Today, more than 50% of new cancer cases and nearly two thirds of cancer deaths occur in low-income, lower middle-income and upper middle-income countries. By the year 2030, the developing world is expected to bear 70% of the global cancer burden. Locally advanced cancers are more prevalent in developing countries, in part due to insufficient screening programmes. Nuclear techniques such as lymphoscintigraphy and hybrid imaging technology such as SPECT/CT, can now, in combination, improve the clinical management of patients with certain types of cancer such as breast, melanoma, head and neck and pelvic.
The sentinel lymph node (SN) is defined as the first lymph node that receives lymphatic drainage from a tumour. Lymphoscintigraphy helps to potentially assess initial cancer spread to the lymph nodes using small amounts of radioactive materials called radiotracers that are typically injected into or around certain types of cancers. It is a robust technique able to provide a roadmap for surgeons by tracing the direct lymphatic pathway from the tumour site to the SN, after which surgical decisions are crucially made for the further management of the patient.? Emerging hybrid imaging technologies used in lymphoscintigraphy, such as SPECT/CT, show promise in improving the accuracy of detection and enhancing patient management. The combination of lymphoscintigraphy and SPECT/CT would help to improve the management of patients with certain cancers such as breast, melanoma, head and neck and pelvic.
This CRP aims to validate the additional value of hybrid imaging technology SPECT/CT over planar lymphoscintigraphy imaging in SN detection in malignancies with different lymphatic drainage such as breast cancer, melanoma and pelvic tumours. From 2010 to 2013, 1,508 patients were recruited in this international multicentre study.
SPECT/CT detected more SNs and changed the drainage territory, leading to surgical adjustments in a considerable number of patients in all malignancies studied, but especially in the pelvic cancer group because of this group's deep lymphatic drainage. This CRP recommended SPECT/CT in all breast cancer patients with no SN visualized on planar imaging, all patients with melanoma of the head and neck or trunk, all patients with pelvic malignancies, and those breast cancer and melanoma patients with unexpected drainage on planar imaging. It placed an emphasis on the role of nuclear techniques in human health, specifically, how nuclear technologies such as hybrid imaging could play an important role on the management of patients with cancer.
Researchers from Brazil, Bulgaria, Chile, Colombia, Croatia, France, India, the Netherlands, the Philippines, South Africa and Spain participated in this CRP.
For more information, please see the CRP description:
http://www.dgdingfa.net/projects/crp/e13037
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