A study on the value of computer-assisted assessment for SPECT/CT-scans in sentinel lymph node diagnostics of penile cancer as well as clinical reliability and morbidity of this procedure

Because of the increasing importance of computer-assisted post processing of image data in modern medical diagnostic we studied the value of an algorithm for assessment of single photon emission computed tomography/computed tomography (SPECT/CT)-data, which has been used for the first time for lymph node staging in penile cancer with non-palpable inguinal lymph nodes. In the guidelines of the relevant international expert societies, sentinel lymph node-biopsy (SLNB) is recommended as a diagnostic method of choice. The aim of this study is to evaluate the value of the afore-mentioned algorithm and in the clinical context the reliability and the associated morbidity of this procedure.

Between 2008 and 2015, 25 patients with invasive penile cancer and inconspicuous inguinal lymph node status underwent SLNB after application of the radiotracer Tc-99m labelled nanocolloid. We recorded in a prospective approach the reliability and the complication rate of the procedure. In addition, we evaluated the results of an algorithm for SPECT/CT-data assessment of these patients.

SLNB was carried out in 44 groins of 25 patients. In three patients, inguinal lymph node metastases were detected via SLNB. In one patient, bilateral lymph node recurrence of the groins occurred after negative SLNB. There was a false-negative rate of 4 % in relation to the number of patients (1/25), resp. 4.5 % in relation to the number of groins (2/44). Morbidity was 4 % in relation to the number of patients (1/25), resp. 2.3 % in relation to the number of groins (1/44). The results of computer-assisted assessment of SPECT/CT data for sentinel lymph node (SLN)-diagnostics demonstrated high sensitivity of 88.8 % and specificity of 86.7 %.

SLNB is a very reliable method, associated with low morbidity. Computer-assisted assessment of SPECT/CT data of the SLN-diagnostics shows high sensitivity and specificity. While it cannot replace the assessment by medical experts, it can still provide substantial supplement and assistance.

Cancer imaging : the official publication of the International Cancer Imaging Society. 2016 Sep 07*** epublish ***

Ulf Lützen, Carsten Maik Naumann, Marlies Marx, Yi Zhao, Michael Jüptner, René Baumann, László Papp, Norbert Zsótér, Alexey Aksenov, Klaus-Peter Jünemann, Maaz Zuhayra

Department of Nuclear medicine, Molecular Imaging Diagnostics and Therapy, University Hospital Schleswig Holstein, Campus Kiel, Feldstr. 21 (Haus 50), 24105, Kiel, Germany. ., Department of Urology and Pediatric Urology, University Hospital Schleswig Holstein, Campus Kiel, Kiel, Germany., Department of Nuclear medicine, Molecular Imaging Diagnostics and Therapy, University Hospital Schleswig Holstein, Campus Kiel, Feldstr. 21 (Haus 50), 24105, Kiel, Germany., Department of Radiotherapy, University Hospital Schleswig Holstein, Campus Kiel, Kiel, Germany., Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria., Mediso Ltd., Budapest, Hungary.