In determining the best options for lymphoscintigraphy, investigators have tried many different radiopharmaceuticals and protocols. There are varying opinions on the best route of administration, timing for delayed images, and radiopharmaceutical. Debate around which radiopharmaceutical is best arises from the requirement that it clear from healthy lymph channels quickly enough to reveal the SLN. This paper reviews and compares 9 recognized publications on lymphoscintigraphy, illustrates the different preferences regarding the procedure, and describes the generally accepted protocols for the best way to locate the sentinel lymph node. Detailed explanations are given for the variable involvement of the sentinel lymph node and the variations in disease stage seen with different protocols. All discrepancies between protocols are supported with evidence such as positive results or false-positive results. On reading this paper, you will be able to form an opinion on the best protocols and radiopharmaceuticals and learn why lymphoscintigraphy is a crucial tool in improving a patient's prognosis.
Keywords: lymph node mapping; melanoma; sentinel lymph node.
© 2020 by the Society of Nuclear Medicine and Molecular Imaging.