Radioguided surgery for head and neck cancer

Abstract

Tumor status of locoregional lymph nodes is an important prognostic factor in patients with squamous cells carcinomas of the head and neck (HNSCC). Sentinel lymph node biopsy (SLNB) approach meets the expectations of accurately staging the lymph node status of these patients. The procedure consists of preoperative peritumoral injection of the tracer followed by lymphoscintigraphy using planar and single photon emission tomography/computed tomography (SPECT/CT) imaging. Based on the preoperative lymphoscintigraphy findings, the position of the sentinel lymph node (SLN) is marked on the skin. Intraoperative detection of the SLN is guided by combination of a portable handheld gamma ray detection probe (radionuclide detection) and dissection/harvesting of the radioactive lymph node(s). After surgical removal, the SLN is subjected to meticulous histopathological examination.