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At least 253 records · Page 14Linked to original sources
PubMed2000

Lymphoscintigraphy in breast cancer patients--comparison of peritumoural and intradermal injection.

UNLABELLED: AIM of this study was to determine whether the sentinel lymph nodes (SLNs) can be accurately identified in breast cancer patients with intradermal injection of the radiotracer above the primary tumour in comparison to peritumoural injection. METHODS: In 45 women with breast cancer we performed lymphoscintigraphy on two separate days. We injected Tc-99m nanocolloid on the first day peritumourally, and on a separate day intradermally. The results of both investigations using different injection sites were compared in order to determine the number and location of SLNs. RESULTS: The SLN identification rate using peritumoural injection was 71% (32 of 45 patients) and 96% (43 out of 45 patients) using intradermal injection. In 62% (28 of 45 patients) the number and location of the SLNs were identical. In 97% (31 of 32 patients) in whom a SLN was detected using peritumoural injection, the same SLNs reappeared with intradermal injection. There were no false negative findings with the peritumoural administration of tracer whereas the intradermal administration approach resulted in a false negative rate of 13%. CONCLUSION: In women with breast cancer the reproducibility of lymphoscintigraphy using peritumoural and intradermal injection sites was 62%. The intradermal injection modality enables the detection of a SLN in patients where the peritumoural injection failed but it has the disadvantage of a higher false negative rate in comparison to the peritumoural injection technique.

Adult↗
PubMed2002

Sentinel lymph nodes lymphoscintigraphy and biopsy in breast cancer.

OBJECTIVES: To determine the clinical value of sentinel lymph node (SLN) detection by lympho- scintigraphy and gamma ray detecting probe (GDP) and to assess the value of hematoxylin and eosin (H&E) staining combined with immunohistochemistry (IHC) analys is for detecting micrometastasis in lymph nodes (LNs). METHODS: Forty-two patients with breast cancer were included in this study. (99)Tc(m)-dextran was injected peritumourally. Lymphoscintigraphy images were obtained in anterior and lateral views. SLNs were removed with the aid of GDP during surgery. A standard axillary lymph nodes (ALNs) dissection was performed. All lymph nodes were first analyzed by HE staining. When all of the SLNs in a patient were negative, the ALNs were subjected to additional HE staining combined with IHC analysis. RESULTS: SLNs were successfully detected and removed in 39 (92.9%) of the 42 patients. The sensitivity, specificity and accuracy of SLN biopsy were 92.9% (13 in 14), 100% (25 in 25) and 97.4% (38 in 39) respectively. Additional HE staining combined with IHC analysis of the ALNs detected micrometastasis in 3 SLNs (2 cases), but there were no positives in the non-sentinal lymph nodes (NSLNs). CONCLUSIONS: This study suggests that lymphoscintigraphy and GDP may be used to detect SLN. Additional HE staining combined with IHC analysis of the ALNs may help predict micrometastasis. Biopsy of SLN may be an accurate method for staging breast cancer.

Adult↗
PubMed2003

Nonvisualization of axillary sentinel node during lymphoscintigraphy: is there a pathologic significance in breast cancer?

UNLABELLED: The aim of this study was to define the factors associated with nonvisualization of a sentinel node (SN) in the axilla area during preoperative lymphoscintigraphy. METHODS: We retrospectively studied 332 women with T0, T1, or T2 <3-cm, N0 invasive breast cancer who underwent a sentinel lymph node biopsy procedure. All patients had intradermal and intraparenchymal injection of 37 MBq (99m)Tc-sulfur colloid in a total volume of 4 x 0.1 mL, above and around the tumor. Anterior and lateral static views were obtained a few minutes and 2-4 h after injection. Surgery was performed the next day. The SNs were localized intraoperatively with the aid of patent blue dye and using a hand-held gamma-probe. SNs were analyzed by serial sections stained with hematoxylin-eosin, with the adjacent section stained with anticytokeratin antibodies. Different parameters, such as the number of positive lymph nodes, presence of lymphovascular invasion, tumor size, tumor grade, histology (invasive vs. in situ), prior excisional biopsy, and patient age were analyzed to determine whether they had any significant correlation with nonvisualization of SNs in the axillary area. RESULTS: An axillary SN was successfully visualized on the preoperative lymphoscintigraphy in 302 of 332 patients (90.7%). No axillary drainage was found in 30 patients on the delayed images, even after a second injection of radiocolloid, and 5 of 30 patients showed uptake outside the axillary area. Positive nodes were identified in 86 of 302 patients (28.5%) with successful axillary drainage and in 19 of 30 patients (63.3%) with unsuccessful axillary drainage. More than 4 invaded axillary nodes (P < 0.0001) and the presence of lymphovascular invasion in the breast tumor (P = 0.004) were the only significant variables on univariate analysis, although multivariate analysis showed that only the increased number of invaded nodes was statistically significant. CONCLUSION: Patients with unsuccessful axillary mapping have an increased risk for axillary involvement.

Adult↗
PubMed2005

Diagnostic protocol for lymphoscintigraphy in newborns.

The purpose of this methods paper is to offer pediatricians and nuclear medicine physicians a diagnostic protocol for performing lymphoscintigraphy in newborns that may be useful for enhancing diagnosis and management of newborns with congenital lymphatic abnormalities. Indications for lymphoscintigraphy, choice of tracer, optimal dose, routes of administration, methods of data acquisition, timing, and interpretation of results for newborns are presented and discussed.

Diagnosis, Differential↗
PubMed2005

Lymphoedema: lymphoscintigraphy versus other diagnostic techniques--a clinician's point of view.

This paper overviews the problem of the clinical basis, diagnosis and available therapy modalities for lymphoedema. Regarding diagnostics, the measurement of circumference, volume and thickness of the limb are presented, as well as diagnostic imaging modalities. These include direct and indirect lymphography, MRI, CT, ultrasound imaging and lymphoscintigraphy, which is currently considered the leading technique in primary diagnosis of lymphoedema and its follow-up. This paper discusses the treatment of lymphoedema and the role of lymphoscintigraphy in the follow-up of patents with lymphoedema.

Diagnostic Imaging↗
PubMed1992

The role of cutaneous lymphoscintigraphy in determining regional lymph node drainage of truncal melanomas.

In the absence of clinically positive regional nodes, any value of prophylactic dissection in malignant melanomas depends on accurate preoperative determination of the pathway of lymphatic drainage. We report on the use of noninvasive radionuclide lymphoscintigraphy in the determination of regional patterns of lymph node drainage in patients with melanomas. Ten patients were studied; treatment was altered by test results in 2. Eleven node groups were excised in 7 patients. There have been no metastatic melanomas found in any nodal basins not detected by lymphoscintigraphy 23 to 42 months after operation.

Adult↗
PubMed2005

[Use of the lymphoscintigraphy in detection of sentinel lymph nodes of the neck].

Technique of the application of radioactive tracer to the primary tumor and lymphoscintigraphy with use of the stationary and handheld gamma probe was presented. Various types of the used radioactive tracers were characterized. Scintigraphical criteria for sentinel nodes recognition were discussed. Advantages and limitations of the use of lymphoscintigraphy for sentinel nodes detection were described. Necessity of further study to determine feasibility of sentinel nodes radiolocalization in stage N0 in head and neck cancer was pointed out.

Humans↗
PubMed1990

[Progress in the evaluation of lymphatic involvement in cancer of the rectum: endoscopic rectal lymphoscintigraphy].

The preoperative evaluation of lymphatic spread in rectal cancer constitutes a considerable problem. A prospective study including 45 patients operated for rectal cancer, was carried out in order to assess the diagnostic value of a new technique: endoscopic rectal lymphoscintigraphy. The results of the preoperative assessment were compared with histological data according to Dukes' classification (Dukes A/B: 22 cases, Dukes C: 23 cases). Analysis of these results revealed the sensitivity (80%), specificity (73%) and accuracy (80%) of this new technique. If, combined with endorectal ultrasonography, rectal lymphoscintigraphy might play highly significant role in identifying the indications for local excisions of small tumours; similarly, the effect of preoperative radiotherapy might be more thoroughly assessed.

Adenocarcinoma, Mucinous↗
PubMed1990

Lymphoscintigraphy for cystic hygroma.

We present the case of an infant with a cystic hygroma investigated by lymphoscintigraphy. The source of lymph flowing into the hygroma was identified as were some ectatic lymphatics feeding it. Lymph flow was very rapid. The implications for therapy are discussed. Lymphoscintigraphy can assess many aspects of lymph flow not accessible by other means.

Antimony↗
PubMed1989

The expanding role of lymphoscintigraphy in the management of cutaneous melanoma. First Place Winner: Conrad Jobst award.

Accepted therapy for intermediate-thickness melanomas is wide local excision and regional lymphadenectomy for nodes known to be in the lymph drainage basin. Lymphoscintigraphy has been shown to be of great help in predicting the drainage pattern of truncal, shoulder, proximal extremity, and head and neck melanomas. Lymphoscintigraphy using Technetium-99 antimony sulfur colloid was performed on 17 patients with cutaneous melanomas at H. Lee Moffitt Cancer Center at the University of South Florida. Of 13 patients with primary truncal and shoulder lesions, drainage patterns were discordant 54 per cent of the time and resulted in dissection of nodal groups different than would otherwise have been planned. This resulted in several lymph nodes positive for metastatic disease removed from operative sites not expected to show metastatic spread by clinical experience alone. The discordant rate for head and neck drainage was also high with 2 of 3 forehead studies showing drainage to both anterior and posterior cervical chains when only anterior chain drainage was expected, while only one of these drained to the preauricular nodes. Again, this led to elective lymph-node dissections of nodal basins not anticipated on clinical grounds alone. After a mean follow-up of 2 years, in which 60 to 75 per cent of all recurrences from melanoma are expected to occur, there has been no lymph-node metastasis development in basins that were not predicted by the scan. It is clear from our data that well-known historical patterns of lymph drainage in addition to the clinical impression of experienced surgeons cannot reliably predict the lymphatic drainage of many truncal, shoulder, and head and neck melanomas.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[The importance of lymphoscintigraphy in breast cancer].

The comparison of results of axillary lymphoscintigraphy with those of morphological examination of surgically removed lymph nodes in 78 patients with breast cancer showed overall reliability of the method to be 0.72, specificity--0.56 and sensitivity--0.92. Data of lymphoscintigraphy performed in 82 breast cancer patients to form fields of parasternal lymph node irradiation suggested enlarging standard field by 4 cm in 90.2% of cases and by 5 cm--in 54.9%.

Axilla↗
PubMed1989

[Progress in evaluating lymphatic spread in cancer of rectum: endoscopic rectal lymphoscintigraphy].

The preoperative evaluation of lymphatic spread in rectal cancer constitutes a problem of difficult solution. A prospective study including 45 patients operated for rectal cancer, has been carried out in order to evaluate the diagnostic value of a new technique: The endoscopic rectal lymphoscintigraphy. The results of preoperative assessment were compared with histological date according to Dukes' classification (Dukes A/B: 22 cases, Dukes C: 23 cases). Analysis of these results allowed to accurate sensitivity (80%), specificity (73%) and accuracy (80%) of this new technique. Combined to endorectal ultrasonography, rectal lymphoscintigraphy might play an overwhelming role in characterising the indications for local excisions of small tumors; similarly, the effect of preoperative radiotherapy might be further evaluated.

Adenocarcinoma↗
PubMed1987

Lymphoscintigraphy of human colorectal carcinoma metastases in athymic mice by use of radioiodinated B72.3 monoclonal antibody.

The potential of radioiodinated monoclonal antibody B72.3 for lymphoscintigraphy was evaluated, using suitable animal models of a human colorectal carcinoma. LS174T xenografts were grown at various sites in beta-estradiol-pretreated athymic mice, and the development of metastases in different organs was assessed histologically. After iv inoculation of the mice, 66% of the animals developed "metastases" to the axillary lymph nodes. Of these mice, 100% also developed multiple tumors on their backs and 79% had lung micrometastases. Livers, kidneys, and spleens showed no evidence of tumor growth. In 33% of the mice in which primary LS174T tumors had been removed from the hindfoot pad, metastases to the popliteal lymph nodes were observed 3 1/2 weeks after tumor implantation. BALB/c (nu/nu) female mice bearing axillary and popliteal lymph node metastases were used to test the potential of radiolabeled B72.3 antibody (an IgG1) as a lymphoscintigraphic agent. A monoclonal antibody against horseradish peroxidase (also an IgG1), which did not bind LS174T tumor cells in vitro, served as a control. Both normal and tumor-bearing axillary and popliteal lymph nodes imaged up to 6 hours after the sc injection of 20-40 mu Ci of 125I-labeled B72.3 into either the forefoot or hindfoot pads. The localization index (L.I.) (specific/nonspecific antibody in tumor divided by specific/nonspecific antibody in blood) for LS174T tumors in lymph nodes was approximately 1 during the first 6 hours after antibody injection, thus indicating no specific antibody accumulation. Twenty-four hours and later after sc injection, images of nodal metastases (14-477 mg) and specific antibody accumulations were observed. At these times the L.I.'s ranged 1.5-3.5. Tumor-negative nodes did not image at 24 hours after injection of 125I-labeled B72.3. The L.I.'s of the normal nodes and of other tissues from these mice were about 1.0 at 24 hours, indicating no specific antibody accumulation. Autoradiographic analysis of lymph nodes containing LS174T tumor showed heterogeneous antibody distribution of B72.3 within tumor sections with heavy patches of antibody accumulation in mucin globules. In lymph nodes the normal lymphocytes adjacent to the LS174T tumor cells showed no antibody accumulation. The lack of specific, early antibody accumulation by LS174T tumor-bearing nodes in mice suggests that B72.3 does not accumulate in nodal metastases to the degree necessary to consider it a potential agent for use in lymphoscintigraphy.

Animals↗
PubMed1987

[On the lymphatics of the cardia--with special reference to the study of using endoscopic lymphoscintigraphy with SPECT].

Endoscopic lymphoscintigraphy was performed on 29 patients. In 15 of 29 cases, Single Photon Emission Computed Tomography (SPECT) was performed to observe the lymphatics of the cardia. The rate of detection of paraaortic lymph nodes by SPECT was 66.6%, and in particular the paraaortic lymph nodes in the upper portion of the left renal vein were detected at a rate of 58.3%. The ascending lymph flow from the cardia to the mediastinum could be depicted by SPECT. The SPECT images and the distribution of accumulation of Tc-99m Rhenium colloid into the regional lymph nodes indicated a similar tendency to the actual metastatic rate of carcinoma of the cardia. Endoscopic lymphoscintigraphy with SPECT is considered to be useful for imaging the lymph flow from the cardia to the regional lymph nodes. On the other hand, the conventional planar image was poor in depicting lymph nodes, and was impossible in dynamic analysis. In the early stage of carcinoma of the cardia, if the area limited, proximal gastrectomy seems reasonable, but in progressive and deepseated cancer, it is suggested that it is necessary to remove the lymph nodes in a wide area, including the paraaortic lymph nodes, in addition to performing total gastrectomy.

Adenocarcinoma↗
PubMed1987

The value of lymphoscintigraphy, lymphangiography and computer tomography scanning in the preoperative assessment of lymph nodes involved by pelvic malignant conditions.

In a preoperative study to identify accurately metastases to the lymph nodes within the pelvis and retroperitoneum, the three imaging techniques of pelvic interstitial lymphoscintigraphy, bipedal lymphangiography and computer tomography (CT) scanning were compared in 69 patients with carcinoma of the cervix uteri or rectum. Results were correlated with histologic node examination in all patients and each technique was assessed for sensitivity, specificity and over-all accuracy. Lymphoscintigraphy is too unreliable for routine use in the diagnosis or staging of pelvic malignant conditions. Lymphangiography detects involved lateral pelvic and para-aortic nodes but is unable to visualize the internal iliac or other medial pelvic nodes. CT scanning is only accurate if metastatic nodes are enlarged but may reveal other pathways of spread which will alter the surgical approach.

Adult↗
PubMed1987

Intraarticular lymphoscintigraphy of the human knee joint: a preliminary study.

Intraarticular (knee) lymphoscintigraphy using 99mTc-nanocoll was performed in five patients with chronic synovitis. Scintigrams from the anterior and lateral view of the knee and of the iliac region were taken 1, 2, 4, and 22 hours after injection. The inguinal and iliac lymph nodes uniformly visualized in about 2 hours. Based on radioactivity in regional lymph nodes measured at prescribed time intervals, we were able to quantify lymph drainage from the knee joint. Lymphoscintigraphy is without complication and discomfort and is potentially useful to study synovial fluid reabsorption in joint diseases.

Adult↗
PubMed1986

Prognostic value of axillary lymphoscintigraphy in breast carcinoma patients.

Axillary lymphoscintigraphy (AxLS) with bilateral interdigital injection of [99mTc]antimony sulfide colloid carried out concurrently with internal mammary lymphoscintigraphy in 488 patients with breast carcinoma was evaluated. Patterns of radiocolloid distribution within the ipsilateral axilla and supraclavicular fossa were compared with similar features on the contralateral side to determine whether image characteristics are significantly disrupted by prior surgery, reflect the presence of metastases, and can predict treatment failure. Interpretive criteria for AxLS were refined after correlation of the identified image components with clinical parameters including axillary surgery, lymph node histology and relapse within a follow-up period of 2 years from the study. Results indicate that AxLS is at least as accurate as clinical assessment and provides data predictive of relapse to complement axillary lymph node status although the technique cannot presently replace lymph node sampling for patient staging.

Adolescent↗
PubMed1986

[The value of breast lymphoscintigraphy in the definition of axillary staging in cancer of the breast].

Axillary lymphoscintigraphy (ALS) has been investigated in 51 patients with operable breast carcinoma between July 1982 and February 1984. Pre-operative intra-tumoral injection of 2.5 cm Ci of technetium 99 m antimony sulfide colloid has been performed before axillary dissection. We compared the scans produced by ALS with the results of pre-operative clinical examination of the axilla (UICC criterias) and to the histological status of the nodes surgically removed. We focused on the statistical methodology because, for us, most of the studies use inadequate tests. Axillary lymphoscintigraphy did not predict axillary metastase in breast cancer with precision. Its score was under clinical exam. Today, we are not allowed to abandon axillary dissection for pre-operative ALS. That simple and non traumatic examination appeared to be of no value in order to determine the axillary metastatic nodal status in breast cancer.

Axilla↗