99mTc-Tetrofosmin Pinhole-SPECT (P-SPECT) and Radioguided Sentinel Node (SN) Biopsy and in Breast Cancer Axillary Lymph Node Staging
| Autor: | Antonio Falchi, P Cottu, M.E. Solinas, Angela Spanu, Giuseppe Madeddu, Alberto Porcu, Francesca Chessa, Susanna Nuvoli, P. Solinas, Antonio Mario Scanu, G Dettori |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
Adult
Male Cancer Research Sentinel lymph node Breast Neoplasms Organophosphorus Compounds Breast cancer Biopsy Humans Medicine Radiology Nuclear Medicine and imaging Prospective Studies Stage (cooking) Lymph node Aged Neoplasm Staging Tomography Emission-Computed Single-Photon Pharmacology medicine.diagnostic_test Sentinel Lymph Node Biopsy business.industry Biopsy Needle Carcinoma Ductal Breast Organotechnetium Compounds General Medicine Middle Aged Sentinel node medicine.disease Carcinoma Lobular Axilla medicine.anatomical_structure Oncology Carcinoma Medullary Lymphatic Metastasis Lymph Node Excision Female Lymph Nodes Radiopharmaceuticals business Nuclear medicine Gamma probe |
| Zdroj: | Cancer Biotherapy and Radiopharmaceuticals. 16:501-513 |
| ISSN: | 1557-8852 1084-9785 |
| Popis: | We compared 99mTc-Tetrofosmin P-SPECT with radioguided SN biopsy in 101 T1/T2 BC pts to predict axillary lymph node status. The day before surgery all pts underwent lymphoscintigraphy (LS) to mark the SN, following subdermal injection of 99mTc-colloidal sulphur surrounding the breast lesion. LS was combined with pre and intraoperative gamma probe. Previously, all pts had also undergone P-SPECT. ALND was performed in all cases. The SN(s) was detected in 97/101 cases (96%) by LS and gamma probe; in the 4 missed cases P-SPECT predicted lymph node status. In the 97 comparable cases, radioguided SN biopsy showed a slightly higher accuracy than P-SPECT (94.8% vs 93.8%), but a higher false-negative rate (14.3% vs 8.6%); P-SPECT had a higher NPV (95.2% vs 92.5%). The two procedures when combined achieved 100% accuracy. Radioguided SN biopsy alone had 100% accuracy only in pts with BC15 mm. P-SPECT had 3 false negative cases, 2 of which were micrometastatic SNs, and 3 false positives. P-SPECT identified 81.2% of cases with a single node, determined the exact number of nodes in 82.6% of cases with 1 to 3 node and correctly classified 93.7% of pts as havingor = 3 or3 metastatic nodes. Radioguided SN biopsy seems indicated in selected, early stage, small BC pts, while P-SPECT shows a high sensitivity independent of primary tumor size, giving additional important preoperative prognostic information. The two procedures combined provided a better axillary lymph node status prediction in T1/T2 carcinomas, and could thus improve ALND pt selection. |
| Databáze: | OpenAIRE |
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