The additional value of SPECT/CT in lymphatic mapping in breast cancer and melanoma.
The recently introduced SPECT/CT integrates the physiologic data of SPECT with the anatomic data of CT into a single image. The purpose of this pilot study was to explore the additional value of SPECT/CT in breast cancer patients and melanoma patients with inconclusive planar image findings.


METHODS
Thirty-one patients had planar lymphoscintigrams showing unexpected lymphatic drainage, 6 had lymphoscintigrams that were difficult to interpret, and 3 showed no drainage on planar imaging. SPECT/CT was performed immediately after delayed planar imaging.


RESULTS
In 4 patients, SPECT/CT showed 6 additional sentinel nodes, of which 2 were tumor-positive and led to upstaging and tailored management in 5% of patients. SPECT/CT depicted sentinel nodes in 3 patients whose delayed planar imaging had shown no drainage.


CONCLUSIONS
SPECT/CT was of additional value in finding the exact anatomic location of sentinel nodes in patients with inconclusive planar image findings. SPECT/CT also detected sentinel nodes in addition to those found on planar images, and SPECT/CT detected sentinel nodes in patients whose planar images had shown none.
van der Ploeg
Iris M C
IM
Department of Surgery, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. i.vd.ploeg@nki.nl
Valdés Olmos
Renato A
RA
Nieweg
Omgo E
OE
Rutgers
Emiel J Th
EJ
Kroon
Bin B R
BB
Hoefnagel
Cornelis A
CA
D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging*; D008297:Male; D008545:Melanoma / Q000000981:diagnostic imaging* / Q000556:secondary; D008875:Middle Aged; D019275:Radiopharmaceuticals; D012878:Skin Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D013668:Technetium Tc 99m Aggregated Albumin; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed
D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; C083602:technetium Tc 99m nanocolloid