KMID : 0861420100140020133
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Korean Journal of Nuclear Medicine Technology 2010 Volume.14 No. 2 p.133 ~ p.137
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Usefulness of Breast Lymphoscintigraphy after Whole Body Bone Scan
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Jang Dong-Gun
Bahn Young-Kag Chung Seok Park Hun-hee Kang Chun-Koo Lim Han-Sang Kim Jae-Sam Lee Chang-Ho
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Abstract
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Purpose: Breast cancer is known to be more vulnerable to bone metastasis and lymph node metastasis than other types of cancer, and nuclear examinations whole body bone scan and lymphoscintigraphy are performed commonly before and after breast cancer operation. In case whole body bone scan is performed on the day before lymphoscintigraphy, the radiopharmaceutical taken into and remaining in the bones provides anatomical information for tracking and locating sentinel lymph nodes. Thus, this study purposed to examine how much bone density affects in locating sentinel lymph nodes.
Materials and Methods: The subjects of this study were 22 patients (average age 52¡¾7.2) who had whole body bone scan and lymphoscintigraphy over two days in our hospital during the period from January to December, 2009. In the blind test, 22 patients (average age 57¡¾6.5) who had lymphoscintigraphy using 57Co flood phantom were used as a control group. In quantitative analysis, the relative ratio of the background to sentinel lymph nodes was measured by drawing ROIs on sentinel lymph nodes and the background, and in gross examination, each of a nuclear physician and a radiological technologist with five years¡¯ or longer field experience examined images through blind test in a five-point scale.
Results: In the results of quantitative analysis, the relative ratio of the background to sentinel lymph nodes was 14.2:1
maximum and 8.5:1 (SD¡¾3.48) on the average on the front, and 14.7:1 maximum and 8.5:1 (SD¡¾3.42) on the average on the side. In the results of gross examination, when 57Co flood phantom images were compared with images containing bones, the score was relative high as 3.86 (SD¡¾0.35) point for 57Co flood phantom images and 4.09 (SD¡¾0.42) for bone images.
Conclusion: When whole body bone scan was performed on the day before lymphoscintigraphy, the ratio of the background to sentinel lymph nodes was over 10:1, so there was no problem in locating lymph nodes. In addition, we expect to reduce examination procedures and improve the quality of images by indicating the location of sentinel lymph nodes using bone images as body contour without the use of a source.
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KEYWORD
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Whole Body Bone Scan (WBBS) , Sentinel lymph node (SLN) , Lymphoscintigraphy
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