Localization of sentinel nodes in head and neck tumours by combined lymphoscintigraphy and bone scintigraphy

Sentinel node scintigraphy in tumours of the head arid neck region was comb ined with bone scintigraphy to provide anatomical landmarks in order to bet ter locate the lymph node uptake. Tc-99(m)-nanocolloid (40 MBq) was injecte d in the peritumour region 1 h after the administration of bone-seeking Tc- 99(m)- methylene diphosphonate (200 MBq). After 5 min, A-P and lateral proj ections of the head and neck region were acquired. In all the 26 patients e xamined, the surrounding anatomy was clearly depicted. In 23 patients, the lymphatic drainage was identified within 30 min. In these patients, all hot spots appearing outside the deposited activity could be located according to the neck region classification system of the Memorial Sloan-Kettering Ho spital. No lymphatic drainage was visualized in the remaining three patient s. The injection of bone-seeking activity 1 h before deposition of the radi ocolloid provided ima,soft tissues as well as skeletal structures, thus imp roving the topical diagnosis. Correlation with the results of surgery was n ot performed, The administration of a small amount of bone-seeking activity prior to sentinel node scintigraphy of head and neck tumours improves the anatomical localization of the lymph node activity. ((C) 2001 Lippincott Wi lliams & Wilkins).