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Since the report on the sentinel lymph node (SLN) concept by Morton et al. (1), SLN biopsy has become a standard method for assessing occult métastases in regional lymph nodes in various cancers, including cutaneous malignant melanoma, head and neck squamous cell carcinoma, and breast cancer (1-3). The combined use of vital blue dye and radioactive tracer with a hand-held gamma probe in addition to preoperative lymphoscintigraphy is a reliable method to search for SLNs (4). The single-photon-emission computed tomography/computed tomography (SPECT/CT) system is also useful for determining the anatomical location of SLNs, though the specialized equipment is expensive (5, 6). Another method using CT-lymphography with a non-ionic contrast medium for identification of SLNs has been reported to be useful in many institutions in Japan that do not have the necessary facilities for radioisotopes (7-9). The aim of this study was therefore to evaluate the efficacy of CT-lymphography compared with that of the ordinary method for identification of SLNs in patients with cutaneous melanoma.

Difficulty to Identify Sentinel Lymph Nodes with Computed Tomography-lymphography in Patients with Cutaneous Melanoma