title: Improved detection of axillary hot nodes in lymphoscintigraphy in breast cancer located in the upper lateral quadrant with additional projection imaging.
abstract: BACKGROUND
  Sentinel node (SN) biopsy has been becoming a standard method for early stage breast cancer. Scintigraphic image of SN helps the biopsy procedure. It is reported that the scintigraphic detection rate is not 100%. The value of taking additional projection view in SN detection was assessed in breast cancer patients.
  
  
  METHODS
  Consecutive 114 breast cancer patients with upper lateral quadrant tumor were included in this study. After injection of 99mTc-phytate, scintigram was taken at the projection of anterior oblique (AO) 30 degrees view and an additional AO 60 degrees view. Images were evaluated visually.
  
  
  RESULTS
  In 7 of 114 patients, an axillary hot node was hidden on the activity at the injected site on AO 30 degrees view, and was visualized on AO 60 degrees view. In 17 of 114 patients, the axillary hot node was seen as a hump from the injected activity, and was separate on AO 60 degrees view. In 90 of 114 patients, the axillary hot node was separately seen on AO 30 degrees view.
  
  
  CONCLUSIONS
  Multi-directional views are helpful to depict the axillary sentinel nodes that are concealed behind the injected radioactivity.
authors.affiliation: Department of Nuclear Medicine, Cancer Institute Hospital, Tokyo, Japan. mitsuru@jfcr.or.jp
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Koizumi
authors.forename: Etsuji
authors.initials: E
authors.lastname: Nomura
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Yamada
authors.forename: Tohohiro
authors.initials: T
authors.lastname: Takiguchi
authors.forename: Motoki
authors.initials: M
authors.lastname: Ishii
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamashita
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Tada
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Nishimura
authors.forename: Kaoru
authors.initials: K
authors.lastname: Takahashi
authors.forename: Masujiro
authors.initials: M
authors.lastname: Makita
authors.forename: Takuji
authors.initials: T
authors.lastname: Iwase
authors.forename: Masataka
authors.initials: M
authors.lastname: Yoshimoto
authors.forename: Fujio
authors.initials: F
authors.lastname: Kasumi
mesh_terms: D001365:Axilla / Q000000981:diagnostic imaging* / Q000473:pathology*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D011877:Radionuclide Imaging; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000379:methods*