Stereoscopic scintigraphic imaging of breast cancer sentinel lymph nodes.
Stereoscopic scintigraphic imaging of breast cancer sentinel lymph nodes.
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DOI：
10.2325/jbcs.14.92
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发表时间：
2007-01-01
期刊：
影响因子：
--
通讯作者：
Kubo, Atsushi
中科院分区：
文献类型：
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作者：
Tanaka, Chikako;Fujii, Hirofumi;Kubo, Atsushi
背景：术前使用淋巴显像来识别前哨淋巴结（sln）。传统的平面闪烁成像不能为SLN活检提供三维（3D）信息。我们将立体成像应用于术前淋巴显像以获得三维信息并评估其有效性。方法：44例临床I期乳腺癌患者（男1例，女43例，年龄59.4+/-11.4岁）纳入研究。Tc-99m注射3小时后，获取10度斜位图像及常规正侧位图像。除2例患者外，所有研究均获得前位和侧位立体图像；只做了侧面视图。两位经验丰富的放射科医生列举了可视化的热结节。结果：42例患者中有8例（19.0%）在正位，44例患者中有5例（11.4%）在侧位，44例患者中有11例（25.0%）在正位或侧位，与常规平面成像相比，立体成像描绘了更多的腋窝淋巴结。立体与常规平面成像方法在前位（p=0.012）和侧位（p=0.043）上的差异有统计学意义。立体成像提供了三维信息，并有效地分离了在传统平面图像上被视为一个热节点的紧密位置的热节点。42例患者中有38例（90%）采用前位立体影像与侧位立体影像相比，发现相同数量或更多的腋窝热淋巴结。结论：立体显像方法可提高sln的术前鉴别能力。该方法技术简单，可作为乳腺癌SLN成像的有力诊断工具。
BACKGROUND: Lymphoscintigraphy is used preoperatively to identify sentinel lymph nodes (SLNs). Conventional planar scintigraphy cannot provide three-dimensional(3D) information for SLN biopsy. We applied stereoscopic imaging to preoperative lymphoscintigraphy to obtain 3D information and evaluated its usefulness.METHODS: Forty-four clinical stage I breast cancer patients (1 male, 43 females; age, 59.4+/-11.4 years) were enrolled in this study. Three hours after the injection of Tc-99m, 10 degrees of oblique images and routine anterior and lateral images were acquired. Anterior and lateral stereoscopic images were obtained in all studies, except for 2 patients; only lateral views were done for those. Two experienced radiologists enumerated the visualized hot nodes.RESULTS: Stereoscopic imaging delineated more hot axillary lymph nodes compared to routine planar imaging in 8 of 42 patients (19.0%) on anterior view, 5 of 44 patients (11.4%) on lateral view, and 11 of 44 patients (25.0%) on either the anterior or lateral view. Statistically significant differences were observed between stereoscopic and routine planar imaging method on the anterior (p=0.012) and the lateral views (p=0.043). The stereoscopic imaging provided 3D information and effectively separated closely located hot nodes that were viewed as one hot node on conventional planar images. Thirty-eight out of 42 cases (90%) with anterior stereoscopic images identified the same number or more axillary hot nodes compared with lateral stereoscopic images.CONCLUSION: The stereoscopic imaging method could improve the preoperative identification of SLNs. This method is technically simple, and could be a powerful diagnostic tool for SLN imaging breast cancer.