Sentinel lymph node biopsy is associated with reduced arm morbidity and better quality of life than standard axillary treatment and should be the treatment of choice for patients who have early-stage breast cancer with clinically negative nodes.

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There are technical differences between the tracers. Overall image quality score is superior using technetium, with less low-count artefact and less attenuation. Stress defect depth and extent are slightly greater using thallium, with no difference between MIBI and tetrofosmin. All three tracers perform well in clinical terms, with high sensitivity and specificity for angiographic stenosis and no differences in accuracy between the tracers.

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SUMMARY Twenty patients satisfying standard clinical criteria for Alzheimer's disease (AD) and six age-matched normal controls were studied using 9'Tc hexamethyl-propyleneamine oxime and single photon emission tomography. The AD patients had lower regional cerebral blood flow (rCBF) in the temporal and posterior parietal lobes compared to controls. AD patients with apraxia and aphasia had lower rCBF in the lateral temporal and posterior parietal lobes than AD patients without these features. Within the AD group, correlations were found between neuropsychological tests and rCBF: praxis correlated with posterior parietal activity, memory with left temporal lobe activity and language with activity throughout the left hemisphere.Neuroimaging has developed rapidly in the past few years with the introduction of x-ray computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET) and single photon emission tomography (SPET). CT and MRI offer unique anatomical information while PET and SPET reveal physiological functions such as cerebral blood flow and cerebral metabolism. 9'Tc hexamethyl-propyleneamine oxime (HMPAO) is a new radiopharmaceutical which crosses an intact blood brain barrier and is trapped inside functioning cells in proportion to cerebral blood flow (CBF).'2 Alzheimer's disease (AD) affects between 6 to 7% of the population over the age of 653 and represents a major health issue. The cause is not known and no effective treatment exists. CT studies of subjects with AD have demonstrated abnormalities including cerebral atrophy and ventricular enlargement.4 MRI has demonstrated white matter lesions and abnormal spin lattice relaxation times.5 PET scanning has shown defects in metabolism in temporal and parietal lobes6 and similar results have been found using SPET.75 Although in some ways PET is the ideal way of studying functional imaging the technique is extremely expensive and requires a large highly trained technical staff.The majority of SPET studies in dementia have attempted to describe the scan appearances in different types of dementia and to assess the ability of the