JOURNAL DESCRIPTION
The Medical Radiology and Radiation Safety journal ISSN 1024-6177 was founded in January 1956 (before December 30, 1993 it was entitled Medical Radiology, ISSN 0025-8334). In 2018, the journal received Online ISSN: 2618-9615 and was registered as an electronic online publication in Roskomnadzor on March 29, 2018. It publishes original research articles which cover questions of radiobiology, radiation medicine, radiation safety, radiation therapy, nuclear medicine and scientific reviews. In general the journal has more than 30 headings and it is of interest for specialists working in thefields of medicine¸ radiation biology, epidemiology, medical physics and technology. Since July 01, 2008 the journal has been published by State Research Center - Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency. The founder from 1956 to the present time is the Ministry of Health of the Russian Federation, and from 2008 to the present time is the Federal Medical Biological Agency.
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Medical Radiology and Radiation Safety. 2023. Vol. 68. № 5
DOI:10.33266/1024-6177-2023-68-5-88-95
A.A. Medvedeva, A.N. Rуbina, R.V. Zeltchan, O.D. Bragina, A.V. Doroshenko,
E.Iu. Garbukov, N.A. Tarabanovskaya, L.A. Tashireva, V.I. Chernov
Radionuclide Diagnosis of Sentinel Lymph Nodes in Breast cancer with a Radiopharmaceutical Based on Technetium-99m Labeled Gamma Aluminum Oxide
Cancer Research Institute, Tomsk National Research Medical Center, Tomsk, Russia
Contact person: A.A. Medvedeva, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
ABSTRACT
Аim: To analyze the results of radionuclide diagnostics of sentinel lymph nodes (SLN) in patients with breast cancer (BC) with the radiotracer Sentiscan, 99mTc (manufacturer “MedicorPharma-Ural”) using the multimodal SPECT/CT at the stage of visualization.
Material and methods: The study was retrospective, it included 48 patients with BC with clinical stage T2-3N0M0, who underwent radionuclide diagnostics of SLN and SPECT/CT was performed at the imaging stage. The images were evaluated visually, the intensity of the radiotracer accumulation in the lymph nodes (LN) was analyzed, SUVmax was used as a quantitative parameter. Intraoperative detection of SLN with subsequent histological examination was also carried out with the calculation of the level of the radiotracer accumulation.
Results: On tomoscintigrams, LNs were visualized in 43 patients out of 48, intraoperatively ‒ in 46 cases, in 2 patients, accumulation of the radiotracer in the LN projection was noted neither according to SPECT/CT, nor intraoperatively. When analyzing the intensity of the radiotracer accumulation according to SPECT/CT data, a rather large scatter of SUVmax‒35 [10‒104]. Sentinel were considered LNs with the level of the radiotracer accumulation in them of at least 10 % of the most intense node. According to SPECT/CT data, 165 lymph nodes were identified, the average number of lymph nodes detected in one patient was 2 [1‒3], the maximum number was 6 lymph nodes. In all patients, the lymph nodes were determined in the projection of the 1st level, in 25 cases ‒ in the projection of other zones of regional lymphatic outflow. The total number of lymph nodes removed during surgery was n=247, on average 3 [2‒5] lymph nodes were removed in one patient, with a maximum of 8 nodes.
Conclusion: The sensitivity of radionuclide diagnostics of SLN with Sentiscan, 99mTc was 89.6 % according to SPECT/CT and 95.8 % according to the results of intraoperative detection. The use of multimodal imaging provides information on the exact anatomical localization of the lymph nodes. In the absence of scintigraphic visualization of the radiotracer redistribution in the lymphatic collector, intraoperative detection does not lose its relevance.
Keywords: breast cancer, sentinel lymph node, radionuclide colloid, single photon emission computed tomography, gamma probe
For citation: Medvedeva AA, Rуbina AN, Zeltchan RV, Bragina OD, Doroshenko AV, Garbukov EIu, Tarabanovskaya NA, Tashire-
va LA, Chernov VI. Radionuclide Diagnosis of Sentinel Lymph Nodes in Breast cancer with a Radiopharmaceutical Based on Technetium-99m Labeled Gamma Aluminum Oxide. Medical Radiology and Radiation Safety. 2023;68(5):88–95. (In Russian). DOI:10.33266/1024-6177-2023-68-5-88-95
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PDF (RUS) Full-text article (in Russian)
Conflict of interest. The authors declare no conflict of interest.
Financing. The study had no sponsorship.
Contribution. Medvedeva A.A.: collection and analysis of literary material, concept and design development, data analysis and interpretation, text writing; Chernov V.I.: concept and design development, scientific text editing, final approval for manuscript publication; Rybina A.N., Zelchan R.V., Bragina O.D.: research concept development, development research design, data analysis, text editing; Doroshenko A.V., Garbukov E.Yu., Tarabanovskaya N.I., Tshireva L.A.: material collection, data analysis, statistical data processing, text editing.
Article received: 20.04.2023. Accepted for publication: 27.05.2023.