role of SPECT/CT in detection and localization of sentinel lymph node in breast cancer

Objectives: The purpose of this study was to compare SPECT/CT and planar lymphoscintigraphy in detecting hot nodes

Methods: In this retrospective study, planar and SPECT/CT lymphoscintigraphy were performed in 119 consecutive women with invasive breast cancer. Both images were assessed for the number of lymph nodes and their anatomical site. Hot nodes were categorized based on the classification used by surgeons as level I, II, III nodes. In addition, pathology reports were retrieved which provided additional information concerning the characteristics of the lesions missed or detected by either or both imaging modalities

Results: SPECT/CT detected hot nodes in 81 [68%] patients, while planar lymphoscintigraphy detected hot nodes in 70 [58.8%] patients. SPECT/ CT and planar imaging had 38 [32%] patients in common where they did not detect any hot nodes. According to histopathology, 15 [12.6%] out of 36 patients with negative lymphoscintigraphic sentinel node identification on both modalities had nodal metastasis. The higher lymph node detection rate by SPECT/CT was significant [p = 0.019]

Conclusion: When compared to planar lymphoscintigraphy, SPECT/CT refines preoperative lymph node detection and thus [N] staging. As such, we recommend that SPECT/CT ought to be performed in a particular set of patients, for it improves localization of the draining nodes, detects nodes missed on planar, and excludes false positives in cases of lymphatic/blood vessel radiotracer accumulation

[Role of 18F-FDG PET/CT in the staging of non small cell lung Cancer [NSCLC] : Lebanese experience regarding 72 cases]

Staging of non-small cell lung cancer [NSCLC] plays a key role in the therapeutic choice and directly affects the prognosis. The role of PET/CT [positron emission tomography] using 18-Fluorodeoxyglucose [FDG] for the staging of NSCLC was studied in the Lebanese population. We compared the results of PET/CT with those of the conventional CT scan in T and N staging for 72 patients; we correlated PET/CT outcome with tumor grade and deter- mined the impact of the difference between staging NSCLC using PET/CT and CT on the therapeutic options. A positive correlation between the results of PET/CT and CT scan was found in 85% of cases. PET/CT has correctly classified pleural effusion as benign in three cases and as malignant in one case and increased the N stage by one point in three cases compared to injected CT scan. PET/CT improves the accuracy of staging of NSCLC allowing a good delineation of the primary tumor, a better evaluation of locoregional lymph node involvement and metastases and identification of the nature of pleural effusion