• 作者：J. Mucientes Rasilla^a ; ^{jorgemuci@vodafone.es} ; L. Farge Balbí ; n^a ; J. Cardona Arbonié ; s^a ; A. Moreno Elola-Olaso^b ; R. Delgado-Bolton^a ; L. Izarduy Pereyra^a ; C. Rodrí ; guez Rey^a ; L. Lapeñ ; a Gutié ; rrez^a ; A. Gonzá ; lez Maté ; ^a ; J.M. Romá ; n Santamarí ; a^b ; J.L. Carreras Delgado^a
• 关键词：SPECT-TAC ; ganglio centinela ; cancer de mama ; fusi&oacute ; n
• 刊名：Revista Espa帽ola de Medicina Nuclear
• 出版年：2008
• 期刊代码：pca315_02126982
• 类别：med
• 出版时间：June 2008
• 卷：27
• 期：3
• 页码：183-190
• 文件大小：384 K

Introduction

Sentinel lymph node biopsy has become a widely accepted procedure for axillary lymph node staging in patients with breast cancer.

Aim

. The aim of this study was to determine the advantages of using SPECT-CT instead of planar scintigraphy in the presurgical localisation of sentinel lymph nodes.

Methods

We prospectively included 25 consecutive patients with breast cancer who were admitted to our department for SLN localisation. Patients were divided into two groups, depending on whether neoadjuvant chemotherapy had been received (B, n = 6) or not (A, n = 19). Four doses (1.0 mCi each) of ^99mTc-nanocolloid were injected intradermallly in all patients, and SPECT-CT and planar images were acquired. All patients underwent surgery and SLN localisation with a hand-held gamma probe. Any axillary 鈥渉ot spots鈥?were resected. The kappa index (ki) was calculated using surgical findings as the gold standard.

Results

In group A, the SLN was correctly detected in 17/19 patients (89.5%) with SPECT-CT and in 12/19 (63.2%) with planar images. The correlation between SPECT-CT and surgical findings (ki 0.91) was better than between planar images and surgical findings (ki 0.57). In group B, the results of SPECT-CT and planar images were identical, with accurate localisation of the SLN in 5/6 patients (ki 0.76).

Conclusions

The results of this study suggest that SPECT-CT may be useful for locating the SLN in breast cancer patients, as it provides accurate localization of the SLN with useful anatomical information. This may allow the surgeon to search exclusively for SLN viewed on SPECT-CT, and avoid false negative and false positive results.