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Improved body-outline imaging technique for localization of sentinel lymph nodes in breast surgery
Elizabeth Clarke1, Alp Notghi, Keith Harding
1Department of Physics and Nuclear Medicine, City Hospital NHS Trust, Birmingham, United Kingdom. elizabeth.clarke@cityhospbham.wmids.nhs.uk
Unlabelled:
Many centers use techniques for localizing the sentinel lymph node (SLN) associated with a breast tumor. Protocols involve the use of an intraoperative probe and blue dye but may or may not include scintigraphy.
Methods:
Three methods of body-outline imaging were investigated to aid SLN localization. Body outlines were acquired using a handheld source; a transmission image was acquired from a (57)Co-flood source; and, finally, a new method is described using a (153)Gd-line source attenuation correction for body outline.
Results:
Method 1 images were of low quality, although 83% of SLNs were visualized. Body outline was unsatisfactory for surgical localization. Method 2 was unsatisfactory because of the lack of a lateral image. Method 3 enabled good presurgical visualization of the SLN (73%) and speeded surgical localization.
Conclusion:
The (153)Gd-line source consistently gives optimal-quality body-outline images. This source is simple, quick, and clearly locates the SLN on multiple projections.