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KMID : 1143620150190020074
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Korean Journal of Nuclear Medicine Technology
2015 Volume.19 No. 2 p.74 ~ p.80
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The comparison of lesion localization methods in breast lymphoscintigraphy
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Yeon Joon-Ho
Hong Gun-Chul
Kim Soo-Young
Choi Sung-Ook
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Abstract
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Purpose : Breast lymphoscintigraphy is an important technique to present for body surface precisely, which shows a lymph node metastasis of malignant tumors at an early stage and is performed before and after surgery in patients with breast cancer. In this study, we evaluated several methods of body outline imaging to present exact location of lesions, as well as compared respective exposure doses.
Materials and Methods : RANDO phantom and SYMBIA T-16 were used for obtaining imaging. A lesion and an injection site were created by inserting a point source of 0.11 M㏃ on the axillary sentinel lymph node and 37 M㏃ on the right breast, respectively. The first method for acquiring the image was used by drawing the body surface of phantom for 30 sec using Na99mTcO4 as a point source. The second, the image was acquired with 57Co flood source for 30 seconds on the rear side and the left side of the phantom, the image as the third method was obtained using a syringe filled with 37 M㏃ of Na99mTcO4 in 10 ㎖ of saline, and as the fourth, we used a photon energy and scatter energy of 99mTc emitting from phantom without any addition radiation exposure. Finally, the image was fused the scout image and the basal image of SPECT/CT using MATLAB® program. Anterior and lateral images were acquired for 3 min, and radiation exposure was measured by the personal exposure dosimeter. We conducted preference of 10 images from nuclear medicine doctors by the survey.
Results : TBR values of anterior and right image in the first to fifth method were 334.9 and 117.2 (1st), 266.1 and 124.4 (2nd), 117.4 and 99.6 (3rd), 3.2 and 7.6 (4th), and 565.6 and 141.8 (5th). And also exposure doses of these method were 2, 2, 2, 0, and 30 μ㏜, respectively. Among five methods, the fifth method showed the highest TBR value as well as exposure dose, where as the fourth method showed the lowest TBR value and exposure dose. As a result, the last method (5th)is the best method and the fourth method is the worst method in this study.
Conclusion : Scout method of SPECT/CT can be useful that provides the best values of TBR and the best score of survey
result. Even though personal exposure dose when patients take scout of SPECT/CT was higher than another scan, it was slight level comparison to 1 m㏜ as the dose limit to non-radiation workers. If the scout is possible to less than 80 kV, exposure dose can be reduced, and also useful lesion localization provided.
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KEYWORD
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Breast lymphoscintigraphy, scout scan, TBR(Tumor to Background Ratio), exposure dose
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