SPECT/CT scan can help detect positive sentinel lymph nodes and lead to higher rate of disease-free survival among patients with melanoma.
Single-photon emission computed tomography/CT can help detect positive sentinel lymph nodes, resulting in a higher rate of disease-free survival among patients with melanoma, say researchers in a study published today in JAMA. This hybrid technique also could reduce current high false positive rates by providing additional pre-operative anatomical information to surgeons.
Depending on the tumor depth, melanoma can metastasize early into regional lymph nodes, wrote the authors. “Sentinel lymph node excision (SLNE) is probably the most important diagnostic and potentially therapeutic procedure for patients with melanoma. The histologic status of the sentinel lymph node is the most relevant prognostic factor for overall survival in patients with melanoma, independent of primary tumor thickness.”
Researchers analyzed findings of 403 patients with melanoma and clinically negative lymph nodes who underwent sentinel lymph node excision (SLNE) with or without preoperative SPECT/CT. Between March 2003 and October 2008, 254 patients underwent SLNE without preoperative SPECT/CT – the standard group. Between November 2008 and April 2011, all sentinel node scintigraphies were performed as SPECT/CT in 149 patients. The SPECT/CT allowed SLNE in the head and neck more frequently. Only 2 percent SLNE occurred in the standard group compared with 23.5 percent in the SPECT/CT group.
Eight hundred thirty tree SLNs were removed among the 403 patients. There were 2.40 SLNs per patient in the SPECT/CT group and 1.87 per patient in the standard group. Of the 358 excised SLNs in the SPECT/CT group, 51 (14.2 percent) showed metastatic involvement. Fifty four of the 475 SLNs in the standard group (11.4 percent) showed metastatic involvement.
Forty one patients (27.5 percent) in the SPECT/CT cohort and 48 (18.9 percent) in the standard cohort were found to have positive SLNs.
“The local relapse rate in the SPECT.CT cohort was lower than in the standard cohort (6.8 percent vs. 23.8 percent), which prolonged four-year disease-free survival (93.9 percent vs. 79.2 percent),” wrote the authors.
What is the Best Use of AI in CT Lung Cancer Screening?
April 18th 2025In comparison to radiologist assessment, the use of AI to pre-screen patients with low-dose CT lung cancer screening provided a 12 percent reduction in mean interpretation time with a slight increase in specificity and a slight decrease in the recall rate, according to new research.
The Reading Room: Racial and Ethnic Minorities, Cancer Screenings, and COVID-19
November 3rd 2020In this podcast episode, Dr. Shalom Kalnicki, from Montefiore and Albert Einstein College of Medicine, discusses the disparities minority patients face with cancer screenings and what can be done to increase access during the pandemic.
Can CT-Based AI Radiomics Enhance Prediction of Recurrence-Free Survival for Non-Metastatic ccRCC?
April 14th 2025In comparison to a model based on clinicopathological risk factors, a CT radiomics-based machine learning model offered greater than a 10 percent higher AUC for predicting five-year recurrence-free survival in patients with non-metastatic clear cell renal cell carcinoma (ccRCC).
Could Lymph Node Distribution Patterns on CT Improve Staging for Colon Cancer?
April 11th 2025For patients with microsatellite instability-high colon cancer, distribution-based clinical lymph node staging (dCN) with computed tomography (CT) offered nearly double the accuracy rate of clinical lymph node staging in a recent study.