The Additional Value of SPECT/CT in Lymphatic Mapping in Breast Cancer and Melanoma

Iris M. C. van der Ploeg, R.A. Valdés Olmos, Omgo E. Nieweg, Emiel J. Rutgers, B.B.R. Kroon, C. A. Hoefnagel

Journal of Nuclear Medicine · 2007 · 131 citations · 17 references

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TL;DR

SPECT/CT fuses SPECT’s functional data with CT’s anatomical detail into a single image. This pilot study evaluated whether SPECT/CT provides additional value for breast cancer and melanoma patients with inconclusive planar lymphoscintigraphy. SPECT/CT was performed immediately after delayed planar imaging, revealing six extra sentinel nodes in four patients, two of which were tumor‑positive and prompted upstaging and tailored management in 5 % of cases. SPECT/CT identified sentinel nodes in patients with negative or ambiguous planar scans, adding nodes and improving localization, and led to upstaging in 5 % of patients.

Abstract

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.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.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.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.

References

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