Aim: Assess the role of hybrid modality SPECT/CT versus planar scintigraphy in sentinel lymph node (SLN) identification in patients with breast cancer. Methods: Planar scintigraphy and hybrid modality SPECT/CT were pe...Aim: Assess the role of hybrid modality SPECT/CT versus planar scintigraphy in sentinel lymph node (SLN) identification in patients with breast cancer. Methods: Planar scintigraphy and hybrid modality SPECT/CT were performed in 23 women with breast cancer (mean age 59.5 years with range 25 - 82 years) with invasive breast cancer (T0, T1 and T2), without clinical evidence of axillary lymph node metastases (N0) and no remote metastases (M0), radiocolloid was injected in four subareolar sites. Planar and SPECT/CT images were separately interpreted. Results: SLNs were detected on lymphoscintigraphy in all patients (100%), taking into consideration both techniques (planar and SPECT-CT images). Planar images identified 45 SLNs in 23 women, with a mean of 1.95 per patient, whereas 56 SLNs were detected on SPECT/CT, increasing this mean to 2.43 per patient. Drainage to internal mammary lymph nodes was seen in 4 patients (17.39%). However, two foci of uptake were identified on planar image as hot SLN in two patients (8.69%);while they have been found as a false positive non-nodal site of uptake on SPECT/CT. Conclusion: SPECT/CT is more focused than planar scintigraphy in the detection of SLN in patients with breast cancer. It detects some lymph nodes not visible on planar images, excludes false positive uptake and exactly locates axillary and non-axillary SLNs.展开更多
文摘Aim: Assess the role of hybrid modality SPECT/CT versus planar scintigraphy in sentinel lymph node (SLN) identification in patients with breast cancer. Methods: Planar scintigraphy and hybrid modality SPECT/CT were performed in 23 women with breast cancer (mean age 59.5 years with range 25 - 82 years) with invasive breast cancer (T0, T1 and T2), without clinical evidence of axillary lymph node metastases (N0) and no remote metastases (M0), radiocolloid was injected in four subareolar sites. Planar and SPECT/CT images were separately interpreted. Results: SLNs were detected on lymphoscintigraphy in all patients (100%), taking into consideration both techniques (planar and SPECT-CT images). Planar images identified 45 SLNs in 23 women, with a mean of 1.95 per patient, whereas 56 SLNs were detected on SPECT/CT, increasing this mean to 2.43 per patient. Drainage to internal mammary lymph nodes was seen in 4 patients (17.39%). However, two foci of uptake were identified on planar image as hot SLN in two patients (8.69%);while they have been found as a false positive non-nodal site of uptake on SPECT/CT. Conclusion: SPECT/CT is more focused than planar scintigraphy in the detection of SLN in patients with breast cancer. It detects some lymph nodes not visible on planar images, excludes false positive uptake and exactly locates axillary and non-axillary SLNs.
文摘目的探讨^(99m)Tc-3PRGD2 SPECT/CT显像半定量参数对可疑乳腺病变的诊断价值,并根据乳腺癌分子分型进行分类比较,分析其与临床病理的相关性。方法收集2020年12月~2022年8月于我院接受检查的70例可疑乳腺病变患者病例资料。根据病理结果,分析乳腺癌Luminal阳性型、Her-2阳性型和三阴性型3种分子亚型与T/N值的相关性;分析雌激素受体、孕激素受体、Her-2及Ki67表达情况与影像学检查指标的关系。结果70例患者病理检查结果证实乳腺癌51例(72.86%),病理分型为Luminal阳性型22例,Her-2阳性型20例,三阴性型9例。乳腺良性病变24例(27.14%)。乳腺癌患者病变侧T/N值高于良性病变患者(3.96±0.82 vs 1.16±0.32),差异有统计学意义(t=14.426,P<0.05)。诊断特异性为84.21%(16/19),敏感度为82.35%(42/51),准确率为82.86%(58/70),ROC曲线下面积为0.834(0.755~0.913),诊断临界值为1.56,即T/N值≥1.56时判定为恶性病变。Her-2阳性型的T/N值高于三阴性型(P<0.05)。Her-2表达阳性患者的T/N值高于Her-2表达阴性的患者(P<0.05)。雌激素受体、孕激素受体和Ki67表达阳性和表达阴性患者的T/N值相比,差异均无统计学意义(P>0.05)。结论^(99m)Tc-3PRGD2 SPECT/CT显像半定量指标在诊断乳腺病变良恶性方面有较高的敏感度,并且Her-2阳性型患者T/N值明显升高,有助于早期发现和诊断乳腺病变,为预测乳腺癌分子分型和治疗有相应的指导作用。
