In the SENTIX trial and subsequent SENTICOL III trial investigating sentinel lymph node mapping in early cervical cancer, the sentinel node detection technique using combined isotope (99mTc) and dye requires injection into which anatomical location?
- A Cervical stromal injection at 3, 6, 9, and 12 o'clock positions (deep and superficial) ✓
- B Intratumoral injection at 12 and 6 o'clock positions
- C Intravenous injection with lymphoscintigraphy 2 hours prior to surgery
- D Submucosally into the anterior vaginal fornix
Explanation
Sentinel lymph node mapping in cervical cancer uses cervical stromal injection at 3, 6, 9, and 12 o'clock positions with radiotracer (99mTc colloid) and blue dye (isosulfan/methylene blue) or ICG (indocyanine green) injected into the cervical stroma both deeply (>3 mm) and superficially. ICG with near-infrared fluorescence has largely replaced traditional blue dye/isotope combinations. The SENTIX trial validated this approach, and SENTICOL III is assessing non-inferiority of sentinel-node-only dissection versus full pelvic lymphadenectomy in terms of recurrence. Correct injection technique is crucial for detection rates.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
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Written and medically reviewed by the StethoPrep medical team.