Contribution of dynamic sentinel lymphoscintigraphy images to the diagnosis of patients with malignant skin neoplasms in the upper and lower extremities.
Contribution of dynamic sentinel lymphoscintigraphy images to the diagnosis of patients with malignant skin neoplasms in the upper and lower extremities.
复制标题
DOI：
10.1186/2193-1801-3-625
复制
发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Sawamura D
中科院分区：
文献类型：
--
作者：
Miura H;Ono S;Shibutani K;Seino H;Tsushima F;Kakehata S;Hirose K;Fujita H;Kakuta A;Aoki M;Hatayma Y;Kawaguchi H;Sato M;Takai Y;Kaneko T;Sawamura D
本研究的目的是确认动态图像在恶性皮肤肿瘤前哨淋巴结造影中的作用：确切地说，调查动态图像是否必要，并观察动态图像是否可以减少活检和解剖所需的区域。对25例下肢（n = 21）和上肢（n = 4）恶性皮肤肿瘤患者进行了回顾性研究。图像由两名独立的评审员进行评价，一名是诊断放射学和核医学专家，另一名是接受培训的诊断放射科医生。仅使用静态平面图像将可视化热点评估为前哨淋巴结。接下来，评估静态平面和动态图像。评审员对确定的前哨淋巴结的诊断置信度值进行评分如下：0，无法确定; 1，可能; 2，很可能; 3，确定。淋巴引流方式分为6种不同途径：（1）腹股沟型，（2）腘型，（3）腹股沟和腘型，（4）腋窝型，（5）肘型，（6）腋窝和肘型。在下肢病例中，使用动态图像，专家评审员改变了3例病例的评估，实习评审员改变了1例病例的评估。没有两名审查员之间的决定被改变为相同的情况。尽管动态图像的平均诊断置信度评估值通常较高，但不存在显著差异。在上肢病例中，两位评审员均改变了对1例患者的评估。经双方同意，动态图像评估发生变化的病例为腹股沟和腘型以及腋窝和肘型。专家评审员注意到淋巴通道仅在动态图像上可见，并更改了评估。确定淋巴结是否是前哨淋巴结取决于淋巴网络的可视化。在目前的情况下，不应排除所有确定为淋巴结的热点活检。但是，应尽可能避免过多的活检。有必要使用动态图像以及熟练的观察。
The aim of the present study was to confirm the contribution of dynamic images in sentinel lymphoscintigraphy in malignant skin neoplasms: precisely, to investigate if dynamic images were necessary and to observe if dynamic images could reduce the areas needed for biopsy and dissection. Twenty-five patients with malignant skin neoplasms of the lower (n = 21) and upper (n = 4) extremities were retrospectively investigated. Images were evaluated by two independent reviewers, an expert in diagnostic radiology and nuclear medicine and a diagnostic radiologist in training. Visualized hot spots were assessed to be sentinel nodes using only static planar images. Next, both static planar and dynamic images were assessed. Reviewers scored diagnostic confidence values of determined sentinel nodes as follows: 0, cannot be decided; 1, possible; 2, probable; and 3, definitive. Patterns of lymphatic drainage were categorized into six different pathways: (1) inguinal type, (2) popliteal type, (3) inguinal and popliteal type, (4) axillary type, (5) cubital type, and (6) axillary and cubital type. In cases in the lower extremities, with dynamic images, the expert reviewer changed assessment in three cases and the trainee reviewer changed it in one case. There were no cases in which a decision was changed to be the same between both reviewers. Although the average diagnostic confidence value of assessment is usually higher with dynamic images, significant differences were not present. In cases of the upper extremities, both reviewers changed their assessment in one patient. By mutual agreement, cases in which assessment was changed with dynamic images were the inguinal and popliteal type, and the axillary and cubital type. The expert reviewer noticed lymphatic channels only visualized on dynamic images and changed assessment. Determination of whether or not a lymph node is a sentinel node depends on visualization of the lymphatic network. In the present circumstances, all biopsies of hot spots determined to be lymph nodes should not be excluded. However, excessive biopsies should be avoided as much as possible. It is necessary to use dynamic images alongside skillful observation.
登录
查看更多内容
DOI：
10.1007/bf00801606
发表时间：
1995-11-01
期刊：
EUROPEAN JOURNAL OF NUCLEAR MEDICINE
影响因子：
--
作者：
PIJPERS, R;COLLET, GJ;HOEKSTRA, OS
通讯作者：
HOEKSTRA, OS
影响因子：
2.6
作者：
Pijpers, R;Borgstein, PJ;Teule, GJJ
通讯作者：
Teule, GJJ
影响因子：
2.5
作者：
Mariani, G;Erba, P;Strauss, HW
通讯作者：
Strauss, HW
影响因子：
2.2
作者：
Higashi, H;Natsugoe, S;Aikou, T
通讯作者：
Aikou, T
影响因子：
3.4
作者：
Belhocine, T;Piérard, GE;Rigo, P
通讯作者：
Rigo, P