Although lymphoscintigraphy was originally introduced into clinical routine for identification of the cause of peripheral edema, more recently it has been widely applied for radioguided biopsy of the sentinel lymph node in patients with solid cancers. The procedure is now considered crucial for adequate planning of oncologic surgery in a growing number of cancers. This atlas presents a collection of richly illustrated teaching cases that demonstrate the clinical relevance and impact of lymphoscintigraphy in different pathologic conditions. After introductory chapters on the anatomy, physiology, and pathophysiology of lymphatic circulation, the role of lymphoscintigraphy in differential diagnosis of peripheral edema and characterization of intracavitary lymph effusions is addressed. The principal focus of the book, however, is on the use of lymphoscintigraphic mapping for radioguided sentinel node biopsy in cutaneous melanoma and cancers at a range of anatomic sites. The most commonly observed lymphoscintigraphic patterns are depicted, and anatomic variants and technical pitfalls of the procedure receive careful attention. The role of tomographic multimodality imaging is also considered. The atlas will be an excellent learning tool for residents in nuclear medicine and other specialists with an interest in the field.
Mục lục
Anatomy and physiology of lymphatic circulation.- Pathophysiology of lymphatic circulation in different disease conditions.- Methodological aspects of lymphoscintigraphy: radiopharmaceuticals and instrumentation.- Lymphoscintigraphy for the differential diagnosis of peripheral edemas.- Lymphoscintigraphy for the characterization of intracavitary lymph effusions.- The sentinel lymph node concept in oncologic surgery.- General concepts on radioguided sentinel lymph node biopsy: preoperative imaging, intraoperative gamma-probe guidance, intraoperative imaging, multimodality imaging.- SPECT/CT image generation and criteria of interpretation for sentinel lymph node mapping.- Preoperative and intraoperative lymphatic mapping for radioguided sentinel node biopsy in breast cancer.- Preoperative and intraoperative lymphatic mapping for radioguided sentinel node biopsy in cutaneous melanoma.- Preoperative and intraoperative lymphatic mapping for radioguided sentinel node biopsy in head and neckcancers.- Preoperative and intraoperative lymphatic mapping for radioguided sentinel node biopsy in non-small-cell lung cancer.- Preoperative and intraoperative lymphatic mapping for radioguided sentinel node biopsy in cancers of the gastrointestinal tract.- Preoperative and intraoperative lymphatic mapping for radioguided sentinel node biopsy in cancers of the female reproductive system.- Preoperative and intraoperative lymphatic mapping for radioguided sentinel node biopsy in cancers of the male reproductive system.- Preoperative and intraoperative lymphatic mapping for radioguided sentinel node biopsy in kidney and bladder cancers.
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