Accuracy of non-operative identification of the sentinel lymph node using combined gamma and ultrasound scanning

Clin Radiol. 2014 Aug;69(8):849-52. doi: 10.1016/j.crad.2014.03.021. Epub 2014 Jun 2.

Abstract

Aim: To assess how accurately the sentinel lymph node (SLN) can be identified percutaneously, using gamma probe and ultrasound technology.

Materials and methods: Women with breast cancer, scheduled for wide local excision or mastectomy with SLN biopsy (SLNB), were included. Peri-areolar intradermal injection of technetium-99 nanocolloid was performed on the morning of surgery and 1-2 ml of blue dye was injected in the peri-areolar region once the patient was anaesthetized. Prior to surgery, a gamma probe was used over the skin to identify any hot spot that could represent a SLN. Ultrasound, guided by the hot spot, was then used to visualize potential SLNs and guide the insertion of a localizing wire. The accuracy in localizing the SLN by preoperative gamma-probe guided ultrasonography was assessed by comparison to SLNB.

Results: A SLN was correctly identified and marked using gamma-probe guided ultrasonography in 44 of 59 cases (75%; 95% CI: 63-86%).

Conclusion: This study supports the case for investigating percutaneous gamma probe and ultrasound guided interventions in the axilla in women with breast cancer, as a potential alternative to surgical SLNB.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Axilla
  • Breast Neoplasms / diagnosis*
  • Breast Neoplasms / surgery
  • Female
  • Gamma Rays*
  • Humans
  • Lymph Nodes / diagnostic imaging*
  • Middle Aged
  • Preoperative Care / methods*
  • Radiography
  • Radiopharmaceuticals
  • Reproducibility of Results
  • Sentinel Lymph Node Biopsy / methods*
  • Technetium Tc 99m Aggregated Albumin
  • Ultrasonography, Interventional / methods*

Substances

  • Radiopharmaceuticals
  • Technetium Tc 99m Aggregated Albumin