To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: SPECT/CT May Be Better Than Lymphoscintigraphy at Detecting Sentinel Lymph Nodes in Breast Cancer: Presented at ESSO URL: http://www.pslgroup.com/dg/22C5D6.htm Doctor's Guide September 15, 2008
By Shazia Qureshi THE HAGUE, Netherlands -- September 15, 2008 -- A single-photon-emission computed tomography camera with integrated computed tomography (SPECT/CT) was better for lymphatic mapping than conventional lymphoscintigraphy in patients with breast cancer, according to study findings reported here at the 14th Congress of the European Society of Surgical Oncology (ESSO). In the study, SPECT/CT aided surgical biopsy planning by detecting the sentinel lymph nodes that were not detected by the conventional imaging technique and by visualising the precise anatomical location of the sentinel nodes. Iris van der Ploeg, MD, Department of Surgery, Netherlands Cancer Institute and Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands, discussed the study findings in a presentation on September 12. She remarked that SPECT/CT may improve staging by providing an improved indication of lymph node metastases. Imaging of sentinel lymph nodes is usually done with lymphoscintigraphy, followed by sentinel node biopsy to test for the presence of tumour cells. The researchers used SPECT/CT in 110 patients with breast cancer with inconclusive or unusual lymphoscintigraphy results. These included 18 patients whose lymphoscintigrams were difficult to interpret, 15 patients who showed no sentinel nodes on lymphoscintigraphy, and 77 patients whose lymphoscintigrams showed unusual lymphatic drainage. With conventional imaging using lymphoscintigraphy, 224 sentinel nodes were seen in 95 patients (86%). These sentinel nodes were also seen with SPECT/CT, but SPECT/CT also showed an additional 15 sentinel nodes in 13 patients. Of these 15 additional nodes, 14 were harvested and 4 were found to be tumour-positive in 3 patients. In addition, of the 15 patients with no sentinel nodes visible with conventional imaging, SPECT/CT identified lymphatic drainage in 8 patients. According to Dr. van der Ploeg, the use of SPECT/CT increased the visualisation rate from 86% using lymphoscintigraphy to 94% using lymphoscintigraphy followed by SPECT/CT. SPECT/CT imaging established the precise anatomical location of all the sentinel nodes that it visualised. In 68% of patients, the surgeons chose another location for making an incision in the lymph node basin than that suggested by the lymphoscintigraphy results alone. They also made the incision in another nodal field in 25% of patients based on the SPECT/CT findings. SPECT/CT was particularly useful in determining the specific intercostal space of internal mammary chain sentinel nodes and in establishing a location behind a rib, according to the researchers. Following sentinel node biopsy surgery, 31 sentinel nodes in 24 patients were found to be tumour-positive. Of these, SPECT/CT but not lymphoscintigraphy identified 4 (13%) of them, and 3 (10%) had been identified only by blue dye during the biopsy surgery but not by either imaging technique. Dr. van der Ploeg added that while this study used 2-dimensional SPECT/CT, in the future, "3-dimensional SPECT/CT may be used to display a sentinel node surrounded by skin, muscle, and bone structures, and this will give even better anatomical insight into the precise location of the sentinel node." [Presentation title: The Potential Value of SPECT/CT for Lymphatic Mapping in Patients With Breast Cancer. Abstract 131] --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. All contents Copyright (c) 1998 P\S\L Consulting Group Inc. All rights reserved.