Document Detail

Localization of sentinel nodes in breast cancer: novel method and device to help pen marking of active nodes during gamma camera imaging.
MedLine Citation:
PMID:  15798326     Owner:  NLM     Status:  MEDLINE    
Gamma camera imaging with Tc-99m marking is a widely used method to locate sentinel lymph nodes (SNs) in breast cancer patients. Prior to SN biopsy, the anterior and lateral location of the SN is marked on the patient's skin using an ink pen. The pen marks guide the surgeon during an operation. However, in many cases the marking is difficult due to limited space under the detectors of a gamma camera. The aim of this study was to improve the pen marking method. Eleven female patients were imaged 3-4 h after injection of Tc-99m labelled Nanocol. Injection was performed to parenchyma surrounding the breast tumour. To facilitate pen marking, two polycarbonate (PC) plates with 40 x 32 holes (spacing=10 mm) were engineered for anterior and lateral side imaging and then installed on the bed of a dual-head gamma camera. Two drops of Tc-99m were placed into the top corners of both the PC plates, in order to trace the corresponding x-y coordinates first from the acquired images and then from the plates. After imaging, the x-y coordinates of the SN(s) were determined from the anterior and lateral side images. Subsequently, the location of each SN was marked with an ink pen on the skin through the small holes in the PC plates. According to the surgeon's evaluation, the distance between the marks and the true location of the SNs was 4.5+/-6.9 mm. Measurements with a custom made phantom revealed that the accuracy of the novel method was significantly (P=0.06) higher as compared with the traditional method (2.7+/-3.0 mm versus 9.2+/-3.0 mm). In addition, we were not able to mark the weakest activity (0.02 MBq) with the traditional method. Taken together, the marking process was considerably easier with the novel method, it had better accuracy and sensitivity than the traditional method and the device is simple enough to be adapted for most gamma cameras.
Mikko S Laasanen; Jari O Heikkinen; Simo Saarakkala; Hannu Paajanen
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2005-03-16
Journal Detail:
Title:  Physics in medicine and biology     Volume:  50     ISSN:  0031-9155     ISO Abbreviation:  Phys Med Biol     Publication Date:  2005 Apr 
Date Detail:
Created Date:  2005-03-30     Completed Date:  2005-08-01     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0401220     Medline TA:  Phys Med Biol     Country:  England    
Other Details:
Languages:  eng     Pagination:  N49-54     Citation Subset:  IM    
Department of Nuclear Medicine, Mikkeli Central Hospital, POB 87, FIN-50100 Mikkeli, Finland.
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MeSH Terms
Breast Neoplasms / pathology,  radionuclide imaging*,  surgery
Equipment Design
Equipment Failure Analysis
Image Enhancement / instrumentation*,  methods
Lymph Nodes / pathology*,  radionuclide imaging*,  surgery
Lymphatic Metastasis
Middle Aged
Preoperative Care / instrumentation*,  methods
Radionuclide Imaging / instrumentation*,  methods
Reproducibility of Results
Sensitivity and Specificity
Sentinel Lymph Node Biopsy / instrumentation*,  methods
Subtraction Technique / instrumentation

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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