Single-Photon Emission Computed Tomography/Computed Tomographyfor Sentinel Node Mapping in Breast Cancer
Section snippets
Our Experience With SPECT/CT Imaging for SN Mapping in Breast Cancer
The gynecologists at our institution routinely use SN scintigraphy in breast cancer patients for preoperative SN mapping. To evaluate the additional value of multimodal, multiplanar images for SN mapping, we performed SPECT/CT imaging in addition to the planar images in 41 consecutive patients (mean age, 55 years; range, 26-80 years) with breast cancer. All patients were planned for breast surgery and SN biopsy (tumor size ranging from 2 to 30 mm). All patients had a clinically negative axilla,
SPECT/CT Compared With Planar Images
SPECT/CT showed more accurate information in 34 patients (82%). The localization and number of SN was exactly the same in only 7 patients (17%). All these 7 patients had one Level I SN. In 29 patients (70%), the exact anatomical localization was equivocal on planar images, whereas SPECT/CT showed the exact anatomical information needed to assign the SN Levels according to the American Joint Committee on Cancer (AJCC). In 6 patients (14%), SNs close to the injection site were detected with
Experience of Other Groups With SPECT/CT Imaging for SN Mapping
There is only little literature dealing with SPECT/CT for SN mapping. In 2003, Kretschmer and coworkers7 performed SPECT and the image fusion technique with CT in 29 patients with malignant melanoma. They found SPECT/CT to be an excellent tool to anatomically localize the SN in malignant melanoma draining to the pelvic region. With planar images of the pelvis, the exact anatomical localization of the pelvic SN cannot be given. It is crucial to examine the lymph nodes because they can contain
Discussion
Our results with SPECT/CT for SN mapping of breast cancer and the results of other groups with SPECT/CT for SN mapping in the head and neck and the pelvis indicate that the combination of lymphoscintigraphy and integrated SPETCT/CT imaging improves the anatomic localization and the identification of the SN. In our study, integrated SPECT/CT was clearly superior to SPECT alone or planar images, especially with regard to exact anatomical localization of the SN. The identification of intramammary
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