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Lymphoscintigraphy in Cutaneous Melanoma: A Total Body Atlas of Sentinel Node Mapping¹

¹ From the Division of Nuclear Medicine, Department of Radiology (C.M.I., S.M.K., J.I.P., H.C.L.), and the Department of Surgery (J.C.K.), Thomas Jefferson University Hospital, 132 S 10th St, Rm 861 Main Bldg, Philadelphia, PA 19107. Received September 4, 2001; revision requested November 16 and final revision received January 11, 2002; accepted January 14. Address correspondence to C.M.I. (e-mail: charles.intenzo@mail.tju.edu).

Lymphoscintigraphy of malignant melanoma has been a reliable method of identifying regional lymph nodes at risk for metastases and is now considered part of the standard of care in patients with melanoma. The status of the sentinel lymph node (SLN) is predictive of the metastatic status of the corresponding regional lymph node group. Lymphatic channel mapping allows identification of the SLN, thereby making selective lymph node sampling possible. Consequently, SLN identification with lymphoscintigraphy results in both less extensive surgery and more efficient pathologic examination of the lymph node specimens. Therefore, it is imperative that radiologists and nuclear medicine physicians know which radiopharmaceuticals to use, recognize different lymphatic drainage patterns from various primary tumor sites throughout the body, use proper imaging techniques, and recognize potential pitfalls in image interpretation.

© RSNA, 2002

Index Terms: Lymphatic system, radionuclide studies, 99.12974 • Melanoma, _**.8332² • Skin, neoplasms, _**.8332

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