This is injected several hours before surgery. It is performed by injecting a radioactive tracer under the skin, which flows toward and into the sentinel node and its lymphatic channel, and may be imaged by a gamma camera that produces a map of the path of the radioactive tracer and its first appearance in the sentinel node. Lymphoscintigraphy is a nuclear medicine procedure performed prior to the surgical procedure to locate the sentinel node (s) for the surgeon.
Methods used to identify sentinel node include use of lymphoscintigraphy and/or direct visualization during surgery following an injection of vital dye (e.g., isosulfan blue). When tumor cells are identified in a sentinel node, it suggests that cancer has spread to other nodes, indicating that a regional lymph node dissection may be necessary to assess the extent of metastasis.
CPT SENTINEL LYMPH NODE BIOPSY FREE
When a sentinel node in a given chain is free of tumor cells, it may be assumed that the remainder of the lymph nodes in that lymphatic channel is also free of cancer. One or more lymphatic channels or basins, each of which has its own sentinel node, may drain any primary tumor site. Sentinel lymph node biopsy involves the identification, removal, and evaluation of lymph nodes that drain the area of a malignant tumor.
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CPT SENTINEL LYMPH NODE BIOPSY MANUAL
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