+ Site Statistics
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn

+ Translate
+ Recently Requested

Evaluation of mammary lymphoscintigraphy by a single intratumoral injection for sentinel node identification

Evaluation of mammary lymphoscintigraphy by a single intratumoral injection for sentinel node identification

Journal of Nuclear Medicine 41(9): 1500-1506

The aim of this study was to evaluate the findings of mammary lymphoscintigraphy by a single intratumoral injection in 150 patients with breast carcinoma: 100 patients (group A) investigated in the validation phase of the study and 50 (group B) studied after the tracer dose was optimized. Methods: Immediately after injection of 99mTc-nanocolloid using a 25-gauge needle and a 0.2-mL volume, simultaneous anterior and lateral images were acquired with a dual-head gamma camera during 20 min followed by sequential static anterior and prone lateral breast images after 30 min and after 2 and 4 h. 57Co-assisted skin marking defined the sentinel node location for subsequent gamma probe, blue dye-guided sentinel node biopsy. Results: In group A (mean dose, 61.6 MBq; range, 42-88 MBq) scintigraphy revealed lymph nodes in 83 patients (83%), with an increase in the rate of visualization from 72% for the first 40 patients to 90% for the last 60; patient age (P = 0.01) and administered tracer dose (P = 0.04) were found to be significant factors for visualization, with optimal results obtained from doses higher than 65 MBq. Lymph nodes were visible in 34 patients (41%) during the first 30 min after injection, whereas in 49 patients appearance occurred at 2-4 h. A total of 97 lymphatic basins were visualized (80 axillary, 3 clavicular, 14 internal mammary). In group B (mean dose, 90.8 MBq; range, 68-124 MBq), the visualization rate was 94%, with early lymph node appearance in 27 patients (57%) and a total of 53 basins (45 axillary, 8 internal mammary). In combination with intraoperative blue dye mapping and gamma probing, the identification rate increased to 90% in group A and 98% in group B. Prone lateral images contributed to identification of intramammary lymph nodes in a total of 14 patients and axillary nodes close to the injection site in 8 other patients. Conclusion: Mammary lymphoscintigraphy by single intratumoral injection is a valid method for lymphatic mapping and identification of both axillary and nonaxillary sentinel nodes. Lymph node visualization appears to be improved with higher tracer doses. The compactness of the injection site enables high-quality additional lateral images that can depict intramammary or axillary lymph nodes adjacent to the injection site.

(PDF emailed within 1 workday: $29.90)

Accession: 010616731

Download citation: RISBibTeXText

PMID: 10994729

Related references

Single intratumoral injection for sentinel node identification in breast cancer. Journal of Nuclear Medicine 41(5 Suppl ): 281P, 2000

Single-dose isotope injection for both preoperative lymphoscintigraphy and intraoperative sentinel lymph node identification in melanoma patients. Melanoma Research 7(6): 500-506, 1998

Should decisions on internal mammary lymph node irradiation be based on current lymphoscintigraphy techniques for sentinel lymph node identification?. Cancer 100(3): 518-523, 2004

Breast lymphoscintigraphy A comparison between intradermal injection and intraoperative isosulfan dye in sentinel node identification. Journal of Nuclear Medicine 43(5 Supplement): 291P, 2002

Immediate dynamic lymphoscintigraphy delivers no additional value to lymphoscintigraphy 3 hr after tracer injection in sentinel lymph node biopsy in breast cancer patients. Journal of Surgical Oncology 95(6): 469-475, 2006

Prostate lymphoscintigraphy for sentinel lymph node identification in canines: reproducibility, uptake, and biokinetics depending on different injection strategies. Urological Research 31(3): 152-158, 2003

A second radioisotope injection enhances intraoperative sentinel node identification in breast cancer patients without visualized nodes on preoperative lymphoscintigraphy. Acta Radiologica 47(8): 760-763, 2006

Internal mammary lymph node drainage in sentinel node lymphoscintigraphy for breast cancer. Journal of Nuclear Medicine 40(5 SUPPL ): 138P, 1999

Identification of sentinel lymph node in breast cancer by lymphoscintigraphy and surgical gamma probe with peritumoral injection of scintimammographic agent "99mTc MIbI". Annals of Nuclear Medicine 16(2): 121-126, 2002

The role of sentinel node lymphoscintigraphy in identifying patterns of internal mammary node drainage in breast cancer. International Journal of Radiation Oncology Biology Physics 48(3 Supplement): 197, 2000

Patterns of internal mammary drainage during sentinel node lymphoscintigraphy. Breast Cancer Research & Treatment 64(1): 40, November, 2000

Correlation of number and identification of sentinel nodes during radiographer led lymphoscintigraphy prior to sentinel lymph node biopsy in breast cancer patients. Radiography 18(1): 9-14, 2012

Inappropriate Intra-cervical Injection of Radiotracer for Sentinel Lymph Node Mapping in a Uterine Cervix Cancer Patient: Importance of Lymphoscintigraphy and Blue Dye Injection. Asia Oceania Journal of Nuclear Medicine & Biology 2(2): 135-137, 2014

Penile lymphoscintigraphy for sentinel node identification. European Journal of Nuclear Medicine 28(5): 581-585, 2001

Lymphoscintigraphy with peritumoral injection versus lymphoscintigraphy with subdermal periareolar injection of technetium-labeled human albumin to identify sentinel lymph nodes in breast cancer patients. Acta Radiologica 55(1): 39-44, 2014