Sentinel Node Identification in Melanoma: An Update of the Last Decade

What is it about?

Melanoma is the most lethal skin cancer. The sentinel lymph node (SLN) is the first lymph node draining the tumor. SLN biopsy provides important prognostic information, which helps patient management, and avoids the side effects of complete lymph node dissection. The rationale of identifying and removing the SLN relies on the low probability of subsequent metastatic nodes in case of a negative histological exam performed in the SLN. 99mTc-labeled colloids are still the most commonly used radiotracers but new promising radiotracers, such as 99mTc-Tilmanocept, are now on the market. In the last decades, single photon emission computed tomography-computerized tomography (SPECT/CT) has gained wider diffusion in clinical departments and there is large evidence about its superior diagnostic accuracy over planar lymphoscintigraphy (PL) in the detection of SLN in patients with melanoma. Scientists are also investigating new hybrid techniques combining functional and anatomical images for the depiction of SLN but further evidence about their value is needed.

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Photo by Online Marketing on Unsplash

Photo by Online Marketing on Unsplash

Why is it important?

This review examined the predictive and prognostic factors of lymphoscintigraphy for metastatic involvement of SLN, the currently available and emerging radiotracers and the evidence of the additional value of SPECT/CT over PL for the identification of SLN in patients with melanoma. The review was written with the joint efforts of nuclear medicine physicians and plastic surgeons.

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