[Usefulness of imaging posture using anterior view of the half supine position for sentinel lymphscintigraphy in patients with breast cancer].

OBJECTIVES: Sentinel lymphoscintigraphy(SLSG) is focused on the visualization of an injection site and lymph nodes. Therefore, an anterior view is effective in identifying the location of a lymph node easily. For this reason, we devised a new imaging method of anterior view (Modified Anterior View; MAV), and the usefulness was assessed. METHODS: SLSG was obtained in 166 patients with breast cancer. In MAV imaging, patients were laid in an oblique position on a triangular styrene foam elevating the target axillary side. The detector was also leaned. Just after the MAV were imaged, the patient was shifted to the supine position and the SAV imaging was also performed using the same acquisition times. RESULTS: The detectability of MAV and SAV was 92.42% and 81.99%, respectively. However, the detectability of SAV showed the better value for the few cases which the lymph node detected by the inside of injection site. CONCLUSION: MAV may improve detectability of SLN. However, SAV is still required for a few cases in which lymph node is detected by the inside of injection site.

[Usefulness of imaging posture using modified oblique view of the axilla (MOVA) for sentinel lymph node scintigraphy in patients with breast cancer].

Identification of the sentinel lymph nodes in patients with breast cancer is often hampered by high radioactivity from the injection site, since the distance between the injection site and regional lymph nodes is quite short in these patients. We investigated the usefulness of the modified oblique view of the axilla (MOVA) method introduced by Haigh et al., aiming at better discrimination of the target and higher resolution. Compared with the standard anterior view (SAV) of the supine position and conventional oblique view (COV) imaging, MOVA was able to obtain a longer distance between the injection site and axillary lymph nodes in 20 of 21 lymph nodes. MOVA provided more effective information for visual evaluation of the geometry of axillary lymph nodes in half the cases, and one lymph node was detected only with MOVA. In contrast, SAV provided better imaging in one patient. Although our results support the usefulness of MOVA, the combined application of MOVA and SAV is desirable, since sentinel lymph node detection with the gamma-probe is performed in the supine position during surgery.