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Factors Affecting Visualization Rates of Internal Mammary Sentinel Nodes During Lymphoscintigraphy

Borys R. Krynyckyi, MD, Hyolim Chun, MD, Hyun Ho Kim, MD, Yasser Eskandar, MD, Chun K. Kim, MD and Josef Machac, MD

Division of Nuclear Medicine, Department of Radiology, Mount Sinai School of Medicine, New York, New York



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  		FIGURE 1. (Top) Anterior end of study views in 3 different patients: IM SNs (dashed arrows) and axillary SNs (solid arrows). (Bottom) 8-min sequence of lateral views. First frame shows SN from perilesional injection. Second frame shows injection (activity in syringe) at areolar cutaneous junction. Rapid rise in SN activity levels in subsequent frames is noted. Inverted J pattern is seen from upward tenting of lymphatic channels due to raised arm position (fourth frame). LB = LymphoBoost.

 


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  		FIGURE 2. Numeric values immediately surrounding nipple indicate location of primary lesions in breast for both groups. Bold text indicates number of IM SN–positive patients for any particular breast location. Text outside breast indicates rate of IM SN visualization for clearly medial or lateral primary lesions, excluding 12- and 6-o’clock positions.

 


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  		FIGURE 3. (A) Close proximity (short arrow) of average lesion (black oval) in small breast to IM chain of nodes. (B) Markedly increased distance (long arrow) between average lesion in large breast and IM chain of nodes.

 




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