title: Localization and evaluation of sentinel lymph node in breast cancer from computed tomographic lymphography.
abstract: OBJECTIVE
  This study aimed to determine the accuracy of computed tomographic (CT) localization and CT-based diagnosis of sentinel lymph nodes (SLNs) metastasis.
  
  
  METHODS
  Thirty-four patients with confirmed breast cancer underwent 40-row CT scanning, and the first one or several lymph node(s) in the lymphatic drainage pathway was/were defined as the SLN(s). Dye and γ probe-guided SLN biopsy was performed on all patients. To accurately localize the SLN, 19 patients (55.9%) underwent the percutaneous lymph node puncture procedure. The morphologic features of all the SLNs on CT scans were analyzed and compared with the SLN biopsy pathologic diagnosis.
  
  
  RESULTS
  Sentinel lymph nodes were successfully identified for all patients without any significant adverse effects. All localized SLNs corresponded well with SLNs identified on SLN biopsy, with an accuracy of 89.5%. Accuracy increased to 100% when the CT scan technique was combined with the blue dye method. The size criteria for metastatic diagnosis had a sensitivity of 85%, which increased to 94.7% when long-to-short-axis ratio and margin characteristics were also considered.
  
  
  CONCLUSIONS
  The CT lymphography combined with the blue dye method accurately localized the SLNs. The CT-based diagnostic criteria improved the diagnostic accuracy of SLN metastases and were useful for evaluating the axillary status in early stage breast cancer patients.
authors.affiliation: Department of Radiology, Cancer Hospital/Institute, Shanghai Medical College, Fudan University, Shanghai, China.
authors.forename: Hongna
authors.initials: H
authors.lastname: Tan
authors.forename: Benlong
authors.initials: B
authors.lastname: Yang
authors.forename: Jiong
authors.initials: J
authors.lastname: Wu
authors.forename: Shengping
authors.initials: S
authors.lastname: Wana
authors.forename: Yajia
authors.initials: Y
authors.lastname: Gu
authors.forename: Wentao
authors.initials: W
authors.lastname: Li
authors.forename: Zhaoxia
authors.initials: Z
authors.lastname: Jiang
authors.forename: Min
authors.initials: M
authors.lastname: Qian
authors.forename: Weijun
authors.initials: W
authors.lastname: Peng
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging* / Q000473:pathology; D008220:Lymphography / Q000379:methods*; D008875:Middle Aged; D011857:Radiographic Image Interpretation, Computer-Assisted; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy; D013671:Technetium Tc 99m Sulfur Colloid; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D019275:Radiopharmaceuticals; D013671:Technetium Tc 99m Sulfur Colloid