Pelin Arıcan

Ankara Numune Eğitim ve Araştırma Hastanesi, Nükleer Tıp Kliniği, Ankara, Türkiye


The lymph node status is very important for the prognosis and treatment in patients with breast cancer. The sentinel lymph node is the first node to which lymphatic drainage and metastasis from the primary tumor occurs. The sentinel lymph node detection and biopsy have already been implemented into clinical practice in breast cancer. Planar lymphoscintigraphy, blue dye and intraoperative gamma probe are used for detection of the the sentinel lymph node and lymphatic drainage. Planar lymphoscintigraphy usually determines the sentinel lymph node in all patients. However, planar lymphoscintigraphy is not adequate for the precise anatomic localization of the sentinel lymph node, or sometimes lymphatic drainage may not be shown at all. Recently, hybrid single photon emission computed tomography gamma camera-computed tomography system (SPECT/CT) has been improved. This system could help overcome these difficulties. When SPECT images are fused with the anatomical details provided by CT, accurate anatomic localization of the sentinel lymph node and lymphatic mapping can be obtained. SPECT/CT increases the sensitivity of planar lymphoscintigraphy, detects more nodes compared to planar lymphoscintigraphy, and the accurate localization of the sentinel lymph nodes acts as a guide for surgical planning. In this review, the clinical use of hybrid SPECT/ CT in the identification of the sentinel lymph node in patients with breast cancer, in comparison with planar images, literature about this subject together with our experience were presented.

Keywords: Breast cancer, sentinel lymph node, lymphoscintigraphy, SPECT