Improved detection of axillary hot nodes in lymphoscintigraphy in breast cancer located in the upper lateral quadrant with additional projection imaging.
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.
Koizumi
Mitsuru
M
Department of Nuclear Medicine, Cancer Institute Hospital, Tokyo, Japan. mitsuru@jfcr.or.jp
Nomura
Etsuji
E
Yamada
Yasuhiko
Y
Takiguchi
Tohohiro
T
Ishii
Motoki
M
Yamashita
Takashi
T
Tada
Keiichiro
K
Nishimura
Seiichiro
S
Takahashi
Kaoru
K
Makita
Masujiro
M
Iwase
Takuji
T
Yoshimoto
Masataka
M
Kasumi
Fujio
F
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*