SPECT/CT in imaging sentinel nodes

Wagner, Thomas; Gnanasegaran, Gopinath; Buscombe, J. R.

doi:10.1007/s40336-015-0113-3

Cited by 5 publications

(5 citation statements)

References 54 publications

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“…MagUS seems to be a method that can allow for alternatives to surgical axillary mapping. It comes to add to the armamentarium of other minimally invasive techniques that have previously been proposed [ 17 , 19 , 22 , 61 ] allowing for tailored axillary mapping in breast cancer. Its presumed advantages are the combination of different imaging modalities, together with that SPIO remains in the node a longer period, so as to allow for delayed SLND.…”

Section: Discussionmentioning

confidence: 99%

“…The contrast will then be taken up by the lymphatics and reach the SLNs and will subsequently be visualized by a radiological modality. Previously, several methods such as single-photon emission computed tomography (SPECT), tridimensional computed tomography lymphography (3D-CTLG) or contrast enhanced ultrasound with microbubbles (CEUS) have been evaluated as alternatives to surgery [ 17 , 18 , 19 ]. Most of these have shown promising results, but larger studies are missing and, complicated logistics, need for access to nuclear medicine facilities and demanding learning curves are restricting their introduction into clinical practice.…”

Section: Introductionmentioning

confidence: 99%

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Magnetic-Guided Axillary UltraSound (MagUS) Sentinel Lymph Node Biopsy and Mapping in Patients with Early Breast Cancer. A Phase 2, Single-Arm Prospective Clinical Trial

Jazrawi

Pantiora

Abdsaleh

et al. 2021

Cancers

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Lymph Node Dissection (SLND) is standard of care for diagnosing sentinel lymph node (SLN) status in patients with early breast cancer. Study aim was to determine whether the combination of Superparamagnetic iron oxide nanoparticles (SPIO) MRI-lymphography (MRI-LG) and a Magnetic-guided Axillary UltraSound (MagUS) with biopsy can allow for minimally invasive, axillary evaluation to de-escalate surgery. Patients were injected with 2 mL of SPIO and underwent MRI-LG for SN mapping. Thereafter MagUS and core needle biopsy (CNB) were performed. Patients planned for neoadjuvant treatment, the SLN was clipped and SLND was performed after neoadjuvant with the addition of isotope. During surgery, SLNs were controlled for signs of previous biopsy or clip. The primary endpoint was MagUS SLN detection rate, defined as successful SLN detection of at least one SLN of those retrieved in SLND. In 79 patients, 48 underwent upfront surgery, 12 received neoadjuvant and 19 had recurrent cancer. MagUS traced the SLN in all upfront and neoadjuvant cases, detecting all patients with macrometastases (n = 10). MagUS missed only one micrometastasis, outperforming baseline axillary ultrasound AUS (AUC: 0.950 vs. 0.508, p < 0.001) and showing no discordance to SLND (p = 1.000). MagUS provides the niche for minimally invasive axillary mapping that can reduce diagnostic surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Magnetic-Guided Axillary UltraSound (MagUS) Sentinel Lymph Node Biopsy and Mapping in Patients with Early Breast Cancer. A Phase 2, Single-Arm Prospective Clinical Trial

Jazrawi

Pantiora

Abdsaleh

et al. 2021

Cancers

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“…Conventional planar lymphoscintigraphy (PL), through dynamic and static imaging in multiple positions, provides a two-dimensional display of lymphatic drainage and the SLN. Single-photon emission computed tomography (SPECT) through the acquisition of multiple cross-sections, allows obtaining a three-dimensional image which increases the sensitivity, and in combination with computed tomography as hybrid SPECT/CT technology provides more accurate anatomical localization of the SLN [9][10][11]. Identification of the SLN leads to its simpler and faster detection, and also to a reduction in the extent of surgery.…”

Section: Originalmentioning

confidence: 99%

Preoperative detection of sentinel lymph node in patients with endometrial cancer — comparison of planar lymphoscintigraphy, spect and SPECT/CT

Jankulovska

Rizova²,

Bozhinovska³

et al. 2022

Nucl. Med. Rev.

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Background: Sentinel lymph node (SLN) mapping allows minimal invasive assessment of lymph node status in patients with early-stage endometrial cancer (EC). Intraoperative detection of SLNs is based on the results obtained from preoperative nuclear medical images. The purpose of this study was to compare the data obtained from planar lymphoscintigraphy (PL), single-photon emission computed tomography (SPECT), and SPECT with computed tomography (SPECT/CT) for preoperative SLN detection in patients with EC. Material and methods: A total of 44 images in 22 patients with early-stage EC (22 PL, 9 SPECT and 13 SPECT/CT) were analyzed. The scans were performed in the period 2018-2020 at the Institute of Pathophysiology and Nuclear Medicine in Skopje. Thirteen patients underwent PL and SPECT/CT and nine patients underwent PL and SPECT after cervical injection of 4 mCi 99m Tc-SENTI-SCINT on the day of surgery. Descriptive statistics, Wilcoxon Matched Pairs Test, and Spearman rank R coefficient were used for data analyses.Results: Twenty-two patients with mean age of 61.1 ± 7.5 and body mass index (BMI) 34.62 ± 6.4 kg/m 2 were included in the study. In four patients (18.2%) SLN was not detected on PL. Detection rate on SPECT and SPECT/CT was 100%. The average number of detected SLN was 1.4 ± 1.05, 2.2 ± 1.1 и 2.15 ± 1.1 on PL, SPECT and SPECT/CT respectively. We found a statistically significant difference in the number of detected SLNs on PL vs. SPECT/CT (p = 0.0077). The most common SLN location on SPECT/CT was the right internal iliac followed by the left common iliac region. Conclusions:The results of the presented study indicate a higher diagnostic value of SPECT/CT in terms of SLN detection and exact anatomic localization as compared to planar lymphoscintigraphy (PL).

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“…Preoperative whole-body SPECT-CT provides a 3D imaging alternative to 2D lymphoscintigraphy in SLNB, with advantages that include more accurate anatomical localization and improved ability to visualize nodes near the injection site [4,5]. It has been effectively utilized in numerous applications of SLNB, including melanoma, breast cancer, and head and neck cancer [6].…”

Section: Sentinel Lymph Node Mappingmentioning

confidence: 99%

Evaluation of Camera-Based Freehand SPECT in Preoperative Sentinel Lymph Node Mapping for Melanoma Patients

Kogler

Polemi

Nair

et al. 2020

Preprint

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BackgroundAssessment of lymphatic status via sentinel lymph node (SLN) biopsy is an integral and crucial part of melanoma surgical oncology. The most common technique for sentinel node mapping is preoperative planar scintigraphy of an injected gamma-emitting lymphatic tracer followed by intraoperative node localization using a non-imaging gamma probe with auditory feedback. In recent years, intraoperative visualization of SLNs in 3-D has become possible by coupling the probe to an external system capable of tracking its location and orientation as it is read out, thereby enabling computation of the 3D distribution of the tracer (freehand SPECT). In this project, the non-imaging probe of the fhSPECT system was replaced by a unique handheld gamma camera containing an array of sodium iodide crystals optically coupled to an array of silicon photomultipliers (SiPMs). A feasibility study was performed in which preoperative SLN mapping was performed using camera fhSPECT and the number of detected nodes was compared to that visualized by lymphoscintigraphy, probe fhSPECT, and to the number ultimately excised under non-imaging probe guidance.ResultsAmong five subjects, SLNs were detected in nine lymphatic basins, with one to five SLNs detected per basin. A basin-by-basin comparison showed that the number of SLNs detected using camera fhSPECT exceeded that using lymphoscintigraphy and probe fhSPECT in seven of nine basins and five of five basins, respectively (probe fhSPECT scans were not performed for four basins). It exceeded the number excised under non-imaging probe guidance for seven of nine basins, and equaled the number excised for the other two basins. ConclusionsFreehand SPECT using a prototype SiPM-based gamma camera demonstrates high sensitivity for detection of SLNs in a preoperative setting. Camera fhSPECT is a potential means for efficiently obtaining real-time 3D activity distribution maps in applications such as image-guided percutaneous biopsy, and surgical SLN biopsy or radioguided tumor excision.

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SPECT/CT in imaging sentinel nodes

Cited by 5 publications

References 54 publications

Magnetic-Guided Axillary UltraSound (MagUS) Sentinel Lymph Node Biopsy and Mapping in Patients with Early Breast Cancer. A Phase 2, Single-Arm Prospective Clinical Trial

Magnetic-Guided Axillary UltraSound (MagUS) Sentinel Lymph Node Biopsy and Mapping in Patients with Early Breast Cancer. A Phase 2, Single-Arm Prospective Clinical Trial

Preoperative detection of sentinel lymph node in patients with endometrial cancer — comparison of planar lymphoscintigraphy, spect and SPECT/CT

Evaluation of Camera-Based Freehand SPECT in Preoperative Sentinel Lymph Node Mapping for Melanoma Patients

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