| Improved sentinel node identification by SPECT/CT in overweight patients with breast cancer. | |
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MedLine Citation:
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PMID: 17268015 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Overweight has been reported as a cause for the nonvisualization of sentinel nodes (SNs) on preoperative planar lymphoscintigraphy in patients with breast cancer. The purpose of this study was to assess whether SPECT/CT may improve SN identification in overweight patients. METHODS: Lymphoscintigraphy was performed in 220 consecutive patients with breast cancer. Body mass index (BMI) was calculated for each. A total of 122 patients were overweight or obese (BMI, > or = 25). Planar images and SPECT/CT images were interpreted separately, and SN identification on each of the modalities was related to BMI and to findings at surgery. RESULTS: Planar imaging identified SNs in 171 patients (78%) with a BMI (mean +/- SD) of 25.2 +/- 4 kg/m2 and failed to do so in 49 patients (22%) with a BMI of 28 +/- 8 kg/m2. In 29 of the latter patients (59%), SNs were identified on SPECT/CT. SPECT/CT detected "hot" nodes in 200 patients (91%) and failed to do so in 20 patients with a BMI of 29.2 +/- 6.6 kg/m2. For the 122 overweight or obese patients, planar assessment failed to identify SNs in 34 patients (28%) and SPECT/CT failed to do so in 13 patients (11%) (P < 0.001). For 116 patients, surgery took place in our hospital (Tel-Aviv Sourasky Medical Center). An intraoperative blue dye technique failed to detect SNs in 48 patients (41%) with a BMI of 28.2 +/- 7 kg/m2. SPECT/CT localized hot nodes in 36 (75%) of the latter patients, and planar imaging did so in 22 (46%) of those patients. Of 19 patients for whom scintigraphy failed, 6 (32%) had nodal metastatic involvement. CONCLUSION: The addition of SPECT/CT to lymphoscintigraphy improved SN identification in overweight patients with breast cancer. Moreover, SPECT/CT accurately identified SNs in 75% of patients for whom the identification of SNs by the intraoperative blue dye technique failed. |
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Authors:
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Hedva Lerman; Gennady Lievshitz; Osnat Zak; Ur Metser; Shlomo Schneebaum; Einat Even-Sapir |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of nuclear medicine : official publication, Society of Nuclear Medicine Volume: 48 ISSN: 0161-5505 ISO Abbreviation: J. Nucl. Med. Publication Date: 2007 Feb |
Date Detail:
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Created Date: 2007-02-01 Completed Date: 2007-04-06 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0217410 Medline TA: J Nucl Med Country: United States |
Other Details:
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Languages: eng Pagination: 201-6 Citation Subset: IM |
Affiliation:
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Department of Nuclear Medicine, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel. hedval@tasmc.health.gov.il |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Body Mass Index Breast Neoplasms / pathology*, radiography, radionuclide imaging Female Humans Image Processing, Computer-Assisted Lymph Nodes / pathology, radiography, radionuclide imaging Middle Aged Sentinel Lymph Node Biopsy / methods* Tomography, Emission-Computed, Single-Photon Tomography, X-Ray Computed |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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