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便携式γ相机在乳腺癌手术中检测前哨淋巴结的作用。

Contribution of the portable gamma camera to detect the sentinel node in breast cancer during surgery.

作者信息

Cardona-Arboniés J, Mucientes-Rasilla J, Moreno Elola-Olaso A, Salazar-Andía G, Prieto-Soriano A, Chicharo de Freitas J, Román-Santamaría J M, Carreras-Delgado J L

机构信息

Departamento de Medicina Nuclear, Hospital Clínico San Carlos de Madrid, Madrid, Spain.

出版信息

Rev Esp Med Nucl Imagen Mol. 2012 May-Jun;31(3):130-4. doi: 10.1016/j.remn.2011.05.007. Epub 2011 Jul 26.

Abstract

AIM

To show our experience using the portable gamma camera during surgery in the detection of the sentinel node in breast cancer.

MATERIAL AND METHODS

A total of 46 women diagnosed with breast cancer were included. This study was carried out by means of the periareolar intradermal injection. Planar images and SPECT/CT were acquired. On the following day, the sentinel nodes were localized intraoperatively with a portable gamma camera and a gamma probe. Images of the anterior axillary line projection and lateral axillary line projection were acquired before and after extraction of all the sentinel nodes.

RESULTS

The images acquired with the portable gamma-camera during the operation showed no activity in all of the patients after the removal of the sentinel nodes. In four out of the 46 cases, the portable gamma camera provided relevant information during the procedure (it detected a sentinel node in two cases in which it had not been detected prior to the surgery and it oriented the surgeon in the localization of low activity nodes when the probe screening had been negative).

CONCLUSIONS

The use of the intraoperative portable gamma camera to detect the sentinel node in breast cancer patients is useful in order to ensure, independently of the surgeon, that all the sentinel nodes have been removed. It can also help guide the surgeon in the event of a single low activity sentinel node.

摘要

目的

展示我们在乳腺癌手术中使用便携式γ相机检测前哨淋巴结的经验。

材料与方法

共纳入46例确诊为乳腺癌的女性患者。本研究通过乳晕周围皮内注射进行。采集平面图像和SPECT/CT图像。次日,术中使用便携式γ相机和γ探头定位前哨淋巴结。在所有前哨淋巴结切除前后,采集腋窝前线投影和腋窝侧线投影的图像。

结果

术中使用便携式γ相机采集的图像显示,所有患者在切除前哨淋巴结后均无活性。在46例病例中的4例中,便携式γ相机在手术过程中提供了相关信息(在2例术前未检测到前哨淋巴结的病例中检测到了前哨淋巴结,并且在探头筛查为阴性时,它为外科医生定位低活性淋巴结提供了指导)。

结论

术中使用便携式γ相机检测乳腺癌患者的前哨淋巴结有助于确保(独立于外科医生)所有前哨淋巴结均已被切除。在出现单个低活性前哨淋巴结的情况下,它也可以帮助指导外科医生。

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