{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T10:24:16Z","timestamp":1776162256402,"version":"3.50.1"},"reference-count":32,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T00:00:00Z","timestamp":1757548800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: The preoperative detection of sentinel lymph nodes (SLN) using technetium-99m (Tc-99m) is crucial for surgical staging in early-stage endometrial cancer (EC). The optimal imaging timing and modality remain debated. This study compares early planar scintigraphy (30 min), SPECT\/CT (1 h), and 18-h planar scintigraphy after a single Tc-99m injection. Methods: A total of 125 patients with early-stage EC underwent SLN mapping with Tc-99m (120 MBq). Imaging included 30-min planar scintigraphy, SPECT\/CT (1 h), and 18-h planar scintigraphy on the day of surgery. Detection sensitivity, the bilateral mapping rate, and image quality (signal-to-noise ratio (SNR), contrast factor (C-factor)) were evaluated, with intraoperative gamma probe detection and histopathology as references. Results:\u00a0The 18-h planar scintigraphy achieved the highest SLN detection sensitivity (94.4%, 118\/125), compared with SPECT\/CT (87.2%, OR = 2.48, 95% CI: 0.98\u20136.27, p = 0.051) and 30-min scintigraphy (72.0%). Only the 18-h protocol underwent intraoperative and histopathological verification; results for 30-min planar and 1-h SPECT\/CT were based on imaging alone, which limits direct comparability. Bilateral detection was higher at 18 h (80.80%) than SPECT\/CT (73.60%). All SLNs detected at 18 h were confirmed intraoperatively and histologically, yielding 100% PPV (95% CI: 96.9\u2013100.0%) and NPV (95% CI: 59.0\u2013100.0%). The 18-h protocol showed superior imaging contrast (C-factor: 10.30 \u00b1 1.22) despite lower residual activity. The method remained effective in patients with BMI \u2265 30 (94.00%). Only 1.60% of patients required hysterectomy before mapping due to background interference. Conclusions: The 18-h planar scintigraphy is a highly effective, low-cost, and accessible method for SLN detection in early-stage EC, potentially reducing the need for SPECT\/CT, radiation exposure, and costs.<\/jats:p>","DOI":"10.3390\/cancers17182976","type":"journal-article","created":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T14:23:50Z","timestamp":1757600630000},"page":"2976","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["18-Hour Planar Scintigraphy Versus SPECT\/CT for Sentinel Lymph Node Detection in Early-Stage Endometrial Cancer"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7682-7176","authenticated-orcid":false,"given":"Wiktor","family":"Szatkowski","sequence":"first","affiliation":[{"name":"Department of Gynecological Oncology, Maria Sk\u0142odowska-Curie National Research Institute, Krak\u00f3w Branch, Garncarska 11, 31-115 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karolina","family":"Pniewska","sequence":"additional","affiliation":[{"name":"Department of Gynecological Oncology, Maria Sk\u0142odowska-Curie National Research Institute, Krak\u00f3w Branch, Garncarska 11, 31-115 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pawe\u0142","family":"Blecharz","sequence":"additional","affiliation":[{"name":"Department of Gynecological Oncology, Maria Sk\u0142odowska-Curie National Research Institute, Krak\u00f3w Branch, Garncarska 11, 31-115 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-1337-5813","authenticated-orcid":false,"given":"Ma\u0142gorzata","family":"Nowak-Jastrz\u0105b","sequence":"additional","affiliation":[{"name":"Department of Gynecological Oncology, Maria Sk\u0142odowska-Curie National Research Institute, Krak\u00f3w Branch, Garncarska 11, 31-115 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janusz","family":"Ry\u015b","sequence":"additional","affiliation":[{"name":"Department of Pathology, Maria Sk\u0142odowska-Curie National Research Institute, Krak\u00f3w Branch, Garncarska 11, 31-115 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6656-2490","authenticated-orcid":false,"given":"Tomasz","family":"Bana\u015b","sequence":"additional","affiliation":[{"name":"Department of Gynecological Oncology, Maria Sk\u0142odowska-Curie National Research Institute, Krak\u00f3w Branch, Garncarska 11, 31-115 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renata","family":"Pacholczak-Madej","sequence":"additional","affiliation":[{"name":"Department of Gynecological Oncology, Maria Sk\u0142odowska-Curie National Research Institute, Krak\u00f3w Branch, Garncarska 11, 31-115 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emilia","family":"Krzywonos","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy, Maria Sk\u0142odowska-Curie National Research Institute, Krak\u00f3w Branch, Garncarska 11, 31-115 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5212-5484","authenticated-orcid":false,"given":"Kamila","family":"Rawoj\u0107","sequence":"additional","affiliation":[{"name":"Department of Medical Physics, Maria Sklodowska-Curie National Research Institute of Oncology, Krakow Division, Garncarska 11, 31-115 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3217-2918","authenticated-orcid":false,"given":"Kamil","family":"Kisielewicz","sequence":"additional","affiliation":[{"name":"Department of Medical Physics, Maria Sklodowska-Curie National Research Institute of Oncology, Krakow Division, Garncarska 11, 31-115 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2053","DOI":"10.1056\/NEJMra1514010","article-title":"Endometrial Cancer","volume":"383","author":"Lu","year":"2020","journal-title":"N. 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