How morphometric analysis of metastatic load predicts the (un)usefulness of PET scanning: the case of lymph node staging in XXXX .

@entity1 @entity5 @entity320 @entity3
BACKGROUND: In primary @entity320 , the sentinel node (SN) biopsy is an accurate method for the staging of the lymph nodes. Positron emission tomography (PET) has been suggested as a useful alternative. However, the sensitivity of PET may be too low to detect SN @entity3 , which are often small. AIM: To predict the value of PET for initial lymph node staging in @entity320 based on morphometric analysis of SN metastatic load, without exposing @entity1 to PET. MATERIALS AND METHODS: In 59 SN positive @entity1 with @entity320 , the sizes of @entity5 deposits in the SNs and subsequent dissection specimens were measured by morphometry and correlated with the detection limits of current and future PET scanners. RESULTS: The median @entity5 volume within the basin was 0.15 mm(3) (range, 0.0001-118.86). Seventy per cent of these deposits were smaller than 1 mm(3). State of the art PET scanners that have a resolution of about 5 mm would detect only 15-49% of positive basins. Logistic regression analysis revealed no pretest indicators identifying @entity1 expected to have a positive PET. However, the SN @entity5 load was a significant and single predictor of the presence of PET detectable @entity5 . CONCLUSION: Morphometric analysis of metastatic load predicts that PET scanning is unable to detect most metastatic deposits in sentinel lymph nodes of @entity1 with @entity320 because the @entity3 are often small. Therefore, the SN biopsy remains the preferred method for initial regional staging.
