Using lymphoscintigraphy as a prognostic tool in patients with cancer

Abstract

Using lymphoscintigraphy as a prognostic tool in patients with cancer Sergi Vidal-Sicart,1 Renato A Valdés Olmos2 1Nuclear Medicine Department, Hospital Clínic Barcelona, Barcelona, Spain; 2Nuclear Medicine Section and Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Centre, Leiden, the NetherlandsAbstract: Early detection of metastatic involvement of lymph nodes is one of the greatest difficulties faced by the physicians. In the last few centuries, the lymphatic system has become an important field of interest in oncology. The lymphatic system functions in two opposing ways in cancer: defense against circulating tumor cells, and, on the other hand, a route for metastasis and a site of tumor growth when the defense mechanism fails. The significant impact of lymphatic dissemination on the staging, treatment, and outcome of solid cancers has stimulated investigations aimed at gaining more insight into several aspects of the lymphatic system. Its application in oncology has evolved in the last 50 years fostered by the recognition of the relationship of lymph node metastases to prognosis in several types of malignant tumors. Lymphatic mapping also offers the opportunity for repetitive studies undertaken for evaluation of the patient during follow-up, thereby offering early evidence of recurrence of the disease. More recent and widespread applications of lymphoscintigraphy form the basis for biopsy of the sentinel lymph node in patients with solid cancers. This article reviews the applications of lymphoscintigraphy in the current diverse oncologic clinical indications for the assessment of secondary lymphedema related to oncologic treatments and sentinel lymph node lymphatic mapping.Keywords: lymphatic mapping, lymphedema, sentinel node, cancer