ATLAS OF LYMPHOSCINTIGRAPHY AND SENTINEL NODE MAPPING : a pictorial case.

Foreword
Preface
Acknowledgements
Contents
1: Anatomy and Physiology of Lymphatic Circulation: Application to Lymphatic Mapping
	1.1	 Introduction
	1.2	 Physiology of Lymph Flow
	1.3	 Anatomy of the Lymphatic System
	1.4	 Lymphatics of the Breast
	1.5	 Lymphatics of the Skin
	1.6	 Visualisation of Lymphatics and New Developments
	References
2: Pathophysiology of Lymphatic Circulation in Different Disease Conditions
	2.1	 History
	2.2	 Physiology of the Lymphatic System
	2.3	 Lymphatic Circulation and Lipid Absorption
	2.4	 Pathophysiology of Lymph Drainage Failure
		2.4.1	 Role of Leukotrienes and Inflammation in Lymphedema
		2.4.2	 Aging of Lymphatic Vessels
	2.5	 Lymphedema
	2.6	 Lymphatic Malignancies
	2.7	 Lymphangiothrombosis and Acute Lymphangitis
	2.8	 Pathophysiology of Lymphatic Circulation in Systemic Diseases
		2.8.1	 Obesity
		2.8.2	 Arterial Hypertension
		2.8.3	 Atherosclerosis
		2.8.4	 Myocardial Infarction
	2.9	 Concluding Remarks
	References
3: Methodological Aspects of Lymphatic Mapping: Radiopharmaceuticals, Multimodal Lymphatic Mapping Agents, Instrumentations
	3.1	 Introduction
	3.2	 Radiopharmaceuticals for Lymphatic Mapping
		3.2.1	 Radiocolloids and Other Agents for SLN Mapping
		3.2.2	 Injected Volume and Activity for Lymphatic Mapping
		3.2.3	 Factors Affecting Radiocolloid Uptake During Lymphatic Mapping
		3.2.4	 Other PET Radiopharmaceuticals for Lymphatic Mapping
	3.3	 Iodine-Based CT Contrast Agents for Lymphatic Mapping
	3.4	 MR, MRL, and PET/MRI Contrast Agents for Lymphatic Mapping
		3.4.1	 Dendrimers for Lymphatic Mapping
		3.4.2	 Superparamagnetic Iron Oxide Particles (SPIONs and USPIOs) for Lymphatic Mapping
	3.5	 Contrast-Enhanced Ultrasound Imaging for Lymphatic Mapping
	3.6	 Optical Imaging Agents for Lymphatic Mapping
	3.7	 Multimodal Tracers for Lymphatic Mapping
	3.8	 Instrumentations for Lymphatic Mapping
		3.8.1	 Intraoperative Probes for Radioguided Surgery
		3.8.2	 Portable Gamma Cameras for Lymphatic Mapping
	3.9	 Near-Infrared (NIR) Imaging for Lymphatic Mapping
	References
4: Methodological Aspects of Lymphoscintigraphy: Bicompartmental Versus Monocompartmental Radiocolloid Administration
	4.1	 Introduction
	4.2	 Methodology of Lymphoscintigraphy
	4.3	 Imaging for Lymphoscintigraphy
	4.4	 Qualitative Visual Interpretation of Lymphoscintigraphy
	4.5	 Lymphoscintigraphy with Stress Test
	4.6	 Quantitative Lymphoscintigraphy
	4.7	 Virtual Reality for Preoperative Planning with Lymphoscintigraphy
	4.8	 PET/CT and PET/MR Lymphoscintigraphy
		4.8.1	 PET/CT Imaging Protocol of Lymphatic Circulation
		4.8.2	 PET/MR Imaging Protocol of Lymphatic Circulation
		4.8.3	 Imaging Interpretation of PET-Based Lymphoscintigraphy
	4.9	 CT Imaging of Lymph Nodes and Lymphatic Circulation
		4.9.1	 CT for Lymph Node Assessment
		4.9.2	 CT Lymphography (CT-LG)
	4.10	 Magnetic Resonance Imaging of Lymph Nodes and Lymphatic Circulation
		4.10.1	 Dynamic Contrast-Enhanced MRI of Lymph Nodes
		4.10.2	 Contrast-Enhanced Magnetic Resonance Lymphography
	4.11	 Indocyanine Green Lymphography
	References
5: Lymphoscintigraphy for the Differential Diagnosis of Peripheral Edema and Intracavitary Lymph Effusion
	5.1	 Introduction
		5.1.1	 Stage O Lymphedema: Latent or Preclinical Stage
		5.1.2	 Stage I Lymphedema
		5.1.3	 Stage II Lymphedema
		5.1.4	 Stage III Lymphedema
	5.2	 Differential Diagnosis
	5.3	 Diagnostic Characterization
	5.4	 Management of Lymphedema
	5.5	 Lymphoscintigraphy in the Management of Lymphedema
		5.5.1	 Lymphoscintigraphy for the Differential Diagnosis of Lymphedema
			5.5.1.1	 Lymphoscintigraphy in Lipedema
			5.5.1.2	 Lymphoscintigraphy for Predicting the Risk to Develop Lymphedema
			5.5.1.3	 Lymphoscintigraphy for Assessing the Efficacy of Physical and/or Surgical Treatments
	5.6	 X-Ray Computed Tomography and Magnetic Resonance Imaging
	5.7	 Virtual Reality for Preoperative Planning
	Clinical Cases
	References
6: The Sentinel Lymph Node Concept
	6.1	 History
	6.2	 Concept
	6.3	 Definition of a SLN
	6.4	 Other Definitions
	6.5	 Concluding Remarks
	References
7: General Concepts on Radioguided Sentinel Lymph Node Biopsy: Preoperative Imaging, Intraoperative Gamma Probe Guidance, Intraoperative Imaging, Multimodality Imaging
	7.1	 Introduction
	7.2	 Preoperative Imaging
	7.3	 Intraoperative Gamma Probe Guidance
	7.4	 Intraoperative and Multimodality Imaging
	References
8: SPECT/CT Image Generation and Criteria for Sentinel Lymph Node Mapping
	8.1	 Introduction
	8.2	 The Clinical Problem
	8.3	 Image Generation with SPECT/CT
	8.4	 General Indications for SPECT/CT Imaging
	8.5	 Comprehensive Interpretation of Preoperative SLN Imaging
	8.6	 SPECT/CT as a Roadmap for Intraoperative SLN Detection
	8.7	 Imaging Report Combining Planar Lymphoscintigraphy and SPECT/CT
	References
9: Preoperative and Intraoperative Lymphatic Mapping for Radioguided Sentinel Lymph Node Biopsy in Breast Cancer
	9.1	 Introduction
	9.2	 The Clinical Problem
	9.3	 Lymphatic Drainage of the Breast
		9.3.1	 Lymphatic System of the Breast
		9.3.2	 Draining Lymph Node Stations
	9.4	 Lymphoscintigraphy: Technical Controversies
		9.4.1	 Radiopharmaceuticals
		9.4.2	 Radiocolloid Injection for SLN Mapping in Patients with Breast Cancer
		9.4.3	 Preoperative Imaging for SLN Mapping in Patients with Breast Cancer
		9.4.4	 Contribution of SPECT/CT Imaging for SLN Mapping in Patients with Breast Cancer
	9.5	 Intraoperative SLN Detection in Patients with Breast Cancer
		9.5.1	 Combining Existent Technologies with New Modalities for SLN Mapping in Patients with Breast Cancer
	9.6	 Indications and Controversies for SLN Mapping in Patients with Breast Cancer
		9.6.1	 Pregnancy
		9.6.2	 Internal Mammary Chain
		9.6.3	 Large and Multifocal/Multicentric Breast Cancers
		9.6.4	 Ductal Carcinoma In Situ
		9.6.5	 Recurrent Disease and SLN Mapping in Patients with Breast Cancer
		9.6.6	 SLNB in the Neoadjuvant Setting
	9.7	 Clinical Impact of SLNB in Breast Cancer
		9.7.1	 The Paradigm Shift in Axillary Management
		9.7.2	 SLN-Negative Breast Cancer
		9.7.3	 SLN-Positive Breast Cancer
		9.7.4	 SLN-Positive Breast Cancer, Downstaged After Neoadjuvant Therapy
	Clinical Cases
	References
10: Preoperative and Intraoperative Lymphatic Mapping for Radioguided Sentinel Lymph Node Biopsy in Cutaneous Melanoma
	10.1	 Introduction
	10.2	 The Clinical Problem
	10.3	 Lymphatic Drainage of Skin and Lymph Nodal Groups
	10.4	 Indications and Contraindications for SLNB in Melanoma
	10.5	 Technical Issues
		10.5.1	 Radiotracers
		10.5.2	 Radiotracer Injection
	10.6	 Preoperative Imaging of SLNs
	10.7	 Contribution of SPECT/CT Imaging
	10.8	 Intraoperative Approach
		10.8.1	 Intraoperative Use of Handheld Gamma Probe for SLNB in Melanoma
		10.8.2	 Vital Dyes
		10.8.3	 Intraoperative Imaging
	10.9	 Practical Considerations for SLN Mapping in Melanoma
		10.9.1	 In-Transit, Aberrant or Ectopic Lymph Nodes
		10.9.2	 Head and Neck Location
	10.10	 Technical Pitfalls in Lymphatic Mapping for Melanoma Patients
	10.11	 The Dawn of a New Era?
	Clinical Cases
	References
11: Preoperative and Intraoperative Lymphatic Mapping for Radioguided Sentinel Node Biopsy in Head and Neck Cancers
	11.1	 Introduction
	11.2	 The Clinical Problem
	11.3	 Indications for SLNB
	11.4	 Radiocolloids and Modalities of Injection
	11.5	 Preoperative SLN Imaging
	11.6	 Lymphatic Drainage and Lymph Node Groups of the Neck
	11.7	 Intraoperative SLN Detection in the Head and Neck
	11.8	 Intraoperative Imaging for SLNB in the Head and Neck
	11.9	 Contribution of SPECT/CT Imaging
	11.10	 Common and Rare Variants for SLN Mapping in Head and Neck Cancers
	11.11	 Technical Pitfalls During SLN Mapping in Head and Neck Cancers
	11.12	 Accuracy of Radioguided SLNB in Head and Neck Cancers
	11.13	 Reporting SLN Mapping
	Clinical Cases
	References
12: Preoperative and Intraoperative Lymphatic Mapping for Radioguided Sentinel Node Biopsy in Non-small Cell Lung Cancer
	12.1	 Introduction
	12.2	 The Clinical Problem
	12.3	 Indications for SLNB in NSCLC
	12.4	 SLN Mapping Techniques in NSCLC
		12.4.1	 Non-radionuclide Methods
		12.4.2	 Radiocolloids and Modalities of Injection
	12.5	 Preoperative SLN Imaging
	12.6	 Intraoperative SLN Detection
	12.7	 Accuracy and Perspectives of Radioguided SLNB in NSCLC
	References
13: Preoperative and Intraoperative Lymphatic Mapping for Sentinel Node Biopsy in Cancers of the Gastrointestinal Tract
	13.1	 Introduction
	13.2	 SLN Mapping in Esophagogastric Cancer
		13.2.1	 SLN Mapping in Gastric Cancer
			13.2.1.1	 Preoperative SLN Mapping with Radiocolloid
			13.2.1.2	 Intraoperative SLN Mapping Using Dye Staining
			13.2.1.3	 Intraoperative SLN Mapping by Combined Radiocolloid and Staining
		13.2.2	 SLN Mapping in Esophageal Cancer
			13.2.2.1	 SLN Harvesting
	13.3	 SLN Mapping in Colon Cancer
		13.3.1	 Methods for SLN Mapping in Colorectal Cancer
			13.3.1.1	 Dye Staining Method
			13.3.1.2	 Radioguided Method
	Clinical Cases
	References
14: Preoperative and Intraoperative Lymphatic Mapping for Radioguided Sentinel Node Biopsy in Cancers of the Female Reproductive System
	14.1	 Introduction
	14.2	 The Clinical Problem
	14.3	 Lymphatic Drainage of Gynecological Tumors
	14.4	 Indications and Contraindications of SLN Mapping
	14.5	 Modalities of Radiocolloid Injection
	14.6	 Preoperative SLN Imaging
	14.7	 Added Value of SPECT/CT Imaging
	14.8	 Intraoperative SLN Detection
	14.9	 Technical Pitfalls in SLN Mapping
	Clinical Cases
	References
15: Preoperative and Intraoperative Lymphatic Mapping for Radioguided Sentinel Node Biopsy in Cancers of the Male Reproductive System
	15.1	 Introduction
		15.1.1	 Tracer Development: Hybrid Radio- and Fluorescence-Guided Approaches
	15.2	 Penile Cancer
		15.2.1	 The Clinical Problem
		15.2.2	 Indications and Contraindications for SLNB
		15.2.3	 Radiocolloid and Modalities of Injection
		15.2.4	 Preoperative Imaging of SLNs
		15.2.5	 Lymphatic Drainage
		15.2.6	 Intraoperative Detection of SLNs
		15.2.7	 Contribution of SPECT/CT
		15.2.8	 Intraoperative Imaging
		15.2.9	 Common and Rare Variants
		15.2.10 Technical Pitfalls
		15.2.11 Accuracy of Radioguided SLNB
	15.3	 Prostate Cancer
		15.3.1	 The Clinical Problem
		15.3.2	 Indications and Contraindications for SLNB
		15.3.3	 Radiocolloid and Modalities of Injection
		15.3.4	 Preoperative Imaging of SLNs
		15.3.5	 Lymphatic Drainage
		15.3.6	 Intraoperative Detection of SLNs
		15.3.7	 Contribution of SPECT/CT
		15.3.8	 Common and Rare Variants
		15.3.9	 Technical Pitfalls
		15.3.10 Accuracy of Radioguided SLNB
	15.4	 Testicular Cancer
		15.4.1	 The Clinical Problem
		15.4.2	 Indications and Contraindications for SLNB
		15.4.3	 Radiocolloid and Modalities of Injection
		15.4.4	 Preoperative Imaging of SLNs
		15.4.5	 Lymphatic Drainage
		15.4.6	 Intraoperative Detection of SLNs
		15.4.7	 Contribution of SPECT/CT
		15.4.8	 Intraoperative Imaging
		15.4.9	 Common and Rare Variants
		15.4.10 Technical Pitfalls
		15.4.11 Accuracy of Radioguided SLNB
	Clinical Cases
	References
16: Preoperative and Intraoperative Lymphatic Mapping for Radioguided Sentinel Lymph Node Biopsy in Kidney and Bladder Cancers
	16.1	 Introduction
	16.2	 The Clinical Problem
	16.3	 Lymphatic Drainage and Nodal Groups in Renal Cancer
	16.4	 Lymphatic Drainage and Nodal Groups in Bladder Cancer
	16.5	 Radiocolloid Administration in Renal and Bladder Cancers
	16.6	 Preoperative Imaging of SLNs in Renal and Bladder Cancer
	16.7	 Intraoperative SLN Detection Nodes in Renal and Bladder Cancer
	16.8	 Contribution of SPECT/CT Imaging for SLN Mapping in Renal and Bladder Cancers
	16.9	 Intraoperative SLN Imaging in Renal and Bladder Cancers
	16.10	 Accuracy of Radioguided SLNB in Renal or Bladder Cancer
	Clinical Cases
	References
Index