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Sentinel node imaging: Validation of new technique to compare SPECT/CT volume uptake with histopathology

¹ Radiology, Royal Preston Hospital, Preston, United Kingdom

1126

Objectives: The purpose of this study is to investigate the hypothesis that non-visualisation or poor 99-mTc uptake values in sentinel nodes on SPECT/CT imaging would be associated with negative histology and higher 99-mTc uptake values would be associated with positive histology.

Methods: 95 breast cancer patients were retrospectively reviewed and underwent SPECT/CT imaging over a one year period. Using Xeleris software (GE Infinia) we quantified the volume uptake in both the sentinel node and injection site in the first hour of 99-mTc decay. We then deduced a percentage uptake in the sentinel node (SN%). To identify a trend, we set gradually increasing increments in SN%, and then subdivided histologically positive and negative patients to their respective SN% categories. Finally, we carried out statistical analysis of the data.

Results: 14 patients out of 95 did not have any nodal uptake on SPECT/CT, and 13 were histologically negative (93% negative predictive value). The remaining 81 patients had visualised nodes and 34 were histologically positive. The other 47 patients were histologically negative. The sensitivity and specificity, is therefore, 97% and 22% respectively. To visualise the trends please see affixed graph. Analytically there was a high correlation between SN% and positive/negative histological percentages, with r=0.677 and r=-0.659, respectively.

Conclusions: SPECT/CT has shown a clear correlation in identifying histologically positive and negative disease in relation to patient SN% values. In light of a high negative predictive value and a strong relationship illustrated by the graph, important clinical implications can be derived. These findings increase the degree of confidence in interpreting disease positivity and negativity and this in turn helps to decide upon surgical management.

This Article Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Virdee, S. Articles by Coffey, J. PubMed Articles by Virdee, S. Articles by Coffey, J.