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The role of ultrasound and lymphoscintigraphy in the assessment of axillary lymph nodes in patients with breast cancer.

Nieciecki M, Dobruch-Sobczak K, Wareluk P, Gumińska A, Białek E, Cacko M, Królicki L - J Ultrason (2016)

Bottom Line: The importance of ultrasound in patient qualification for sentinel lymph-node biopsy has been discussed in a number of works.Furthermore, different lymphoscintigraphy protocols have been compared in the literature.Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: Department of Diagnostic Imaging, Mazovian Bródno Hospital, Warsaw, Poland.

ABSTRACT
Breast cancer is the most common malignancy and the leading cause of death due to cancer in European women. Mammography screening programs aimed to increase the detection of early cancer stages were implemented in numerous European countries. Recent data show a decrease in mortality due to breast cancer in many countries, particularly among young women. At the same time, the number of sentinel node biopsy procedures and breast-conserving surgeries has increased. Intraoperative sentinel lymph node biopsy preceded by lymphoscintigraphy is used in breast cancer patients with no clinical signs of lymph node metastasis. Due to the limited sensitivity and specificity of physical examination in detecting metastatic lesions, developing an appropriate diagnostic algorithm for the preoperative assessment of axillary lymph nodes seems to be a challenge. The importance of ultrasound in patient qualification for sentinel lymph-node biopsy has been discussed in a number of works. Furthermore, different lymphoscintigraphy protocols have been compared in the literature. The usefulness of novel radiopharmaceuticals as well as the methods of image acquisition in sentinel lymph node diagnostics have also been assessed. The aim of this article is to present, basing on current guidelines, literature data as well as our own experience, the diagnostic possibilities of axillary lymph node ultrasound in patient qualification for an appropriate treatment as well as the role of lymphoscintigraphy in sentinel lymph node biopsy.

No MeSH data available.


Related in: MedlinePlus

Lymphoscintigraphy in a patient with left breast cancer performed the day before planned surgical treatment. The SPECT/CT revealed a focus of increased tracer accumulation in the projection of axillary lymph node
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Figure 0006: Lymphoscintigraphy in a patient with left breast cancer performed the day before planned surgical treatment. The SPECT/CT revealed a focus of increased tracer accumulation in the projection of axillary lymph node

Mentions: Lymphoscintigraphy uses several types of radiopharmaceuticals, usually colloid compounds differing in particle size. Sodium pertechnetate (Na99mTcO4) is usually used for labeling. The size of tracer particles determines its velocity of distribution in the lymphatic system as well as the duration of node labeling. Their optimal size is 100-200 nm(23). Usually a sentinel lymph node is visualized within 2 hours, and its sampling should be performed within 16-20 hours after radiopharmaceutical administration(24). Both, planar images, usually in two projections: A-P and lateral(23, 24) (Fig. 5), as well as methods of three-dimensional image acquisition, i.e. single-photon emission computed tomography (SPECT) and single-photon emission computed tomography/computed tomography (SPECT/CT) may be used (Fig. 6). Bluemel et al. assessed the usefulness of a novel tool for intraoperative three-dimensional image projection, i.e. freehand SPECT. The authors achieved more than 92% detectability of the sentinel lymph nodes, which had an influence on altered surgical management in about 10% of patients. For comparison – detectability using conventional techniques utilizing typical scintillation probe was 69.1% in this study(25).


The role of ultrasound and lymphoscintigraphy in the assessment of axillary lymph nodes in patients with breast cancer.

Nieciecki M, Dobruch-Sobczak K, Wareluk P, Gumińska A, Białek E, Cacko M, Królicki L - J Ultrason (2016)

Lymphoscintigraphy in a patient with left breast cancer performed the day before planned surgical treatment. The SPECT/CT revealed a focus of increased tracer accumulation in the projection of axillary lymph node
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4834366&req=5

Figure 0006: Lymphoscintigraphy in a patient with left breast cancer performed the day before planned surgical treatment. The SPECT/CT revealed a focus of increased tracer accumulation in the projection of axillary lymph node
Mentions: Lymphoscintigraphy uses several types of radiopharmaceuticals, usually colloid compounds differing in particle size. Sodium pertechnetate (Na99mTcO4) is usually used for labeling. The size of tracer particles determines its velocity of distribution in the lymphatic system as well as the duration of node labeling. Their optimal size is 100-200 nm(23). Usually a sentinel lymph node is visualized within 2 hours, and its sampling should be performed within 16-20 hours after radiopharmaceutical administration(24). Both, planar images, usually in two projections: A-P and lateral(23, 24) (Fig. 5), as well as methods of three-dimensional image acquisition, i.e. single-photon emission computed tomography (SPECT) and single-photon emission computed tomography/computed tomography (SPECT/CT) may be used (Fig. 6). Bluemel et al. assessed the usefulness of a novel tool for intraoperative three-dimensional image projection, i.e. freehand SPECT. The authors achieved more than 92% detectability of the sentinel lymph nodes, which had an influence on altered surgical management in about 10% of patients. For comparison – detectability using conventional techniques utilizing typical scintillation probe was 69.1% in this study(25).

Bottom Line: The importance of ultrasound in patient qualification for sentinel lymph-node biopsy has been discussed in a number of works.Furthermore, different lymphoscintigraphy protocols have been compared in the literature.Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: Department of Diagnostic Imaging, Mazovian Bródno Hospital, Warsaw, Poland.

ABSTRACT
Breast cancer is the most common malignancy and the leading cause of death due to cancer in European women. Mammography screening programs aimed to increase the detection of early cancer stages were implemented in numerous European countries. Recent data show a decrease in mortality due to breast cancer in many countries, particularly among young women. At the same time, the number of sentinel node biopsy procedures and breast-conserving surgeries has increased. Intraoperative sentinel lymph node biopsy preceded by lymphoscintigraphy is used in breast cancer patients with no clinical signs of lymph node metastasis. Due to the limited sensitivity and specificity of physical examination in detecting metastatic lesions, developing an appropriate diagnostic algorithm for the preoperative assessment of axillary lymph nodes seems to be a challenge. The importance of ultrasound in patient qualification for sentinel lymph-node biopsy has been discussed in a number of works. Furthermore, different lymphoscintigraphy protocols have been compared in the literature. The usefulness of novel radiopharmaceuticals as well as the methods of image acquisition in sentinel lymph node diagnostics have also been assessed. The aim of this article is to present, basing on current guidelines, literature data as well as our own experience, the diagnostic possibilities of axillary lymph node ultrasound in patient qualification for an appropriate treatment as well as the role of lymphoscintigraphy in sentinel lymph node biopsy.

No MeSH data available.


Related in: MedlinePlus