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J Comput Assist Tomogr. 2011 May-Jun;35(3):367-74. doi: 10.1097/RCT.0b013e318213ccd9.

Localization and evaluation of sentinel lymph node in breast cancer from computed tomographic lymphography.

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1
Department of Radiology, Cancer Hospital/Institute, Shanghai Medical College, Fudan University, Shanghai, China.

Abstract

OBJECTIVE:

This study aimed to determine the accuracy of computed tomographic (CT) localization and CT-based diagnosis of sentinel lymph nodes (SLNs) metastasis.

METHODS:

Thirty-four patients with confirmed breast cancer underwent 40-row CT scanning, and the first one or several lymph node(s) in the lymphatic drainage pathway was/were defined as the SLN(s). Dye and γ probe-guided SLN biopsy was performed on all patients. To accurately localize the SLN, 19 patients (55.9%) underwent the percutaneous lymph node puncture procedure. The morphologic features of all the SLNs on CT scans were analyzed and compared with the SLN biopsy pathologic diagnosis.

RESULTS:

Sentinel lymph nodes were successfully identified for all patients without any significant adverse effects. All localized SLNs corresponded well with SLNs identified on SLN biopsy, with an accuracy of 89.5%. Accuracy increased to 100% when the CT scan technique was combined with the blue dye method. The size criteria for metastatic diagnosis had a sensitivity of 85%, which increased to 94.7% when long-to-short-axis ratio and margin characteristics were also considered.

CONCLUSIONS:

The CT lymphography combined with the blue dye method accurately localized the SLNs. The CT-based diagnostic criteria improved the diagnostic accuracy of SLN metastases and were useful for evaluating the axillary status in early stage breast cancer patients.

PMID:
21586933
DOI:
10.1097/RCT.0b013e318213ccd9
[Indexed for MEDLINE]
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