Nelson Kasey P, Choudhury Kingshuk Roy, Coleman R Edward, Shipes Steven W, Siler William L, Hubble William L, Wong Terence Z
Department of Nuclear Medicine, Duke University Medical Center, Durham, NC 27710, USA.
J Nucl Med Technol. 2013 Jun;41(2):92-8. doi: 10.2967/jnmt.112.117820. Epub 2013 Apr 29.
The purpose of this study was to determine whether certain factors in the preparation and use of (99m)Tc-sulfur colloid affected the number of sentinel lymph nodes (SLNs) detected during SLN mapping and during intraoperative SLN identification. The factors that were investigated included the use of a dry heat block versus a hot water bath to heat the (99m)Tc-sulfur colloid bulk vial, amount of (99m)TcOH4(-) added to form the sulfur colloid particles, time between the unit dose calibration and the injection of the dose, and breast quadrant in which the injection occurred.
Data were collected retrospectively and quantitatively analyzed from images and reports of 488 patients with breast cancer who had undergone SLN mapping and intraoperative SLN identification from January 1, 2008, to June 30, 2011, inclusive. The dependent variables assessed were the number of SLNs visualized during lymphoscintigraphy, number of radioactive SLNs removed during surgery, and total number of lymph nodes removed intraoperatively.
There was no significant difference in outcomes when comparing the amount of (99m)TcOH4(-) added during the preparation process to form the sulfur colloid particles, time between the unit dose calibration time and the time that the unit doses were injected, or location in the breast tissue in which the unit dose was administered. Initially, there were observed significant differences in outcomes when the heating methods used to prepare the (99m)Tc-sulfur colloid were compared. When the increased number of patients who were administered a calibrated unit dose activity of 74 MBq in the group using a dry heat block preparation method was taken into account, however, the findings were not significant.
The use of a dry heat block versus a hot water bath to heat the (99m)Tc-sulfur colloid bulk vial, amount of (99m)TcOH4(-) added to form sulfur colloid particles, time between the unit dose calibration and the injection of the dose, and breast quadrant in which the injection occurred do not affect the number of SLNs detected during SLN mapping and during intraoperative SLN identification.
本研究的目的是确定（99m）锝-硫胶体的制备和使用中的某些因素是否会影响前哨淋巴结（SLN）定位及术中SLN识别过程中检测到的前哨淋巴结数量。所研究的因素包括使用干热块与热水浴加热（99m）锝-硫胶体大瓶、添加用于形成硫胶体颗粒的（99m）TcOH4（-）的量、单位剂量校准与剂量注射之间的时间，以及注射发生所在的乳腺象限。
回顾性收集并定量分析了2008年1月1日至2011年6月30日（含）期间接受SLN定位及术中SLN识别的488例乳腺癌患者的图像和报告数据。评估的因变量为淋巴闪烁显像期间可视化的SLN数量、手术中切除的放射性SLN数量以及术中切除的淋巴结总数。
比较制备过程中添加用于形成硫胶体颗粒的（99m）TcOH4（-）的量、单位剂量校准时间与单位剂量注射时间之间的时间，或给予单位剂量的乳腺组织位置时，结果无显著差异。最初，比较用于制备（99m）锝-硫胶体的加热方法时观察到结果存在显著差异。然而，考虑到使用干热块制备方法的组中给予校准单位剂量活度为74 MBq的患者数量增加后，结果并不显著。
使用干热块与热水浴加热（99m）锝-硫胶体大瓶、添加用于形成硫胶体颗粒的（99m）TcOH4（-）的量、单位剂量校准与剂量注射之间的时间，以及注射发生所在的乳腺象限，均不会影响SLN定位及术中SLN识别过程中检测到的SLN数量。
