Department of Nuclear Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany,
Eur J Nucl Med Mol Imaging. 2013 Oct;40(11):1656-61. doi: 10.1007/s00259-013-2473-0. Epub 2013 Jun 11.
Sentinel lymph node biopsy (SLNB) is standard of care in early-stage breast cancer. Freehand SPECT (FhSPECT) is a system generating 3-D images for intraoperative visual detection of radioactivity in the body. The aim of our study was to evaluate the sensitivity of this technology for sentinel lymph node (SLN) detection and SLNB guidance.
In 40 patients, FhSPECT was additionally used after planar imaging and probe localization for SLNB. The number of SLNs detected was compared with the number detected by planar scintigraphy (reference method) and the conventional acoustic gamma probe (standard alternative). The sensitivity of FhSPECT was compared with that of the conventional gamma probe (McNemar's test).
FhSPECT mapped the SLNs in 92.3 % of the basins (36/39) intraoperatively in identical positions to those seen on planar scintigrams. The conventional gamma probe correctly detected the SLNs in 35 of 39 basins (89.7 %). After SLNB, remaining radioactivity was detected by FhSPECT in nine patients, resulting in additional resection of SLNs in four patients.
FhSPECT is a highly sensitive modality for intraoperative detection of SLNs, resulting in the identification of a higher number of SLNs than conventional gamma probe detection.
前哨淋巴结活检（SLNB）是早期乳腺癌的标准治疗方法。徒手 SPECT（FhSPECT）是一种生成用于术中检测体内放射性的 3D 图像的系统。本研究的目的是评估该技术在 SLN 检测和 SLNB 引导中的敏感性。
在 40 例患者中，在平面成像和探针定位后，额外使用 FhSPECT 进行 SLNB。比较 FhSPECT 检测到的 SLN 数量与平面闪烁扫描（参考方法）和传统声学伽马探针（标准替代方法）检测到的 SLN 数量。FhSPECT 的敏感性与传统伽马探针的敏感性进行比较（McNemar 检验）。
FhSPECT 在术中以与平面闪烁扫描相同的位置定位了 92.3%（36/39）的区域中的 SLN。传统的伽马探针在 39 个区域中的 35 个区域中正确地检测到了 SLN（89.7%）。在 SLNB 后，FhSPECT 在 9 例患者中检测到残留的放射性，导致 4 例患者额外切除了 SLN。
FhSPECT 是一种用于术中检测 SLN 的高灵敏度方法，可识别比传统伽马探针检测更多的 SLN。
