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Inicio Revista Española de Medicina Nuclear e Imagen Molecular (English Edition) Contribution of the portable gamma camera to detect the sentinel node in breast ...
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Vol. 31. Issue 3.
Pages 130-134 (May - June 2012)
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Vol. 31. Issue 3.
Pages 130-134 (May - June 2012)
Original article
Contribution of the portable gamma camera to detect the sentinel node in breast cancer during surgery
Aportación de una gammacámara portátil en la localización intraoperatoria del ganglio centinela en el cáncer de mama
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J. Cardona-Arboniésa,
Corresponding author
jcardonaarbonies@gmail.com

Corresponding author.
, J. Mucientes-Rasillab, A. Moreno Elola-Olasoc, G. Salazar-Andíaa, A. Prieto-Sorianoa, J. Chicharo de Freitasa, J.M. Román-Santamaríac, J.L. Carreras-Delgadoa
a Departamento de Medicina Nuclear, Hospital Clínico San Carlos de Madrid, Madrid, Spain
b Departamento de Medicina Nuclear, Hospital Puerta de Hierro, Madrid, Spain
c Departamento de Ginecología y Obstetricia, Hospital Clínico San Carlos de Madrid, Madrid, Spain
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Abstract
Aim

To show our experience using the portable gamma camera during surgery in the detection of the sentinel node in breast cancer.

Material and methods

A total of 46 women diagnosed with breast cancer were included. This study was carried out by means of the periareolar intradermal injection. Planar images and SPECT/CT were acquired. On the following day, the sentinel nodes were localized intraoperatively with a portable gamma camera and a gamma probe. Images of the axilla in anterior and lateral projections were acquired before and after extraction of all the sentinel nodes.

Results

The images acquired with the portable gamma-camera during the operation showed no activity in all the patients after the removal of the sentinel nodes. In four out of the 46 cases, the portable gamma camera provided relevant information during the procedure (it detected a sentinel node in two cases in which it had not been detected prior to the surgery and it oriented the surgeon in the localization of low activity nodes when the probe screening had been negative).

Conclusions

The intraoperative portable gamma camera to detect the sentinel node in breast cancer patients is useful in order to ensure, independent of the surgeon that all the sentinel nodes have been removed. It can also help guide the surgeon in the event of a single low activity sentinel node.

Keywords:
Sentinel lymph node biopsy
Portable gamma camera
Breast cancer
Resumen
Objetivo

Mostrar nuestra experiencia en el uso de una gammacámara portátil en la localización intraoperatoria del ganglio centinela en el cáncer de mama.

Material y métodos

46 mujeres diagnosticadas de cáncer de mama fueron incluidas. Se realizo inyección periareolar intradérmica del radiotrazador. Se obtuvieron imágenes planares y SPECT-TAC. El día siguiente se emplearon una sonda y una gammacámara portátil para la detección del ganglio centinela intraoperatorio. Se tomaron imágenes en las proyecciones anterior y lateral de la axila antes y después de la extracción del ganglio centinela.

Resultados

Las imágenes obtenidas intraoperatoriamente no mostraron actividad en todos los pacientes después de la extracción de todos los ganglios centinela. En cuatro de los 46 casos la gammacámara dio información importante (en dos casos localizó ganglios no detectados en las imágenes prequirúrgicas y en otros dos orientó al cirujano en localizar ganglios de baja actividad cuando el rastreo con sonda fue negativo).

Conclusiones

El uso de la gammacámara portátil intraoperatoria en la localización del ganglio centinela en cáncer de mama es útil para asegurar, con independencia del cirujano, que todos los ganglios han sido extirpados. Puede guiar además al cirujano en la localización de ganglios de baja actividad.

Palabras clave:
Biopsia de ganglio centinela
gammacámara portatil
cáncer de mama

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