[The use of SPECT-CT for visualization of sentinel lymph nodes and lymph drainage pathways in prostate cancer patients].

There was studied the use of SPECT-CT for visualization of sentinel lymph nodes and lymph drainage pathways in 35 patients with localized prostate cancer (cT1-T2 N0 M0). Sentinel lymph nodes were imaged in 31 (89%) patients. There were advantageously detected drainage pathways to exterior (77%) and internal iliac (58%) lymph nodes. Visceral (29%) lymph nodes (paraprostatic, paravesical and mesorectal) were less determined. There was established high informative value of SPECT-CT for imaging sentinel lymph nodes, determining their location as well as identification of lymph drainage pathways in patients with prostate cancer.

[Use of SPECT-CT for visualization of sentinel lymph nodes in breast cancer patients].

This study was performed in order to determine individual variability of axillary sentinel lymph nodes (SLN) localization in patient with breast cancer (BC). Individual topography of axillary SLN was determined in 182 patients with early BC. All women were candidates for conservative surgical treatment with postoperative radiotherapy. SPECT-CT visualization of SLN started 120-240 min after intratumoral injection of 74-150MBq of 99mTc-radiocolloids. Distribution of axillary SLN was allocated to following subregions: central (C), pectoral (P), apical (AP), lateral (L), subscapular (SSc). SLN visualization by SPECT-CT was successful in 153 cases (84%). AP nodes were detected in 7 patients (5%). SLN were localized on thoracic wall in 34 cases (22%), in the intrapectoral region--in 3 (2%) women. According to axillary levels they were detected on level I--in 149 (97%), level II--15 (10%), level III-- (7.5%) cases.

[SPECT-CT in the diagnosis of metastatic skeletal lesion].

The aim of this study was to compare the diagnostic capabilities of SPECT-CT and planar osteoscintigraphy with 99m-Tc-labeled phosphates in cancer patients. There were examined 227 patients with various primary malignancies (mean age 57 years). Depending on the identified changes in the planar study patients were divided into four groups: I--no abnormalities (n = 62), II--benign changes (n = 67), III--suspected metastatic lesion (n = 41), IV--metastatic lesion (n = 57). The use of SPECT-CT in group I revealed metastatic lesion in 7 (11%) patients, in 15 (24%) patients there were additionally found benign focal changes in the skeleton. In group II metastases were found in 4 (6%) patients; it was not possible to exclude secondary lesion in 3 (4%) patients. In group III suspected metastatic lesion was excluded in 29 (71%) and confirmed in 7 (17%) patients. In group IV in 14 (25%) patients there were found non-tumor changes, the nature of the changes has not been found in 2 (4%) patients. As a result, SPECT-CT with 99m-Tc-labeled phosphates is more informative method of diagnosis of metastatic skeletal lesion than planar osteoscintigraphy. SPECT-CT application resulted in changes of conclusions of the planar scintigraphy about the nature of bone pathology in 67 (30%) cancer patients. However, in 4% the recognition of the nature of changes in the skeleton has failed.

[The use of SPECT-CT with 99mTc-labeled phosphates in patients with suspected skeletal metastases in planar bone scintigraphy].

We assessed the diagnostic capabilities of SPECT-CT in patients with unclear and suspicious on the secondary lesion with bone scintigraphy background in planar mode (227 patients (mean age - 57 years) with various primary malignancies). All patients underwent planar scintigraphy with 99mTc-labeled phosphates in the "whole body" mode and then - bizonal single-photon-emission computed tomography combined with X-ray computed tomography (SPECT-CT). In patients with the presence of lesions in the skeleton, suspicious on metastases, there was conducted comparison with the data of SPECT-CT. During planar investigation the suspicion on metastases was detected in 41 patients (18%). The use of SPECT-CT allowed excluding metastases in 29 (71%) and confirmed in 7 (17%) of them. In 5 (12%) cases the nature of the changes remained unclear. Thus, in cancer patients with revealed by planar bone scintigraphy unclear or suspicious for metastatic foci in the skeleton, the use of SPECT-CT allowed in most cases (88%) to clarify the nature of these changes.