A multi-institutional feasibility lead-in trial of lymphatic mapping with SPECT-CT for evaluating contralateral disease in lateralized oropharynx cancer using 99m-technetium sulfur colloid

Head Neck. 2024 Dec;46(12):3038-3045. doi: 10.1002/hed.27871. Epub 2024 Jul 17.

Abstract

Background: Lymphatic mapping with SPECT-CT has been demonstrated to accurately define lymphatic drainage patterns in oropharyngeal cancer but there has yet to be a study demonstrating its feasibility across multiple institutions.

Methods: Twelve adult patients with lateralized oropharyngeal carcinoma (T1-T3) who were planned for definitive or adjuvant radiotherapy without contralateral nodal disease underwent injection of 99-m technetium sulfur colloid followed by static planar lymphoscintigraphy to verify tracer migration, and SPECT-CT acquired at 30 ± 15 min (optional) and 3 h (±1 h) (mandatory time-point).

Results: All 12 patients completed the study with 7/12 patients having the injections performed under local anesthetic and 5 patients requiring general anesthetic. There were no tracer migration failures and there were no serious adverse events or complications encountered. Four out of 12 patients (33%) showed contralateral drainage patterns.

Conclusions: Lymphatic mapping with SPECT-CT of lateralized oropharyngeal squamous cell carcinoma can be performed safely across multiple institutions.

Keywords: 99m‐technetium; cancer; lymphatic mapping; oropharyngeal; trial.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Squamous Cell / diagnostic imaging
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / therapy
  • Feasibility Studies*
  • Female
  • Humans
  • Lymphatic Metastasis / diagnostic imaging
  • Lymphoscintigraphy* / methods
  • Male
  • Middle Aged
  • Oropharyngeal Neoplasms* / diagnostic imaging
  • Oropharyngeal Neoplasms* / pathology
  • Oropharyngeal Neoplasms* / therapy
  • Radiopharmaceuticals
  • Single Photon Emission Computed Tomography Computed Tomography
  • Technetium Tc 99m Sulfur Colloid*

Substances

  • Technetium Tc 99m Sulfur Colloid
  • Radiopharmaceuticals