The Value of Imaging in Standing Position in Preoperative Breast Lymphoscintigraphy

被引:2
作者
Anagnostou, Christos [1 ]
Baiocco, Cinzia [1 ]
Arnulfo, Alberto [2 ]
Liberatore, Mauro [3 ]
Baccheschi, Anna Maria [4 ]
Inglese, Eugenio [1 ]
机构
[1] Maggiore della Carita Hosp, Dept Nucl Med, I-28100 Novara, Italy
[2] Maggiore della Carita Hosp, Div Gynecol & Obstet 2, I-28100 Novara, Italy
[3] Univ Roma La Sapienza, Nucl Med Sect, Dept Radiol Sci, Rome, Italy
[4] Univ Roma La Sapienza, Dept Surg Pietro Valdoni, Rome, Italy
关键词
sentinel lymph node; lymphoscintigraphy; standing position acquisition; breast cancer; SENTINEL LYMPH-NODES; NON-VISUALIZATION; UPRIGHT POSITION; CANCER PATIENTS; IDENTIFICATION; BIOPSY; INJECTION;
D O I
10.1097/RLU.0b013e318219b29f
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Purpose: Breast lymphoscintigraphy is an accurate technique, but in a minority of cases the sentinel node (SN) visualization cannot be achieved or can be very difficult. We evaluated the potential clinical advantages and limitations of performing imaging in the standing position. The aim was to establish if this examination modality is quicker and helpful in the presence of "hidden" SN, checking also for any influence of SN skin landmarking in the upright position on the correct intraoperative SN identification. The overall objective was to verify if the standing position can be routinely used in breast lymphoscintigraphy. Methods: A total of 144 patients underwent lymphoscintigraphy in both standing and supine positions. In both modalities, a skin landmark was set coincident with the SN orthogonal projections. The acquisition times of 2 groups (each consisting of 45 patients) examined with the standing or supine acquisition modality, were compared. Results: In 6 cases with hidden SN and in 34 cases with difficult or partial visualization in one of the supine views, the standing protocol was effective and led to better and quicker visualization of lymph nodes (median examination time: 25.5 minutes standing, 35.5 minutes supine). Significant differences in skin landmark position between the 2 modalities were present only in overweight patients and in large breasts. This, however, did not have a negative impact on successful intraoperative localization of SN with the gamma probe. Conclusions: Standing acquisition resulted to be a faster, easier, and more accurate examination protocol and can be used as the routine method for SN detection in breast lymphoscintigraphy.
引用
收藏
页码:683 / 688
页数:6
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