The case involves a 55 year-old male with recently resected cutaneous melanoma of the left cheek. What are the findings, or what other information do you need for a diagnosis?
By performing an additional lateral view, the radiotracer injection site (anterior) is clearly separated and delineated from the more posterior sentinel node. This is a single sentinel lymph nodes localized the ipsilateral preauricular region.
Added View Improves Sentinel Node Localization
1) Customize your lymphoscintigraphy radiotracer injection technique based upon the body area of interest. For example, with this head and neck cancer patient, a single intradermal injection would have been sufficient as well as injecting a smaller amount of the radiotracer.
2) You may need to perform additional imaging besides standard planar AP and/or lateral views to adequately localize the sentinel node(s) - such as additional oblique views.
3) Additional SPECT/CT imaging may be needed to assist with localization of a sentinel lymph node.