title: Lymphoscintigraphy in early-stage non-small cell lung cancer with technetium-99m nanocolloids and hybrid SPECT/CT: a pilot project.
abstract: OBJECTIVE
  The goal of our study was to determine if lymph node activity could be visualized using a hybrid single-photon emission computed tomography/computed tomography (SPECT/CT) scanner with two commonly used colloidal lymphatic radiotracers--99mTc-antimony sulfide colloid (ASC) and 99mTc-filtered sulfur colloid (FSC) in the setting of low-stage non-small cell lung cancer (NSCLC).
  
  
  METHODS
  Patients undergoing CT-guided percutaneous lung biopsies for clinically suspected early-stage lung cancer were randomized to peri-lesional injection of 37 MBq (0.5 mL) of either ASC or FSC. SPECT/CT of the thorax was performed at either 1, 2, or 3 h post-injection. The images were reviewed to determine if lymph node activity separate from the injection site could be identified.
  
  
  RESULTS
  24 patients were included. Lymph node activity was identified in 50% of patients. A total of 15 lymph nodes with activity were visualized including 5 ipsilateral hilar, 6 ipsilateral mediastinal, and 4 distant locations. No contralateral mediastinal or hilar activity was visualized. There was a tendency to improved visualization with ASC and the longer 3 h wait time. Most patients also demonstrated significant pleural, tracheobronchial, and/or systemic activity.
  
  
  CONCLUSIONS
  SPECT/CT imaging can demonstrate lymph node activity separate from the injection site in at least some low-stage NSCLC patients with a perilesional injection of 99mTc nanocolloid tracers. Further investigation into the role of pre-operative lymphoscintigraphy with SPECT/CT in patients with lung cancer is warranted.
authors.affiliation: Department of Radiology and Diagnostic Imaging, University of Alberta, 8440-112 St., 2A2.41 WMC, Edmonton, AB, T6G 2B7, Canada, jabele@ualberta.ca.
authors.forename: Jonathan T
authors.initials: JT
authors.lastname: Abele
authors.forename: Karen
authors.initials: K
authors.lastname: Allred
authors.forename: Tracey
authors.initials: T
authors.lastname: Clare
authors.forename: Eric L R
authors.initials: EL
authors.lastname: Bédard
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D061305:Lymphoscintigraphy; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009367:Neoplasm Staging; D010865:Pilot Projects; D057234:Preoperative Period; D021701:Sentinel Lymph Node Biopsy; D013668:Technetium Tc 99m Aggregated Albumin; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed
chemical_list: D013668:Technetium Tc 99m Aggregated Albumin; C083602:technetium Tc 99m nanocolloid