EANM-EORTC general recommendations for sentinel node diagnostics in melanoma

  • Annette H. ChakeraEmail 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


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.


Blue dye Gamma probe Lymphoscintigraphy Melanoma Pathology Sentinel node 



American Joint Committee on Cancer


Completion regional lymph node dissection


Computed tomography


European Association of Nuclear Medicine


European Organisation for Research and Treatment of Cancer


Fine needle aspiration biopsy




Human serum albumin


International Committee of Radiation Protection


Melanocytic lesion of uncertain malignant potential


Non-sentinel lymph node


Picture Archiving and Communication System


Quality assurance


Quality control


Reticulo-endothelial system


Reverse trascriptase polymerase chain reaction


Sentinel lymph node


Sentinel lymph node biopsy


Single photon emission computed tomography




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Copyright information

© EANM 2009

Authors and Affiliations

  • Annette H. Chakera
    • 1
    • 28
    Email author
  • Birger Hesse
    • 2
  • Zeynep Burak
    • 3
  • James R. Ballinger
    • 4
  • Allan Britten
    • 5
  • Corrado Caracò
    • 6
  • Alistair J. Cochran
    • 7
  • Martin G. Cook
    • 8
  • Krzysztof T. Drzewiecki
    • 1
  • Richard Essner
    • 9
  • Einat Even-Sapir
    • 10
  • Alexander M. M. Eggermont
    • 11
  • Tanja Gmeiner Stopar
    • 12
  • Christian Ingvar
    • 13
  • Martin C. MihmJr.
    • 14
  • Stanley W. McCarthy
    • 15
  • Nicola Mozzillo
    • 6
  • Omgo E. Nieweg
    • 16
  • Richard A. Scolyer
    • 17
  • Hans Starz
    • 18
  • John F. Thompson
    • 19
  • Giuseppe Trifirò
    • 20
  • Giuseppe Viale
    • 21
  • Sergi Vidal-Sicart
    • 22
  • Roger Uren
    • 23
  • Wendy Waddington
    • 24
  • Arturo Chiti
    • 25
  • Alain Spatz
    • 26
  • Alessandro Testori
    • 27
  1. 1.Department of Plastic Surgery and Burns UnitRigshospitaletCopenhagenDenmark
  2. 2.Department of Nuclear Medicine and PETRigshospitaletCopenhagenDenmark
  3. 3.Department of Nuclear MedicineEge University Medical FacultyIzmirTurkey
  4. 4.Department of Nuclear MedicineGuy’s and St Thomas’ NHS Foundation Trust, Great Maze PondLondonUK
  5. 5.Medical Physics & BioengineeringSt. George’s Healthcare NHS TrustLondonUK
  6. 6.National Cancer Institutevia M. SemmolaNaplesItaly
  7. 7.Department of Pathology and Laboratory MedicineDavid Geffen School of Medicine at UCLALos AngelesUSA
  8. 8.Royal Surrey County Hospital and University of SurreyGuildfordUK
  9. 9.California Oncology Research InstituteUCLA School of MedicineSanta MonicaUSA
  10. 10.Department of Nuclear Medicine, Tel Aviv Sourasky Medical Center, Sackler School of MedicineTel Aviv UniversityTel AvivIsrael
  11. 11.Erasmus University MCDaniel den Hoed Cancer CenterRotterdamThe Netherlands
  12. 12.Department for Nuclear MedicineUniversity Medical Centre LjubljanaLjubljanaSlovenia
  13. 13.Department of SurgeryLund University HospitalLundSweden
  14. 14.Massachusetts General HospitalBostonUSA
  15. 15.Department of Anatomical PathologyRoyal Prince Alfred HospitalSydneyAustralia
  16. 16.Department of SurgeryThe Netherlands Cancer InstituteAmsterdamThe Netherlands
  17. 17.Department of Anatomical Pathology and Sydney Melanoma Unit, Royal Prince Alfred Hospital, Sydney, NSW, Australia; Discipline of PathologyThe University of SydneySydneyAustralia
  18. 18.Department of Dermatology and AllergologyKlinikum Augsburg-SuedAugsburgGermany
  19. 19.Sydney Melanoma Unit, Melanoma Institute Australia, Royal Prince Alfred and Mater Hospitals, Sydney, NSW, Australia; Discipline of SurgeryThe University of SydneySydneyAustralia
  20. 20.Division of Nuclear MedicineEuropean Institute of OncologyMilanItaly
  21. 21.European Institute of OncologyUniversity of Milan School of MedicineMilanItaly
  22. 22.Nuclear Medicine DepartmentHospital Clinic BarcelonaBarcelonaSpain
  23. 23.Nuclear Medicine and Diagnostic Ultrasound, RPAH Medical Centre, Discipline of MedicineUniversity of SydneySydneyAustralia
  24. 24.UCL Institute of Nuclear MedicineUCL Hospitals NHS Foundation TrustLondonUK
  25. 25.Nuclear MedicineIstituto Clinico HumanitasRozzanoItaly
  26. 26.Department of PathologyInstitut Gustave RoussyVillejuifFrance
  27. 27.Division of Melanoma and Muscle Cutaneous SarcomasEuropean Institute of OncologyMilanItaly
  28. 28.Department of Plastic Surgery and Burns Unit, section 2102Copenhagen University Hospital RigshospitaletCopenhagenDenmark

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