RT Journal Article
SR Electronic
T1 Prospective Comparison of 3 γ-Probes for Sentinel Lymph Node Detection in 200 Breast Cancer Patients
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 395
OP 399
VO 46
IS 3
A1 Jean-Marc Classe
A1 Maryse Fiche
A1 Caroline Rousseau
A1 Christine Sagan
A1 François Dravet
A1 Raphaëlle Pioud
A1 Albert Lisbona
A1 Ludovic Ferrer
A1 Loic Campion
A1 Isabelle Resche
A1 Chantal Curtet
YR 2005
UL http://jnm.snmjournals.org/content/46/3/395.abstract
AB Previous reports have shown that axillary sentinel lymph node (ASLN) radiodetection allows accurate axillary staging for patients with early breast cancer. Radioguided surgery implies the use of a γ-probe to count the emitted radioactivity of marked ASLNs. Several γ-probes are commercially available, each with its own properties. The clinical impact of the type of γ-probe used for ASLN radiodetection remains to be evaluated. Methods: Three commercially available γ-probes were evaluated: a scintillator with a bismuth germanate crystal (probe A), a semiconductor with a cadmium telluride crystal (probe B), and a semiconductor with a cadmium zinc telluride crystal (probe C). Two hundred patients with early breast cancer were prospectively enrolled to undergo ASLN radiodetection and axillary lymphadenectomy. ASLN mapping consisted of injecting 99mTc-sulfur-colloid around the tumor. For each patient, sentinel lymph nodes were counted successively with the 3 probes and the sensitivity of each γ-probe was determined from ASLN residual activity. The results of detection rates and false-negative rates for each probe were compared. Results: Mean residual ASLN activity was 52 kBq (range, 0.07–189 kBq). Sensitivity was compared among the 3 probes and found to be best for probe A. The detection rate of probe A was significantly better than that of probe B (93% vs. 86%, P = 0.05) but not different from that of probe C (93% vs. 90%). No differences in false-negative rates were observed among the 3 probes. Conclusion: ASLN detection rate depends on the type of γ-probe used. Because failure to detect the ASLN leads to complete axillary lymphadenectomy, involving local morbidity and other sequelae, the type of γ-probe must be considered important for sentinel lymph node radiodetection.