Lymphoscintigraphy in melanoma provides important information
on the dynamic lymphatic drainage of the primary
tumour and the location of the sentinel lymph node
(SLN). Although useful, planar lymphoscintigraphy (PL) images
are two-dimensional and give limited anatomical information.
Single positron emission computerized
tomography (SPECT) facilitates the collection of emitted
gamma radiation from multiple angles, allowing the generation
of three-dimensional images of radiotracer accumulation
and sentinel lymph node location. In common with
PL however, anatomical resolution is poor. The addition of
conventional computerised tomography (CT) to the imaging
protocol provides a solution. Initially SPECT and CT were
only available as separate imaging options and were not
always in the exact same anatomical position. As a result,
localisation of small nodes was problematic. Early fusion
software to combine the images was cumbersome and not
always accurate. The relatively recent development of
hybrid SPECT/CT systems obviates this requirement and
provides the radiologist and surgeon with extremely
detailed information regarding the number and position of
SLNs. This technology has been applied to a variety of
clinical situations including oral squamous cell carcinoma
(SCC), breast cancer, bladder cancer, prostate cancer and
melanoma. Interest in the use of SPECT/CT for lymphatic
mapping (LM) in melanoma has increased recently and it is
the purpose of this study to report the use of this technology
in our unit.