European Journal of Nuclear Medicine and Molecular Imaging Vol. 30, No. 7, July 2003 Abstract. The aim of our study was to prospectively as- sess the clinical usefulness of sentinel lymphoscintigra- phy and intraoperative gamma probe detection in identi- fying sentinel nodes (SNs) in patients with early cervical carcinoma. Between 6 and 24 h before radical hysterec- tomy, lymphoscintigrams were obtained following peri- tumoural injection of technetium-99m antimony sulphur colloid in 26 patients (mean age 45 years, range 32– 71 years) with cervical cancer (FIGO I–IIa). Scanning for radioactive nodes was performed using a hand-held collimated gamma-detecting probe in the initial stages of the main operation, during and before exposure of the retroperitoneal spaces. After separation and removal of radioactive, blue nodes, specimens were submitted for pathological evaluation. SNs were successfully localised using a combination of lymphoscintigraphy and intraop- erative gamma probe detection in all 26 cases. However, in two of the 26 cases, SNs were only localisable using the gamma-detecting probe. A histologically positive SN was found in only one case. It is concluded that, in cervi- cal cancer, lymphoscintigraphy and SN biopsy using a gamma-detecting probe are easy and reliable methods for the detection of SNs and are of value in defining the necessity and extent of node dissection. Keywords: Sentinel node – Lymphoscintigraphy – Cervi- cal cancer Eur J Nucl Med Mol Imaging (2003) 30:1014–1017 DOI 10.1007/s00259-003-1195-0 Introduction The status of the regional lymph nodes is the most reli- able factor in predicting the prognosis of malignant tu- mours. Sentinel nodes (SNs) are defined as the first draining lymph nodes from a tumour when lymphatic metastases occur. Studies on sentinel node scintigraphy in melanoma, breast cancer and vulvar cancer have been reported previously. These studies have described scin- tigraphy to be a very useful method in predicting the pat- tern of metastasis [1, 2, 3, 4]. A histopathologically neg- ative SN would suggest the absence of metastases in non-SNs [1]. Radical hysterectomy with complete pelvic node dis- section has been a commonly adopted surgical treatment modality for early stage cervical carcinoma. However, many patients with complete pelvic node dissection have experienced unexpected complications resulting from the surgery itself [4, 5, 6, 7]. Consequently, preoperative evaluation of the SN is critical in the prevention of un- necessary nodal dissection in non-nodal metastasis. Some researchers recommended a less radical approach for early cervical cancer, with precise preoperative deter- mination of lymph node metastases [8, 9]. Computed to- mography and magnetic resonance imaging have been proposed for this purpose, but their accuracy in assessing preoperative SN status is rather poor [10]. Lymphoscintigraphy is a non-invasive, well-validated procedure that is effective in assessing the anatomical distribution of the lymphatic system. Combination of gamma-detecting probe-guided surgery with lympho- scintigraphy has recently been proposed as a suitable technique for the detection of SNs in early-stage squa- mous cell cancer of the vulva [11]. Against this back- ground, the aim of this study was to prospectively assess the clinical usefulness of lymphoscintigraphy and intra- operative gamma probe detection in identifying SNs in patients with early cervical carcinoma. Soo Kyo Chung ( ✉ ) Department of Nuclear Medicine, Catholic University of Korea Medical College, #505 Banpo-Dong, 137-040 Seocho-Gu, Seoul, Korea e-mail: skchung@catholic.ac.kr Tel.: +82-2-5902463, Fax: +82-2-5932992 Short communication Usefulness of lymphoscintigraphy and intraoperative gamma probe detection in the identification of sentinel nodes in cervical cancer Yong An Chung 1 , Sung Hoon Kim 1 , Hyung Sun Sohn 1 , Soo Kyo Chung 1 , Chae Chun Rhim 2 , Sung Eun Namkoong 2 1 Department of Nuclear Medicine, Catholic University of Korea Medical College, Seocho-Gu, Seoul, Korea 2 Department of Obstetrics and Gynecology, Catholic University of Korea Medical College, Seoul, Korea Received: 23 December 2002 / Accepted: 14 March 2003 / Published online: 22 May 2003 © Springer-Verlag 2003