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Revista Española de Medicina Nuclear e Imagen Molecular (English Edition)
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Inicio Revista Española de Medicina Nuclear e Imagen Molecular (English Edition) Concordance between freehand SPECT and conventional scintigraphy for sentinel ly...
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Vol. 43. Issue 2.
Pages 79-83 (March - April 2024)
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Vol. 43. Issue 2.
Pages 79-83 (March - April 2024)
Original Article
Concordance between freehand SPECT and conventional scintigraphy for sentinel lymph node detection in breast cancer
Concordancia entre SPECT portátil y la gammagrafía convencional para la detección de ganglio centinela en cáncer de mama
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Á. Esteban Hurtadoa,
Corresponding author
angela_esteban@hotmail.es

Corresponding author.
, J. Orozco Cortésa, P. Cárcamo Ibarrab, U. López Gonzálezc, Á. Badenes Romeroa, M.Á. Navas de la Cruza, C. Siscar Geloa, L. Casas Calabuiga, P. Abreu Sáncheza, T. Mut Dóleraa, D. Balaguer Muñoza, M.D. Reyes Ojedaa, C. Plancha Mansaneta, E. Caballero Calabuiga
a Servicio de Medicina Nuclear, Hospital Universitario Doctor Peset, Valencia, Spain
b Servicio de Medicina Nuclear, Hospital Clínico Universitario, Valencia, Spain
c Servicio de Medicina Preventiva, Hospital Universitario Doctor Peset, Valencia, Spain
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Tables (5)
Table 1. Concordance between freehand SPECT and early LS.
Table 2. Concordance between freehand SPECT and delayed LS.
Table 3. Concordance between early and delayed LS.
Table 4. Calculation of Cohen’s Kappa index with different weighted methods among the different tests.
Table 5. Study of concordance and Cohen’s Kappa index for each category.
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Abstract
Introduction

Freehand SPECT can be a useful imaging technique for preoperative planning of sentinel lymph node biopsy (SLNB) as it allows localization of the sentinel node by 3D and real-time tomographic imaging and determines its depth after a few minutes of scanning.

The aim of the study was to evaluate the correlation between the number of detected SNs between freehand SPECT images and lymphoscintigraphy (LS).

Materials and methods

100 patients with a diagnosis of invasive breast cancer and no clinical evidence of lymph node involvement prospectively underwent SLNB. The preoperative study included freehand SPECT imaging at 15min after injection and LS imaging at 25 and 60−90min after injection (early and late). The observed agreement was analyzed and a concordance study was performed between the number of SNs detected with freehand SPECT and LS.

Results

The observed agreement in the detection of SNs between freehand SPECT and early LS was 72%; between freehand SPECT and late LS was 85%; and between early and late LS was 87%. In the concordance study, there was moderate concordance between freehand SPECT and early LS (kappa coefficient: 0.42); moderate-high concordance between freehand SPECT and late LS (kappa coefficient: 0.60); and moderate-high concordance between early and late LS (kappa coefficient: 0.70), with no significant differences between them (p-value=0.16).

Conclusion

Freehand SPECT showed a moderate-high concordance with conventional imaging studies and could be a valid alternative for the presurgical study of SLNB in breast cancer.

Keywords:
Radioguided surgery
Freehand SPECT
Lymphoscintigraphy
Breast cancer
Sentinel lymph node biopsy
Resumen
Introducción

La SPECT portátil puede ser una técnica de imagen útil para la planificación preoperatoria de la biopsia selectiva del ganglio centinela (BSGC) ya que permite la localización del ganglio centinela mediante imágenes tomográficas en 3D y en tiempo real y determina su profundidad, después de unos minutos de exploración.

El objetivo del estudio fue evaluar la correlación entre el número de GC detectados entre las imágenes de la SPECT portátil y la linfogammagrafía (LG).

Materiales y métodos

100 pacientes con diagnóstico de cáncer de mama infiltrante y sin evidencia clínica de afectación ganglionar, se sometieron prospectivamente a una BSGC. El estudio preoperatorio incluyó imágenes de SPECT portátil a los 15 minutos tras la inyección y de LG a los 25 y 60–90 minutos (precoz y tardía). Se analizó el acuerdo observado y se realizó un estudio de concordancia entre el número de GC detectados con SPECT portátil y LG.

Resultados

El acuerdo observado en la detección de GC entre SPECT portátil y LG precoz fue del 72%; entre SPECT portátil y LG tardía del 85%; y entre la LG precoz y la tardía de un 87%. En el estudio de concordancia se registró una concordancia moderada entre la SPECT portátil y la LG precoz (coeficiente kappa: 0,42); una concordancia moderada-alta entre la SPECT portátil y la LG tardía (coeficiente kappa: 0,60); y una concordancia de moderada-alta entre la LG precoz y la tardía (coeficiente kappa: 0,70), sin diferencias significativas entre ellos (valor p=0,16).

Conclusión

La SPECT portátil presentó una concordancia moderada-alta con los estudios de imagen convencional y podría ser una alternativa válida para el estudio prequirúrgico de la BSGC en el cáncer de mama.

Palabras clave:
Cirugía radioguiada
SPECT portátil
Linfogammagrafía
Cáncer de mama
Biopsia selectiva de ganglio centinela

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