The Added Value of a Single-photon Emission Computed Tomography-Computed Tomography in Sentinel Lymph Node Mapping in Patients with Breast Cancer and Malignant Melanoma
Single-photon emission computed tomography-computed tomography (SPECT-CT) allows for physiological and anatomical co-registration in sentinel lymph node (SLN) mapping and offers additional benefits over conventional planar imaging. However, the clinical relevance when considering added costs and rad...
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2015-01-01
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| Series: | World Journal of Nuclear Medicine |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.4103/1450-1147.150543 |
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| author | George Bennie Mariza Vorster John Buscombe Mike Sathekge |
| author_facet | George Bennie Mariza Vorster John Buscombe Mike Sathekge |
| author_sort | George Bennie |
| collection | DOAJ |
| description | Single-photon emission computed tomography-computed tomography (SPECT-CT) allows for physiological and anatomical co-registration in sentinel lymph node (SLN) mapping and offers additional benefits over conventional planar imaging. However, the clinical relevance when considering added costs and radiation burden of these reported benefits remains somewhat uncertain. This study aimed to evaluate the possible added value of SPECT-CT and intra-operative gamma-probe use over planar imaging alone in the South African setting. 80 patients with breast cancer or malignant melanoma underwent both planar and SPECT-CT imaging for SLN mapping. We assessed and compared the number of nodes detected on each study, false positive and negative findings, changes in surgical approach and or patient management. In all cases where a sentinel node was identified, SPECT-CT was more accurate anatomically. There was a significant change in surgical approach in 30 cases - breast cancer (n = 13; P 0.001) and malignant melanoma (n = 17; P 0.0002). In 4 cases a node not identified on planar imaging was seen on SPECT-CT. In 16 cases additional echelon nodes were identified. False positives were excluded by SPECT-CT in 12 cases. The addition of SPECT-CT and use of intra-operative gamma-probe to planar imaging offers important benefits in patients who present with breast cancer and melanoma. These benefits include increased nodal detection, elimination of false positives and negatives and improved anatomical localization that ultimately aids and expedites surgical management. This has been demonstrated in the context of industrialized country previously and has now also been confirmed in the setting of a emerging-market nation. |
| format | Article |
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| institution | DOAJ |
| issn | 1450-1147 1607-3312 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
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| series | World Journal of Nuclear Medicine |
| spelling | doaj-art-8e00a96e3dd449fbb33f92f17fe865f02025-08-20T02:54:43ZengThieme Medical and Scientific Publishers Pvt. Ltd.World Journal of Nuclear Medicine1450-11471607-33122015-01-011401414610.4103/1450-1147.150543The Added Value of a Single-photon Emission Computed Tomography-Computed Tomography in Sentinel Lymph Node Mapping in Patients with Breast Cancer and Malignant MelanomaGeorge Bennie0Mariza Vorster1John Buscombe2Mike Sathekge3Department of Nuclear Medicine, University of Pretoria and Steve Biko Academic Hospital, Pretoria, South AfricaDepartment of Nuclear Medicine, University of Pretoria and Steve Biko Academic Hospital, Pretoria, South AfricaDepartment of Nuclear Medicine, University of Pretoria and Steve Biko Academic Hospital, Pretoria, South AfricaDepartment of Nuclear Medicine, University of Pretoria and Steve Biko Academic Hospital, Pretoria, South AfricaSingle-photon emission computed tomography-computed tomography (SPECT-CT) allows for physiological and anatomical co-registration in sentinel lymph node (SLN) mapping and offers additional benefits over conventional planar imaging. However, the clinical relevance when considering added costs and radiation burden of these reported benefits remains somewhat uncertain. This study aimed to evaluate the possible added value of SPECT-CT and intra-operative gamma-probe use over planar imaging alone in the South African setting. 80 patients with breast cancer or malignant melanoma underwent both planar and SPECT-CT imaging for SLN mapping. We assessed and compared the number of nodes detected on each study, false positive and negative findings, changes in surgical approach and or patient management. In all cases where a sentinel node was identified, SPECT-CT was more accurate anatomically. There was a significant change in surgical approach in 30 cases - breast cancer (n = 13; P 0.001) and malignant melanoma (n = 17; P 0.0002). In 4 cases a node not identified on planar imaging was seen on SPECT-CT. In 16 cases additional echelon nodes were identified. False positives were excluded by SPECT-CT in 12 cases. The addition of SPECT-CT and use of intra-operative gamma-probe to planar imaging offers important benefits in patients who present with breast cancer and melanoma. These benefits include increased nodal detection, elimination of false positives and negatives and improved anatomical localization that ultimately aids and expedites surgical management. This has been demonstrated in the context of industrialized country previously and has now also been confirmed in the setting of a emerging-market nation.http://www.thieme-connect.de/DOI/DOI?10.4103/1450-1147.150543breat cancermelanomasentinel lymph nodesingle-photon emission computed tomography-computed tomography |
| spellingShingle | George Bennie Mariza Vorster John Buscombe Mike Sathekge The Added Value of a Single-photon Emission Computed Tomography-Computed Tomography in Sentinel Lymph Node Mapping in Patients with Breast Cancer and Malignant Melanoma World Journal of Nuclear Medicine breat cancer melanoma sentinel lymph node single-photon emission computed tomography-computed tomography |
| title | The Added Value of a Single-photon Emission Computed Tomography-Computed Tomography in Sentinel Lymph Node Mapping in Patients with Breast Cancer and Malignant Melanoma |
| title_full | The Added Value of a Single-photon Emission Computed Tomography-Computed Tomography in Sentinel Lymph Node Mapping in Patients with Breast Cancer and Malignant Melanoma |
| title_fullStr | The Added Value of a Single-photon Emission Computed Tomography-Computed Tomography in Sentinel Lymph Node Mapping in Patients with Breast Cancer and Malignant Melanoma |
| title_full_unstemmed | The Added Value of a Single-photon Emission Computed Tomography-Computed Tomography in Sentinel Lymph Node Mapping in Patients with Breast Cancer and Malignant Melanoma |
| title_short | The Added Value of a Single-photon Emission Computed Tomography-Computed Tomography in Sentinel Lymph Node Mapping in Patients with Breast Cancer and Malignant Melanoma |
| title_sort | added value of a single photon emission computed tomography computed tomography in sentinel lymph node mapping in patients with breast cancer and malignant melanoma |
| topic | breat cancer melanoma sentinel lymph node single-photon emission computed tomography-computed tomography |
| url | http://www.thieme-connect.de/DOI/DOI?10.4103/1450-1147.150543 |
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