risk cutaneous melanoma (level III, greater than or equal to 1.5mm; greater than or equal to 1.0 mm with ulceration) is in an ambiguous lymphatic drainage site on the trunk, pelvic and shoulder girdles, or head and neck area. Lymphoscintigrams were performed by a circumferential intradermal injection of the biopsy site using technetium /sup 99m/ (/sup 99m/Tc) antimony sulfide colloid in a total dose of 0.2 to 0.6 mCi in a volume of 0.1 to 0.5 ml. Imaging was done with a large-field gamma camera with high-resolution parallel hole collimator. Technetium /sup 99m/ antimony sulfide colloid is an ideal agent for lymphoscintigrams because of small particle size (3-30 micron), which permits early migration into the interstitial space and lymphatics and rapid pickup by lymph nodes. It does not localize the site of lymph node metastases, but indicates only the drainage pattern. Images were obtained at 1, 5, 10, 15, 30, and 60 minutes, respectively, and then three times every hour. The majority of patients had lesions with ambiguous drainage sites: head and neck (4 of 5 patients) and trunk (9 of 13 patients). The drainage by scan was to unpredictive sites in 72%, and resulted in a change of treatment planning by location and extent of ablation with node dissection in 9 of 18 patients. It was concluded that preoperative /sup 99m/Tc antimony sulfide lymphoscintigraphy is a highly useful planning technique in determining the appropriate lymphatic drainage basin for dissection in selected melanoma patients.
- Research Organization:
- Univ. of Virginia Medical Center, Charlottesville
- OSTI ID:
- 5680209
- Journal Information:
- Cancer (Philadelphia); (United States), Journal Name: Cancer (Philadelphia); (United States) Vol. 55:6; ISSN CANCA
- Country of Publication:
- United States
- Language:
- English
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59 BASIC BIOLOGICAL SCIENCES
62 RADIOLOGY AND NUCLEAR MEDICINE
ANTIMONY COMPOUNDS
ANTIMONY SULFIDES
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BIOPSY
BODY
BODY AREAS
CHALCOGENIDES
COUNTING TECHNIQUES
DIAGNOSTIC TECHNIQUES
DISEASES
FEMALES
HEAD
HOURS LIVING RADIOISOTOPES
INTERMEDIATE MASS NUCLEI
ISOMERIC NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
LYMPH NODES
LYMPHATIC SYSTEM
MALES
MEDICINE
MELANOMAS
METASTASES
NECK
NEOPLASMS
NUCLEI
ODD-EVEN NUCLEI
PATIENTS
PATTERN RECOGNITION
PELVIS
RADIOISOTOPE SCANNING
RADIOISOTOPES
SCINTISCANNING
SULFIDES
SULFUR COMPOUNDS
SURGERY
TECHNETIUM 99
TECHNETIUM ISOTOPES
THERAPY
YEARS LIVING RADIOISOTOPES