Improved sentinel node visualization in breast cancer by optimizing the colloid particle concentration and tracer dosage
Faint lymph uptake may hamper sentinel node (SN) identification by scintigraphy and subsequent gamma probe localization. The aim of the present study was to evaluate an adjustment in the colloid particle concentration and tracer dosage to optimize mammary lymphoscintigraphy. Scintigraphy was perform...
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| Veröffentlicht in: | Nuclear medicine communications 2001-05, Vol.22 (5), p.579-586 |
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| creator | VALDÉS OLMOS, R A TANIS, P J HOEFNAGEL, C A NIEWEG, O E MULLER, S H RUTGERS, E J.Th KOOI, M L.K KROON, B B.R |
| description | Faint lymph uptake may hamper sentinel node (SN) identification by scintigraphy and subsequent gamma probe localization. The aim of the present study was to evaluate an adjustment in the colloid particle concentration and tracer dosage to optimize mammary lymphoscintigraphy. Scintigraphy was performed in 151 patients with a palpable breast carcinoma and clinically negative axillafor the first 75 patients (group A) a standard labelling of 0.5 mg nanocolloid with Tc was performed, for the subsequent 76 patients (group B) the labelling dilution volume was reduced from 4 to 2 ml. For both groups the volume of injection was 0.2 ml. Lymph node uptake was evaluated by a 4-step visual score (from 0 = absent to 3+ = very intense), and by count quantification of at 4 h in the first draining SN. The SN visualization rate increased from 93% (70/75) in group A (mean dosage 93.4 MBq, range 57-130 MBq) to 99% (75/76) in group B (mean dosage 106.5 MBq, range 74-139 MBq). The percentage of patients with uptake 3+ was significantly higher (P = 0.001) in group B (51% vs 35% in group A). SN counts were significantly higher for group B (P |
| doi_str_mv | 10.1097/00006231-200105000-00018 |
| format | Article |
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The aim of the present study was to evaluate an adjustment in the colloid particle concentration and tracer dosage to optimize mammary lymphoscintigraphy. Scintigraphy was performed in 151 patients with a palpable breast carcinoma and clinically negative axillafor the first 75 patients (group A) a standard labelling of 0.5 mg nanocolloid with Tc was performed, for the subsequent 76 patients (group B) the labelling dilution volume was reduced from 4 to 2 ml. For both groups the volume of injection was 0.2 ml. Lymph node uptake was evaluated by a 4-step visual score (from 0 = absent to 3+ = very intense), and by count quantification of at 4 h in the first draining SN. The SN visualization rate increased from 93% (70/75) in group A (mean dosage 93.4 MBq, range 57-130 MBq) to 99% (75/76) in group B (mean dosage 106.5 MBq, range 74-139 MBq). The percentage of patients with uptake 3+ was significantly higher (P = 0.001) in group B (51% vs 35% in group A). SN counts were significantly higher for group B (P<0.001). The percentage of patients with less than 2000 counts/node diminished from 45% in group A to 9% in group B (P = 0.001). In group B (P = 0.033) more lymph channels (53% vs 35% in group A) were visualized and for a longer time (26% vs 4% at 4 h). Axillary drainage was seen in 96% in group A and 98% in group B whereas non-axillary drainage was observed in 19% and 25%, respectively. Intraoperative SN identification rate was 97% in group A and 100% in group B. SN metastases were found in 41% of group A and 47% of group B. It is concluded that enhancement of colloid particle concentration and adjustment of tracer dosage led to improved SN identification by substantial increase in lymph node uptake and lymph vessel depiction. A significant reduction of cases with faint SN uptake enables better surgical efficacy.</description><identifier>ISSN: 0143-3636</identifier><identifier>EISSN: 1473-5628</identifier><identifier>DOI: 10.1097/00006231-200105000-00018</identifier><identifier>PMID: 11388582</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins, Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Breast Neoplasms - diagnostic imaging ; Breast Neoplasms - pathology ; Breast Neoplasms - surgery ; Endocrine glands. Genital system. Mammary gland ; Female ; Gynecology. Andrology. Obstetrics ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Lymph Node Excision ; Lymph Nodes - diagnostic imaging ; Lymph Nodes - pathology ; Lymphatic Metastasis - diagnostic imaging ; Mammary gland diseases ; Mammography ; Medical sciences ; Middle Aged ; Radionuclide Imaging ; Radionuclide investigations ; Radiopharmaceuticals ; Sentinel Lymph Node Biopsy ; Technetium Tc 99m Aggregated Albumin ; Tumors</subject><ispartof>Nuclear medicine communications, 2001-05, Vol.22 (5), p.579-586</ispartof><rights>2001 Lippincott Williams & Wilkins, Inc.</rights><rights>2002 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4158-15498d6191b656d03cee4e9a1e2f83139627a7cd631431f86255aa01ade6f9b43</citedby><cites>FETCH-LOGICAL-c4158-15498d6191b656d03cee4e9a1e2f83139627a7cd631431f86255aa01ade6f9b43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14135861$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11388582$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>VALDÉS OLMOS, R A</creatorcontrib><creatorcontrib>TANIS, P J</creatorcontrib><creatorcontrib>HOEFNAGEL, C A</creatorcontrib><creatorcontrib>NIEWEG, O E</creatorcontrib><creatorcontrib>MULLER, S H</creatorcontrib><creatorcontrib>RUTGERS, E J.Th</creatorcontrib><creatorcontrib>KOOI, M L.K</creatorcontrib><creatorcontrib>KROON, B B.R</creatorcontrib><title>Improved sentinel node visualization in breast cancer by optimizing the colloid particle concentration and tracer dosage</title><title>Nuclear medicine communications</title><addtitle>Nucl Med Commun</addtitle><description>Faint lymph uptake may hamper sentinel node (SN) identification by scintigraphy and subsequent gamma probe localization. The aim of the present study was to evaluate an adjustment in the colloid particle concentration and tracer dosage to optimize mammary lymphoscintigraphy. Scintigraphy was performed in 151 patients with a palpable breast carcinoma and clinically negative axillafor the first 75 patients (group A) a standard labelling of 0.5 mg nanocolloid with Tc was performed, for the subsequent 76 patients (group B) the labelling dilution volume was reduced from 4 to 2 ml. For both groups the volume of injection was 0.2 ml. Lymph node uptake was evaluated by a 4-step visual score (from 0 = absent to 3+ = very intense), and by count quantification of at 4 h in the first draining SN. The SN visualization rate increased from 93% (70/75) in group A (mean dosage 93.4 MBq, range 57-130 MBq) to 99% (75/76) in group B (mean dosage 106.5 MBq, range 74-139 MBq). The percentage of patients with uptake 3+ was significantly higher (P = 0.001) in group B (51% vs 35% in group A). SN counts were significantly higher for group B (P<0.001). The percentage of patients with less than 2000 counts/node diminished from 45% in group A to 9% in group B (P = 0.001). In group B (P = 0.033) more lymph channels (53% vs 35% in group A) were visualized and for a longer time (26% vs 4% at 4 h). Axillary drainage was seen in 96% in group A and 98% in group B whereas non-axillary drainage was observed in 19% and 25%, respectively. Intraoperative SN identification rate was 97% in group A and 100% in group B. SN metastases were found in 41% of group A and 47% of group B. It is concluded that enhancement of colloid particle concentration and adjustment of tracer dosage led to improved SN identification by substantial increase in lymph node uptake and lymph vessel depiction. A significant reduction of cases with faint SN uptake enables better surgical efficacy.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Breast Neoplasms - diagnostic imaging</subject><subject>Breast Neoplasms - pathology</subject><subject>Breast Neoplasms - surgery</subject><subject>Endocrine glands. Genital system. Mammary gland</subject><subject>Female</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Lymph Node Excision</subject><subject>Lymph Nodes - diagnostic imaging</subject><subject>Lymph Nodes - pathology</subject><subject>Lymphatic Metastasis - diagnostic imaging</subject><subject>Mammary gland diseases</subject><subject>Mammography</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Radionuclide Imaging</subject><subject>Radionuclide investigations</subject><subject>Radiopharmaceuticals</subject><subject>Sentinel Lymph Node Biopsy</subject><subject>Technetium Tc 99m Aggregated Albumin</subject><subject>Tumors</subject><issn>0143-3636</issn><issn>1473-5628</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kUuPFCEURonROO3oXzBsdFfKLQqKWpqJj0kmcaNrQsGtaZSGFqh5_Xppu3VWkhAeOd8l90AIBfYO2DS-Z23InkPXMwZMtFPXJqgnZAPDyDshe_WUbBgMvOOSyzPyopQfDVFcjs_JGQBXSqh-Q-4ud_ucbtDRgrH6iIHG5JDe-LKa4B9M9SlSH-mc0ZRKrYkWM53vadpXv_MPPl7TukVqUwjJO7o3uXobDheNjDUfK5joaNsfsi4Vc40vybPFhIKvTus5-f7p47eLL93V18-XFx-uOjuAUB2IYVJOwgSzFNIxbhEHnAxgvygOfJL9aEbrJG-9wqJkL4QxDIxDuUzzwM_J22Pd1uavFUvVO18shmAiprXokamJD2JsoDqCNqdSMi56n_3O5HsNTB-s67_W9T_r-o_1Fn19emOdd-gegyfNDXhzAkyxJiy5WfTlkRuACyWhccORu02hYi4_w3qLWW_RhLrV__t1_htPDpsf</recordid><startdate>200105</startdate><enddate>200105</enddate><creator>VALDÉS OLMOS, R A</creator><creator>TANIS, P J</creator><creator>HOEFNAGEL, C A</creator><creator>NIEWEG, O E</creator><creator>MULLER, S H</creator><creator>RUTGERS, E J.Th</creator><creator>KOOI, M L.K</creator><creator>KROON, B B.R</creator><general>Lippincott Williams & Wilkins, Inc</general><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200105</creationdate><title>Improved sentinel node visualization in breast cancer by optimizing the colloid particle concentration and tracer dosage</title><author>VALDÉS OLMOS, R A ; TANIS, P J ; HOEFNAGEL, C A ; NIEWEG, O E ; MULLER, S H ; RUTGERS, E J.Th ; KOOI, M L.K ; KROON, B B.R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4158-15498d6191b656d03cee4e9a1e2f83139627a7cd631431f86255aa01ade6f9b43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Breast Neoplasms - diagnostic imaging</topic><topic>Breast Neoplasms - pathology</topic><topic>Breast Neoplasms - surgery</topic><topic>Endocrine glands. Genital system. Mammary gland</topic><topic>Female</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Lymph Node Excision</topic><topic>Lymph Nodes - diagnostic imaging</topic><topic>Lymph Nodes - pathology</topic><topic>Lymphatic Metastasis - diagnostic imaging</topic><topic>Mammary gland diseases</topic><topic>Mammography</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Radionuclide Imaging</topic><topic>Radionuclide investigations</topic><topic>Radiopharmaceuticals</topic><topic>Sentinel Lymph Node Biopsy</topic><topic>Technetium Tc 99m Aggregated Albumin</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>VALDÉS OLMOS, R A</creatorcontrib><creatorcontrib>TANIS, P J</creatorcontrib><creatorcontrib>HOEFNAGEL, C A</creatorcontrib><creatorcontrib>NIEWEG, O E</creatorcontrib><creatorcontrib>MULLER, S H</creatorcontrib><creatorcontrib>RUTGERS, E J.Th</creatorcontrib><creatorcontrib>KOOI, M L.K</creatorcontrib><creatorcontrib>KROON, B B.R</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Nuclear medicine communications</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>VALDÉS OLMOS, R A</au><au>TANIS, P J</au><au>HOEFNAGEL, C A</au><au>NIEWEG, O E</au><au>MULLER, S H</au><au>RUTGERS, E J.Th</au><au>KOOI, M L.K</au><au>KROON, B B.R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Improved sentinel node visualization in breast cancer by optimizing the colloid particle concentration and tracer dosage</atitle><jtitle>Nuclear medicine communications</jtitle><addtitle>Nucl Med Commun</addtitle><date>2001-05</date><risdate>2001</risdate><volume>22</volume><issue>5</issue><spage>579</spage><epage>586</epage><pages>579-586</pages><issn>0143-3636</issn><eissn>1473-5628</eissn><abstract>Faint lymph uptake may hamper sentinel node (SN) identification by scintigraphy and subsequent gamma probe localization. The aim of the present study was to evaluate an adjustment in the colloid particle concentration and tracer dosage to optimize mammary lymphoscintigraphy. Scintigraphy was performed in 151 patients with a palpable breast carcinoma and clinically negative axillafor the first 75 patients (group A) a standard labelling of 0.5 mg nanocolloid with Tc was performed, for the subsequent 76 patients (group B) the labelling dilution volume was reduced from 4 to 2 ml. For both groups the volume of injection was 0.2 ml. Lymph node uptake was evaluated by a 4-step visual score (from 0 = absent to 3+ = very intense), and by count quantification of at 4 h in the first draining SN. The SN visualization rate increased from 93% (70/75) in group A (mean dosage 93.4 MBq, range 57-130 MBq) to 99% (75/76) in group B (mean dosage 106.5 MBq, range 74-139 MBq). The percentage of patients with uptake 3+ was significantly higher (P = 0.001) in group B (51% vs 35% in group A). SN counts were significantly higher for group B (P<0.001). The percentage of patients with less than 2000 counts/node diminished from 45% in group A to 9% in group B (P = 0.001). In group B (P = 0.033) more lymph channels (53% vs 35% in group A) were visualized and for a longer time (26% vs 4% at 4 h). Axillary drainage was seen in 96% in group A and 98% in group B whereas non-axillary drainage was observed in 19% and 25%, respectively. Intraoperative SN identification rate was 97% in group A and 100% in group B. SN metastases were found in 41% of group A and 47% of group B. It is concluded that enhancement of colloid particle concentration and adjustment of tracer dosage led to improved SN identification by substantial increase in lymph node uptake and lymph vessel depiction. A significant reduction of cases with faint SN uptake enables better surgical efficacy.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins, Inc</pub><pmid>11388582</pmid><doi>10.1097/00006231-200105000-00018</doi><tpages>8</tpages></addata></record> |
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| ispartof | Nuclear medicine communications, 2001-05, Vol.22 (5), p.579-586 |
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| subjects | Adult Aged Aged, 80 and over Biological and medical sciences Breast Neoplasms - diagnostic imaging Breast Neoplasms - pathology Breast Neoplasms - surgery Endocrine glands. Genital system. Mammary gland Female Gynecology. Andrology. Obstetrics Humans Investigative techniques, diagnostic techniques (general aspects) Lymph Node Excision Lymph Nodes - diagnostic imaging Lymph Nodes - pathology Lymphatic Metastasis - diagnostic imaging Mammary gland diseases Mammography Medical sciences Middle Aged Radionuclide Imaging Radionuclide investigations Radiopharmaceuticals Sentinel Lymph Node Biopsy Technetium Tc 99m Aggregated Albumin Tumors |
| title | Improved sentinel node visualization in breast cancer by optimizing the colloid particle concentration and tracer dosage |
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