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Year:
2012
| Volume: 20
| Issue: 3-4
| Pages: 127-131
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Special Article |
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SPECT-CT IN BREAST CANCER
Sonia Sergieva, Elena Alexandrova, George Baitchev, Vesela Parvanova |
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DOI:
10.2298/AOO1204127S |
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Abstract: |
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The most important prognostic factors for breast cancer are the size of primary tumor and axillary lymph node status. Role of scintimammography with the cationic lipophilic 99mTc-Tetrofosmin and 99mTc-Sestamibi in preoperative evaluation and post-treatment follow-up of patients with breast cancer is well known. The added diagnostic value of SPECT-CT has recently been investigated. Scintigraphy provides a description of function or process whereas CT depicts the precise localization and type of morphological changes that have occurred in the lesions. Combined SPECT-CT imaging enables to localize positive primary tumors and/or loco-regional lymph nodes; to evaluate effect of neoadjuvant chemotherapy in locally advanced and non-operable breast tumors. SPECT-CT studies are useful in post-therapeutic follow-up of patients to visualize suspicious local recurrence, lymphadenopathy and disease extension. CT part of the study can increase the specificity of SPECT by more accurate anatomical assessment of the sites of abnormal activity with unclear character such as radiation pulmonitis, postoperative parenchymal changes, fibrocystic changes etc. According to the results reported in literature, all the axillary metastatic nodes that were false negative on SPECT image were non-palpable, small lesion size (<10 mm) with partial metastatic involvement or micrometastases in most cases. Lymphatic mapping of SLNs is now routinely done in breast cancer patients for correct N-staging. SPECT-CT has been used for clear depiction of the SLNs to provide the useful information for intraoperative gamma-probe detection in cases that are difficult to interpret planar images, in cases with unusual drainage or in cases of nonvisualization. SPECT-CT scintimammogarphy is preferable in terms of physical characteristic, execution time and cost-effectiveness, thus suggesting wider application of this procedure. SPECT-CT is a potential new tool for LN localization and radioguided surgery in the coming years. |
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Key words:
Breast Neoplasms; Positron-Emission Tomography and Computed Tomography; Radionuclide Imaging; Lymph Nodes |
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