Improved body-outline imaging technique for localization of sentinel lymph nodes in breast surgery.
Many centers use techniques for localizing the sentinel lymph node (SLN) associated with a breast tumor. Protocols involve the use of an intraoperative probe and blue dye but may or may not include scintigraphy.


METHODS
Three methods of body-outline imaging were investigated to aid SLN localization. Body outlines were acquired using a handheld source; a transmission image was acquired from a (57)Co-flood source; and, finally, a new method is described using a (153)Gd-line source attenuation correction for body outline.


RESULTS
Method 1 images were of low quality, although 83% of SLNs were visualized. Body outline was unsatisfactory for surgical localization. Method 2 was unsatisfactory because of the lack of a lateral image. Method 3 enabled good presurgical visualization of the SLN (73%) and speeded surgical localization.


CONCLUSIONS
The (153)Gd-line source consistently gives optimal-quality body-outline images. This source is simple, quick, and clearly locates the SLN on multiple projections.
Clarke
Elizabeth
E
Department of Physics and Nuclear Medicine, City Hospital NHS Trust, Birmingham, United Kingdom. elizabeth.clarke@cityhospbham.wmids.nhs.uk
Notghi
Alp
A
Harding
Keith
K
D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D003037:Cobalt Radioisotopes; D004396:Coloring Agents; D005260:Female; D005682:Gadolinium; D015902:Gamma Cameras; D006801:Humans; D007430:Intraoperative Care; D011868:Radioisotopes; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D021701:Sentinel Lymph Node Biopsy; D013668:Technetium Tc 99m Aggregated Albumin
D003037:Cobalt Radioisotopes; D004396:Coloring Agents; D011868:Radioisotopes; D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; C083602:technetium Tc 99m nanocolloid; D005682:Gadolinium