PURPOSE: Planar lymphoscintigraphy is routinely used for preoperative sentinel node visualization, but large gamma cameras are not always available. We evaluated the reproducibility of lymphatic mapping with a smaller and portable gamma camera. METHODS: In two centres, 52 patients with breast cancer received preoperative lymphoscintigraphy with a conventional gamma camera with a field of view of 40 × 40 cm. Static anterior and lateral images were performed at 15 min, 2 h and 4 h after injection of the radiotracer ((99m)Tc-nanocolloid). At 2 h after injection, anterior and oblique images were also performed with a portable gamma camera (Sentinella, Oncovision) positioned to obtain a field of view of 20 × 20 cm. Visualization of lymphatic drainage on conventional images and images with the portable device were compared for number of nodes depicted, their intensity and localization of sentinel nodes. RESULTS: The images performed with the conventional gamma camera depicted sentinel nodes in 94%, while the portable gamma camera showed drainage in 73%. There was however no significant difference in visualization between the two devices when a lead shield was used to mask the injection area in 43 patients (95 vs 88%, p = 0.25). Second-echelon nodes were visualized in 62% of the patients with the conventional gamma camera and in 29% of the cases with the portable gamma camera. CONCLUSION: Preoperative imaging with a portable gamma camera fitted with a pinhole collimator to obtain a field of view of 20 × 20 cm is able to depict sentinel nodes in 88% of the cases, if a lead shield is used to mask the injection site. This device may be useful in centres without the possibility to perform a preoperative image.
PURPOSE: Planar lymphoscintigraphy is routinely used for preoperative sentinel node visualization, but large gamma cameras are not always available. We evaluated the reproducibility of lymphatic mapping with a smaller and portable gamma camera. METHODS: In two centres, 52 patients with breast cancer received preoperative lymphoscintigraphy with a conventional gamma camera with a field of view of 40 × 40 cm. Static anterior and lateral images were performed at 15 min, 2 h and 4 h after injection of the radiotracer ((99m)Tc-nanocolloid). At 2 h after injection, anterior and oblique images were also performed with a portable gamma camera (Sentinella, Oncovision) positioned to obtain a field of view of 20 × 20 cm. Visualization of lymphatic drainage on conventional images and images with the portable device were compared for number of nodes depicted, their intensity and localization of sentinel nodes. RESULTS: The images performed with the conventional gamma camera depicted sentinel nodes in 94%, while the portable gamma camera showed drainage in 73%. There was however no significant difference in visualization between the two devices when a lead shield was used to mask the injection area in 43 patients (95 vs 88%, p = 0.25). Second-echelon nodes were visualized in 62% of the patients with the conventional gamma camera and in 29% of the cases with the portable gamma camera. CONCLUSION: Preoperative imaging with a portable gamma camera fitted with a pinhole collimator to obtain a field of view of 20 × 20 cm is able to depict sentinel nodes in 88% of the cases, if a lead shield is used to mask the injection site. This device may be useful in centres without the possibility to perform a preoperative image.
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