Department of Graduate, Shandong First Medical University, Shandong Academy of Medical Sciences, Jinan, Shandong, China.
Department of Nuclear Medicine, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences, Jinan, Shandong, China.
Breast J. 2022 Mar 28;2022:6483318. doi: 10.1155/2022/6483318. eCollection 2022.
We retrospectively enrolled breast cancer patients who underwent SPECT/CT prior to sentinel lymph node biopsy. Quantification of radiotracer uptake from SPECT/CT data was performed. A radioactivity count threshold ( ) using SPECT/CT was calculated for detecting metastatic sentinel lymph nodes. To localize sentinel lymph nodes exactly, we compared the positions of sentinel lymph nodes localized using SPECT/CT with positions localized surgically using an intraoperative -probe.
491 patients were included, with a median of 3 sentinel lymph nodes/patient detected by the -probe and 2 sentinel lymph nodes/patient detected by SPECT/CT. As the number of sentinel lymph nodes visualized on SPECT/CT images, the metastasis incidence of lymph nodes in the ≤2 SLNs group was significantly higher than that in the >2 SLNs group (35% vs. 15%, < 0.001). No metastasis was found in lymph nodes with ≤ 30% in the >2 SLNs group, and thus, 30% (157/526) of SPECT/CT-identified nodes would avoid unnecessary removal. The positions of sentinel lymph nodes localized by SPECT/CT and -probe were identical in 42% (39/93) of patients.
Quantitative Tc-99 m SC SPECT/CT imaging has the potential to preoperatively locate sentinel lymph nodes and intraoperatively avoid unnecessary sentinel lymph node biopsy.
我们回顾性纳入了在进行前哨淋巴结活检前进行 SPECT/CT 的乳腺癌患者。从 SPECT/CT 数据中进行示踪剂摄取的定量分析。计算使用 SPECT/CT 检测转移性前哨淋巴结的放射性计数阈值（）。为了准确定位前哨淋巴结，我们比较了使用 SPECT/CT 定位的前哨淋巴结与术中使用 -probe 定位的前哨淋巴结的位置。
共纳入 491 例患者， -probe 检测到的中位前哨淋巴结数为 3 个/例，SPECT/CT 检测到的中位前哨淋巴结数为 2 个/例。随着 SPECT/CT 图像上可见的前哨淋巴结数量增加，≤2 个 SLNs 组的淋巴结转移发生率明显高于>2 个 SLNs 组（35%比 15%， < 0.001）。>2 个 SLNs 组中， ≤ 30%的淋巴结未发现转移，因此，SPECT/CT 识别的 30%（157/526）个节点可避免不必要的切除。SPECT/CT 和 -probe 定位的前哨淋巴结位置在 42%（39/93）的患者中完全相同。
Tc-99 m SC SPECT/CT 定量成像有可能在术前定位前哨淋巴结，并在术中避免不必要的前哨淋巴结活检。
