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J Nucl Med. 2008; 49 (Supplement 1):88P
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General Clinical Specialties: General Practice-Oncology

Breast and Sentinel Node Imaging

Usefulness of SPECT-CT for the detection of sentinel nodes

Ato Rodríguez-Revuelto1, Elisabet Rivera1, Pilar Paredes1, M. Camamcho1, Montserrat Estorch1, Albert Flotats1, Mireia Quera1 and Ignasi Carrió1

1 Nuclear Medicine, Hospital Sta. Creu i Sant Pau, Barcelona, Barcelona, Spain

351

Objectives: SPECT-CT studies provide accurate diagnosis in nuclear medicine. The aim of this study was to evaluate the usefulness of SPECT-CT for the detection of sentinel nodes (SNs).

Methods: Forty patients were included, mean age 59 (range 30-90): 2 patients were diagnosed of melanoma and 38 of breast cancer. Planar lymphoscintigraphy (PL) and SPECT-CT were obtained after injection of 74-148 MBq of 99mTc-Nanocolloid, using a GEMS Millenium VG & Hawkeye or Philips Precedence SPECT/CT gammacameras. Number of SNs, number of locations and changes in the management of the surgical detection were assessed. SNs detection was performed by means of a gamma-probe during surgery.

Results: PL showed at least 1 accumulation of tracer in 34/40 patients and SPECT-CT images showed drainage in 31/40 patients. Comparing both methods, SPECT-CT detected different number of sentinel nodes and locations in 17/40: a) increasing the number of SNs detected in 5 patients, b) increasing the basins in 3, c) increasing the number of locations in 2, and d) decreasing the number of SNs in 7 ( 4 cases the accumulation on PL was due to activity at the needle used for localise the tumour, and in 3 cases to a lymphatic vessel). At least 1 SN was removed during surgery in 37/40 patients. When the number of SNs was greater on tomographic images, the number of SNs removed was congruent with SPECT-CT. SPECT-CT changed the way of approach the surgery in 12/40 (30%). Five of them were 1 patient with the same number of SNs on PL but different locations, 2 patients with subclavicular SNs and 2 patients with SNs between pectoral muscles.

Conclusions: The time used for the acquisition of SPECT-CT is worthwhile for a better surgical approach. SPECT-CT is a useful tool in the detection of SNs as guide for surgery.





This Article
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Right arrow Email this article to a friend
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Right arrow Alert me to new issues of the journal
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Google Scholar
Right arrow Articles by Rodríguez-Revuelto, A.
Right arrow Articles by Carrió, I.
PubMed
Right arrow Articles by Rodríguez-Revuelto, A.
Right arrow Articles by Carrió, I.