EANM-EORTC general recommendations for sentinel node diagnostics in melanoma Annette H. Chakera Email author Birger Hesse Zeynep Burak James R. Ballinger Allan Britten Corrado Caracò Alistair J. Cochran Martin G. Cook Krzysztof T. Drzewiecki Richard Essner Einat Even-Sapir Alexander M. M. Eggermont Tanja Gmeiner Stopar Christian Ingvar Martin C. MihmJr. Stanley W. McCarthy Nicola Mozzillo Omgo E. Nieweg Richard A. Scolyer Hans Starz John F. Thompson Giuseppe Trifirò Giuseppe Viale Sergi Vidal-Sicart Roger Uren Wendy Waddington Arturo Chiti Alain Spatz Alessandro Testori Guidelines First Online: 28 August 2009 Abstract The accurate diagnosis of a sentinel node in melanoma includes a sequence of procedures from different medical specialities (nuclear medicine, surgery, oncology, and pathology). The items covered are presented in 11 sections and a reference list: (1) definition of a sentinel node, (2) clinical indications, (3) radiopharmaceuticals and activity injected, (4) dosimetry, (5) injection technique, (6) image acquisition and interpretation, (7) report and display, (8) use of dye, (9) gamma probe detection, (10) surgical techniques in sentinel node biopsy, and (11) pathological evaluation of melanoma-draining sentinel lymph nodes. If specific recommendations given cannot be based on evidence from original, scientific studies, referral is given to “general consensus” and similar expressions. The recommendations are designed to assist in the practice of referral to, performance, interpretation and reporting of all steps of the sentinel node procedure in the hope of setting state-of-the-art standards for good-quality evaluation of possible spread to the lymphatic system in intermediate-to-high risk melanoma without clinical signs of dissemination.
Keywords Blue dye Gamma probe Lymphoscintigraphy Melanoma Pathology Sentinel node Abbreviations AJCC American Joint Committee on Cancer
CLND Completion regional lymph node dissection
CT Computed tomography
EANM European Association of Nuclear Medicine
EORTC European Organisation for Research and Treatment of Cancer
FNAB Fine needle aspiration biopsy
H&E Haematoxilin-eosin
HSA Human serum albumin
ICRP International Committee of Radiation Protection
MUMP Melanocytic lesion of uncertain malignant potential
NSN Non-sentinel lymph node
PACS Picture Archiving and Communication System
QA Quality assurance
QC Quality control
RES Reticulo-endothelial system
RT-PCR Reverse trascriptase polymerase chain reaction
SN Sentinel lymph node
SNB Sentinel lymph node biopsy
SPECT Single photon emission computed tomography
US Ultrasound
Chakera and Hesse 50% divided first authorship
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PubMed CrossRef Google Scholar Authors and Affiliations Annette H. Chakera Email author Birger Hesse Zeynep Burak James R. Ballinger Allan Britten Corrado Caracò Alistair J. Cochran Martin G. Cook Krzysztof T. Drzewiecki Richard Essner Einat Even-Sapir Alexander M. M. Eggermont Tanja Gmeiner Stopar Christian Ingvar Martin C. MihmJr. Stanley W. McCarthy Nicola Mozzillo Omgo E. Nieweg Richard A. Scolyer Hans Starz John F. Thompson Giuseppe Trifirò Giuseppe Viale Sergi Vidal-Sicart Roger Uren Wendy Waddington Arturo Chiti Alain Spatz Alessandro Testori 1. Department of Plastic Surgery and Burns Unit Rigshospitalet Copenhagen Denmark 2. Department of Nuclear Medicine and PET Rigshospitalet Copenhagen Denmark 3. Department of Nuclear Medicine Ege University Medical Faculty Izmir Turkey 4. Department of Nuclear Medicine Guy’s and St Thomas’ NHS Foundation Trust, Great Maze Pond London UK 5. Medical Physics & Bioengineering St. George’s Healthcare NHS Trust London UK 6. National Cancer Institute via M. Semmola Naples Italy 7. Department of Pathology and Laboratory Medicine David Geffen School of Medicine at UCLA Los Angeles USA 8. Royal Surrey County Hospital and University of Surrey Guildford UK 9. California Oncology Research Institute UCLA School of Medicine Santa Monica USA 10. Department of Nuclear Medicine, Tel Aviv Sourasky Medical Center, Sackler School of Medicine Tel Aviv University Tel Aviv Israel 11. Erasmus University MC Daniel den Hoed Cancer Center Rotterdam The Netherlands 12. Department for Nuclear Medicine University Medical Centre Ljubljana Ljubljana Slovenia 13. Department of Surgery Lund University Hospital Lund Sweden 14. Massachusetts General Hospital Boston USA 15. Department of Anatomical Pathology Royal Prince Alfred Hospital Sydney Australia 16. Department of Surgery The Netherlands Cancer Institute Amsterdam The Netherlands 17. Department of Anatomical Pathology and Sydney Melanoma Unit, Royal Prince Alfred Hospital, Sydney, NSW, Australia; Discipline of Pathology The University of Sydney Sydney Australia 18. Department of Dermatology and Allergology Klinikum Augsburg-Sued Augsburg Germany 19. Sydney Melanoma Unit, Melanoma Institute Australia, Royal Prince Alfred and Mater Hospitals, Sydney, NSW, Australia; Discipline of Surgery The University of Sydney Sydney Australia 20. Division of Nuclear Medicine European Institute of Oncology Milan Italy 21. European Institute of Oncology University of Milan School of Medicine Milan Italy 22. Nuclear Medicine Department Hospital Clinic Barcelona Barcelona Spain 23. Nuclear Medicine and Diagnostic Ultrasound, RPAH Medical Centre, Discipline of Medicine University of Sydney Sydney Australia 24. UCL Institute of Nuclear Medicine UCL Hospitals NHS Foundation Trust London UK 25. Nuclear Medicine Istituto Clinico Humanitas Rozzano Italy 26. Department of Pathology Institut Gustave Roussy Villejuif France 27. Division of Melanoma and Muscle Cutaneous Sarcomas European Institute of Oncology Milan Italy 28. Department of Plastic Surgery and Burns Unit, section 2102 Copenhagen University Hospital Rigshospitalet Copenhagen Denmark