Open AccessEnhanced Sentinel Lymphoscintigraphic Mapping in Breast Tumor Using the Graded Shield Technique
Author(s) -
Chen YuWen,
Lai YungChang,
Hsu ChienChin,
Hou MingFeng
Publication year - 2003
Publication title -
the kaohsiung journal of medical sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.439
H-Index - 36
eISSN - 2410-8650
pISSN - 1607-551X
DOI - 10.1016/s1607-551x(09)70435-8
Subject(s) - medicine , sentinel lymph node , sentinel node , shield , nuclear medicine , lymphatic system , lymph node , radiology , breast cancer , cancer , pathology , geology , petrology
The graded shield technique was developed to increase the sentinel node detection rate by improving lymphoscintigraphic image contrast. In a 6‐month period, 50 women with clinical suspicion of early stage breast cancer (T1 and T2 tumors) were enrolled in this study. The patients had a mean age of 47.2 ± 10.3 years. A composite graded shield was constructed using three concentric layers of leaded plastic measuring 3 cm, 5 cm, and 7 cm each in diameter. The graded shield was designed with a movable Velcro backing for accurate positioning over the injection site. Images were acquired with a vertical angle dual‐head gamma camera using an established injection procedure developed at our institution. The rate of detection of sentinel lymph nodes using lymphoscintigraphic mapping improved from 74% (37/50 patients) to 96% (48/50) using the graded shield ( p < 0.05). In addition to the increased detection rate, our technique also increased the number of nodes detected and improved visualization of the adjacent lymphatic basin. By enhancing nodal contrast, we have demonstrated that the graded shield technique is an effective method for improving the rate of sentinel node detection.