EANM-EORTC general recommendations for sentinel node diagnostics in melanoma

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.

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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

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Correspondence to Annette H. Chakera.

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Chakera and Hesse 50% divided first authorship

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Chakera, A.H., Hesse, B., Burak, Z. et al. EANM-EORTC general recommendations for sentinel node diagnostics in melanoma. Eur J Nucl Med Mol Imaging 36, 1713–1742 (2009). https://doi.org/10.1007/s00259-009-1228-4

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Keywords

  • Blue dye
  • Gamma probe
  • Lymphoscintigraphy
  • Melanoma
  • Pathology
  • Sentinel node