We describe a novel technique for sentinel lymph node mapping and biopsy of a primary cutaneous malignant melanoma in the medial portion of the external auditory canal. The approach is illustrated through a case repor...We describe a novel technique for sentinel lymph node mapping and biopsy of a primary cutaneous malignant melanoma in the medial portion of the external auditory canal. The approach is illustrated through a case report and technical description of a procedure performed under general anesthesia on a 19-year-old female patient. Due to the hidden and sensitive location of the primary tumor in the medial external auditory canal, the lymphoscintigraphy injection had to be performed by the surgeon immediately prior to the resection of her c T2 a N0M0 lesion. Final pathology revealed clear margins at the primary site resection and 2 intraparotid sentinel lymph nodes with microscopic foci of metastatic malignant melanoma, which led to further surgical management. A completion left parotidectomy and neck dissection yielded no additional metastatic disease in the fifty-five nodes that were evaluated. Using this technique, sentinel lymph node mapping and biopsy accurately predicted the highest risk lymph nodes for the primary lesion of the medial portion of the external auditory canal.展开更多
Background:Somatostatin receptor(SSTR)-targeted positron emission tomography/computed tomography(PET/CT)imaging has risen to the forefront for neuroendocrine tumor(NET)detection and management,yet the variability of s...Background:Somatostatin receptor(SSTR)-targeted positron emission tomography/computed tomography(PET/CT)imaging has risen to the forefront for neuroendocrine tumor(NET)detection and management,yet the variability of significant uptake variability(SUV)as a semiquantitative measure of disease detection and tumor response to treatment has not been fully explored.Methods:We assess the reproducibility and interscan variability of SUV metrics of normal tissue and NET in serial^(68)Ga-DOTA-NOC and^(68)Ga-DOTA-TATE PET imaging to clinically monitor disease state.Eighty-one patients were enrolled in this retrospective study.Results:Both primary and metastatic hepatic lesions demonstrated SUV(SUVmean 16.5±8.0).The median SUVmean was 16 for the spleen,9.7 for the pituitary,12.6 for the adrenal glands,and 4.8 for the liver.The normal pituitary gland demonstrates focal homogenous uptake with SUVmax range of 4.5–23.The adrenal gland showed uptake with SUVmax range of 4.1–29.4,which is more than two times greater than liver uptake(SUVmean range,2.3–12.4).Highest physiological uptake seen in the spleen(average SUVmean of 17.3,range of 5.4–34.4).Conclusions:The highly variable nature of regional SUVmean and SUVmax in both physiologic tissue and lesions suggests the need for incorporation of more reliable quantitative measures for clinical decision making.展开更多
文摘We describe a novel technique for sentinel lymph node mapping and biopsy of a primary cutaneous malignant melanoma in the medial portion of the external auditory canal. The approach is illustrated through a case report and technical description of a procedure performed under general anesthesia on a 19-year-old female patient. Due to the hidden and sensitive location of the primary tumor in the medial external auditory canal, the lymphoscintigraphy injection had to be performed by the surgeon immediately prior to the resection of her c T2 a N0M0 lesion. Final pathology revealed clear margins at the primary site resection and 2 intraparotid sentinel lymph nodes with microscopic foci of metastatic malignant melanoma, which led to further surgical management. A completion left parotidectomy and neck dissection yielded no additional metastatic disease in the fifty-five nodes that were evaluated. Using this technique, sentinel lymph node mapping and biopsy accurately predicted the highest risk lymph nodes for the primary lesion of the medial portion of the external auditory canal.
文摘Background:Somatostatin receptor(SSTR)-targeted positron emission tomography/computed tomography(PET/CT)imaging has risen to the forefront for neuroendocrine tumor(NET)detection and management,yet the variability of significant uptake variability(SUV)as a semiquantitative measure of disease detection and tumor response to treatment has not been fully explored.Methods:We assess the reproducibility and interscan variability of SUV metrics of normal tissue and NET in serial^(68)Ga-DOTA-NOC and^(68)Ga-DOTA-TATE PET imaging to clinically monitor disease state.Eighty-one patients were enrolled in this retrospective study.Results:Both primary and metastatic hepatic lesions demonstrated SUV(SUVmean 16.5±8.0).The median SUVmean was 16 for the spleen,9.7 for the pituitary,12.6 for the adrenal glands,and 4.8 for the liver.The normal pituitary gland demonstrates focal homogenous uptake with SUVmax range of 4.5–23.The adrenal gland showed uptake with SUVmax range of 4.1–29.4,which is more than two times greater than liver uptake(SUVmean range,2.3–12.4).Highest physiological uptake seen in the spleen(average SUVmean of 17.3,range of 5.4–34.4).Conclusions:The highly variable nature of regional SUVmean and SUVmax in both physiologic tissue and lesions suggests the need for incorporation of more reliable quantitative measures for clinical decision making.
