Predictive Value of Preoperative Lymphoscintigraphy for Sentinel Lymph Node Metastasis in Canine Mast Cell Tumours: Comparative Evaluation of Planar Scintigraphy and SPECT.
Canine cutaneous and subcutaneous mast cell tumours (MCTs) are among the most common malignant skin neoplasms in dogs, characterised by locoregional lymphatic spread.
Accurate sentinel lymph node (SLN) mapping is essential for staging, therapeutic planning, and prognostic assessment. In veterinary oncology, SLN mapping has increasingly gained traction over the last years and is now applied to several tumour types, including MCTs, offering unique advantages in terms of diagnostic efficacy and invasiveness.
Lymphoscintigraphy is considered the gold standard for SLN detection in both human and veterinary medicine, due to the ability to perform SLN mapping and guided surgical exploration using a handheld gamma probe.
In dogs with MCTs, planar lymphoscintigraphy, particularly when combined with vital blue dye injection, has demonstrated the highest SLN detection rates (up to 97.9–100%).
Nevertheless, the definitive diagnosis of lymph nodal metastasis currently relies on histopathological evaluation following SLN excision, as no validated method exists for preoperative prediction of metastatic status.
In human oncology, lymphoscintigraphy has proven to be a valuable tool for the prediction of sentinel lymph node (SLN) metastasis, especially in breast cancer and melanoma, with high diagnostic accuracy and strong predictive values.
The present PhD project aims to investigate the potential predictive value of preoperative lymphoscintigraphy in assessing the SLN metastatic status in dogs with cutaneous and subcutaneous MCT.
The study will integrate qualitative, quantitative and visual grading systems for the interpretation of lymphoscintigraphic data, adapted from human oncology: the Qualitative Visual Uptake Score, the Scintigraphic Lymphatic Pattern Score (SLS), and the Normalised Uptake per Lymph Node (NUpL).
This project’s primary aim is to identify significant correlations between these imaging parameters and histologically confirmed metastatic involvement, with particular emphasis on defining reproducible cut-off values for quantitative radiotracer uptake and on characterising lymphatic drainage patterns that may serve as predictive markers of nodal metastasis.
In addition, this project will include a comparative analysis between planar lymphoscintigraphy (PL) and Single Photon Emission Computed Tomography (SPECT) to evaluate the added value of SPECT over PL in the identification of SLNs and the prediction of metastatic involvement in canine MCTs.
It is hypothesised that SPECT, through its three-dimensional functional imaging and superior spatial resolution, may enhance diagnostic accuracy, ultimately resulting in higher sensitivity and greater SLN detection rates.
This advantage may be especially valuable in dogs with complex lymphatic anatomy, sentinel nodes in proximity to the injection site, or in cases of tumour recurrence, where planar imaging may be less reliable.
This research aims to enhance the diagnostic value of preoperative lymphoscintigraphy by identifying reproducible and predictive imaging criteria for SLN metastatic involvement.
The ultimate goal is to support evidence-based surgical decision-making and reduce unnecessary lymphadenectomies, aligning with a more targeted and minimally invasive approach to oncologic care in veterinary medicine.
Graduated from the University of Milan in September 2022 with a thesis focused on the application of artificial intelligence to the interpretation of thoracic radiographs (“An AI-Based Algorithm for the Automatic Classification of Thoracic Radiographs in Cats”, DOI: 10.3389/fvets.2021.731936).
After graduation, she completed a three-month Erasmus+ post-graduate program in the United Kingdom, followed by a one-year rotating internship at Hamilton Specialist Referrals, which concluded in April 2024.
In May 2024, she began a specialist internship in Diagnostic Imaging at the University of Milan.
During this period, she attended several advanced training courses, presented two research projects at the International Diagnostic Imaging Congress, and authored three scientific papers—one of which was published (“Spontaneous urinary bladder rupture in a dog with lymphoplasmacytic cystitis”, DOI: 10.1111/jsap.138589) and another is currently under review.
She also contributed as a teaching assistant and demonstrator in ultrasonography courses organised by Unisvet.
Deeply interested in all imaging modalities, she is particularly enthusiastic about exploring lymphoscintigraphy, a technique that offers significant potential for both clinical and research advancements.
Publications: Orcid
Supervisor Dr.ssa Donatella De Zani
Co-supervisor
