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PubMed2004

X-ray absorption spectroscopy studies of reactions of technetium, uranium and neptunium with mackinawite.

Technetium, uranium and neptunium may all occur in the environment in more than one oxidation state (IV or VII, IV or VI and IV or V respectively). The surface of mackinawite, the first-formed iron sulfide phase in anoxic conditions, can promote redox changes so a series of laboratory experiments were carried out to explore the interactions of Tc, U and Np with this mineral. The products of reaction were characterised using X-ray absorption spectroscopy. Technetium, added as TcO4(-), is reduced to oxidation state IV and forms a TcS(2)-like species. On oxidation of the mackinawite in air to form goethite, Tc remains in oxidation state IV but in an oxide, rather than a sulfide environment. At low concentrations, uranium forms uranyl surface complexes on oxidised regions of the mackinawite surface but at higher concentrations, the uranium promotes surface oxidation and forms a mixed oxidation state oxide phase. Neptunium is reduced to oxidation IV and forms a surface complex with surface sulfide ions. The remainder of the Np coordination sphere is filled with water molecules or hydroxide ions.

Environmental Monitoring↗
PubMed2005

Optimisation of sampling for the temporal monitoring of technetium-99 in the Arctic marine environment.

Monitoring of the marine environment for radioactivity, for both radiological protection and oceanographic purposes, remains an expensive and labour intensive activity due to the large sample volumes needed and the complex and lengthy analytical procedures required to measure low levels of contamination. Because of this, some consideration must be given to the design of sampling plans to ensure effective and efficient sampling that can be defended on the basis of scientific rationale. This article tests the hypothesis that geostatistical techniques may prove of use in the optimisation and design of sampling regimes for the monitoring of temporal fluctuations in the levels of technetium at a location in the Norwegian Arctic marine environment. The level of temporal correlation exhibited by two relevant time series was investigated and the information used to observe the effect of sampling frequency on the production of monthly estimates of activity of technetium in both seawater and seaweed. The results indicate that reduced sampling frequency allows production of estimates that acceptably replicate the actual data and that use of geostatistical procedures may offer advantages in the planning of monitoring systems for marine radioactivity. The use of an oceanographic model was also investigated as a means of assessing the temporal correlation prior to actual sampling, an approach that may offer significant advantages by reducing the need to have lengthy time series prior to designing sampling regimes.

Arctic Regions↗
PubMed2006

The behaviour of technetium during microbial reduction in amended soils from Dounreay, UK.

Radioactive technetium-99 forms during nuclear fission and has been found as a contaminant at sites where nuclear wastes have been processed or stored. Here we describe results from microcosm experiments containing soil samples representative of the UKAEA site at Dounreay to examine the effect of varying solution chemistry on the fate of technetium during microbial reduction. Analysis of a suite of stable element redox indicators demonstrated that microbial activity occurred in a range of microcosm experiments including unamended Dounreay sediments, carbonate buffered sediments, and microcosms amended with ethylenediaminetetraacetic acid (EDTA) a complexing ligand used in nuclear fuel cycle operations. During the development of anoxia mediated by indigenous microbial populations, TcO4- was removed from solution in experiments. In all cases, the removal of TcO4- from solution occurred during active microbial Fe(III)-reduction when Fe(II) was growing into the microcosms. Tc removal was most likely via reduction of TcO4- to poorly soluble Tc(IV) which is retained on the sediments. The potential stability of Tc associated with the soil to remobilisation via complexation with EDTA was examined as reduced Tc-labelled sediments were contacted with a de-oxygenated EDTA solution. No remobilisation of Tc(IV) in the presence of EDTA was observed.

Bicarbonates↗
PubMed1991

Physiological basis of myocardial perfusion imaging with the technetium 99m agents.

In recent years, several technetium 99m-labeled myocardial perfusion agents have been under investigation to determine their utility in assessing regional myocardial blood flow and cellular viability. 99mTc sestamibi (2-methoxyisobutyl isonitrile), one of the most promising of these agents, is a lipophilic cation that is sequestered largely within mitochondria by the large negative transmembrane potential. Experimental studies have shown that this agent is taken up in the myocardium in proportion to blood flow, but like other diffusible radionuclides underestimates flow at high flow rates. Fractional extraction (Emax) for 99mTc sestamibi is lower than that for thallium 201, but net myocardial uptake is comparable between the two radionuclides. Compared with 201Tl, 99mTc sestamibi does not significantly redistribute. Studies have shown that 99mTc sestamibi uptake after reperfusion, preceded by varying periods of coronary occlusion, reflects the degree of myocardial salvage and viability. 99mTc teboroxime, another promising new perfusion agent, is a boronic acid adduct of technetium dioxime complexes. Emax of 99mTc teboroxime is higher than Emax for 201Tl, but myocardial washout is very rapid (half-life = 21 minutes). Myocardial uptake is proportional to regional flow as found with 99mTc sestamibi and 201Tl.

Coronary Circulation↗
PubMed1991

Technetium 99m sestamibi in the assessment of chronic coronary artery disease.

Extensive work has already been performed with regard to both planar and single photon emission computed (SPECT) technetium 99m sestamibi studies. Before widespread application of optimized acquisition and processing methods, clinical results between 99mTc sestamibi and thallium 201 were remarkably similar. It is anticipated that as techniques for 99mTc sestamibi planar and SPECT imaging become optimized, improvements in sensitivity and specificity for detection of coronary artery disease, over those observed with 201TI, might be forthcoming. This expectation is based on the improved image quality inherent in the use of the 99mTc agent with its higher count rate and higher energy. This improvement in image quality may be a principal reason for laboratories to switch from 201TI to 99mTc sestamibi imaging. It is anticipated that, with improved imaging characteristics, it will be easier for the average community hospital to obtain higher quality planar or SPECT imaging using 99mTc sestamibi rather than 201TI. In addition to improved image quality, the characteristics of 99mTc sestamibi allow gated planar or SPECT perfusion images to be obtained. It has been suggested that stress-gated SPECT sestamibi studies may provide all the information contained in a stress-rest nongated 99mTc sestamibi study, thereby potentially increasing patient throughput, a major concern with SPECT. Throughput can also be increased by using dual-isotope approaches with rest 201TI and stress technetium sestamibi acquisitions, employing either separate or simultaneous imaging with which the entire study can be accomplished in less than 2 hours. With simultaneous dual-isotope acquisition, camera time can be reduced by 50%. Finally, 99mTc sestamibi offers the advantage of the ability to perform first-pass exercise ventricular function and SPECT myocardial perfusion studies with a single injection of tracer. Regarding the assessment of myocardial viability, results to date suggest a very high degree of concordance between 201TI and 99mTc sestamibi studies using either planar or SPECT acquisition techniques. Correlative rest studies with both tracers will be of particular interest, as will preoperative and postoperative and position emission tomography correlation studies.

Aged↗
PubMed2003

Comparison of usefulness of dipyridamole stress myocardial contrast echocardiography to technetium-99m sestamibi single-photon emission computed tomography for detection of coronary artery disease (PB127 Multicenter Phase 2 Trial results).

We hypothesized that assessment of hyperemic myocardial blood flow (MBF) velocity using myocardial contrast echocardiography (MCE) can detect coronary artery disease (CAD). We also postulated that only a single MCE study during stress is required for the detection of CAD in patients with normal function at rest. Patients with known or suspected CAD referred for dipyridamole stress technetium-99m sestamibi single-photon emission computed tomographic (SPECT) studies were enrolled. MCE was performed concurrently with SPECT using continuous infusions of PB127 during intermittent harmonic power Doppler imaging at multiple pulsing intervals. MCE and SPECT were compared in 43 of 54 patients who had adequate studies using both techniques. In 15 of the 43 patients, coronary angiography was performed within 30 days of the MCE/SPECT tests. Overall concordance for classification of patients as normal versus abnormal was 84% (kappa = 0.63) between the 2 tests. When false-negative SPECT scans were corrected for results of angiography, concordance increased to 93% (kappa = 0.82). For territorial analysis, concordance between MCE and SPECT for location of perfusion defects was 65% (kappa = 0.41) and 74% (kappa = 0.61) after SPECT was corrected by angiography. In patients with normal function at rest, a single stress MCE perfusion study allowed identification of CAD with the same concordance as rest/stress perfusion studies. In conclusion, visual assessment of regional differences in MBF velocity using PB127 allows detection of CAD with good concordance compared with technetium-99m sestamibi SPECT. In patients with normal left ventricular function at rest, a single stress PB127 MCE perfusion study is adequate for the detection of CAD.

Adult↗
PubMed1991

Myocardial perfusion imaging with technetium-99m-labeled agents.

Thallium-201 (201Tl) is suboptimal as a single-photon emitting agent for myocardial perfusion imaging, in view of its low-energy photons and long half-life. To circumvent these limitations, two new myocardial perfusion imaging agents labeled with technetium-99m (99mTc) have been developed. They are Tc-sestamibi and Tc-teboroxime. Clinical trials of myocardial perfusion with both tracers have shown results similar to those obtained with 201Tl for detection of coronary artery disease. Results to date indicate that Tc-sestamibi accurately detects and locates myocardial infarction and can accurately assess both left and right ventricular ejection fractions by the first-pass technique. In addition, research has shown that rest-stress studies can be performed on the same day and that Tc-sestamibi can be used to assess the results of thrombolytic therapy. Tc-teboroxime has excellent myocardial tracer uptake characteristics but is cleared very rapidly from the myocardium. These features make Tc-teboroxime well suited to rapid serial studies. These new technetium myocardial perfusion agents have just become available for routine clinical use and are likely to replace 201Tl in many of its clinical applications.

Animals↗
PubMed1997

Identification of severe or extensive coronary artery disease in women by adenosine technetium-99m sestamibi SPECT.

To assess the ability of adenosine technetium-99m sestamibi myocardial perfusion single-photon emission computed tomography (SPECT) to identify high-risk women with severe or extensive coronary artery disease (CAD), we studied 130 consecutive women who underwent adenosine sestamibi myocardial perfusion SPECT and catheterization within 2 months. Severe (> or = 50% stenosis of left main coronary artery, > or = 90% stenosis in the proximal left anterior descending or in > or = 2 coronary arteries) or extensive (> or = 70% stenosis in 3 vessels) CAD was present in 54 patients, whereas 76 had no CAD or mild to moderate CAD. Semiquantitative visual SPECT analysis used 20 segments and a 5-point scoring system (0 = normal, 4 = absent uptake). Among the clinical, hemodynamic and nuclear variables analyzed, univariate predictors of severe or extensive CAD included a higher prescan likelihood of CAD, history of myocardial infarction, a higher heart rate at rest, a lower increase in heart rate during adenosine infusion, a higher summed stress score, summed reversibility score, and multivessel scan abnormality. Multivariate logistic analysis of the most predictive clinical (prescan likelihood of CAD), hemodynamic (increase in heart rate during adenosine infusion), and scan variables (summed stress score) revealed summed stress score (chi-square = 32; p <0.0001) and prescan likelihood of CAD (chi-square = 6.4; p <0.05) as the only independent predictors of severe or extensive CAD. Based on these logistic models, we determined the probability for the presence of severe or extensive CAD in patients with low, intermediate, and high prescan likelihood of CAD across the range of values of a summed stress score. This revealed that there were incremental increases in the probability for severe or extensive CAD both as a function of prescan likelihood of CAD and summed stress score. A severely abnormal scan (summed stress score > 8) during adenosine technetium-99m sestamibi myocardial perfusion SPECT had a high sensitivity of 91% and a moderately high specificity of 70% for identifying high-risk women with severe or extensive CAD. These results coupled with the previously defined prognostic significance of these findings suggest this test to be a useful diagnostic tool for the evaluation of CAD in women.

Adenosine↗
PubMed1995

Use of exercise technetium-99m sestamibi SPECT imaging to detect residual ischemia and for risk stratification after acute myocardial infarction.

The clinical presentation, electrocardiographic findings, and technetium-99m sestamibi single-photon emission computed tomography (SPECT) imaging results of 134 consecutive patients who underwent nuclear exercise testing within 14 days of an acute myocardial infarction (AMI) were correlated with cardiac events over a 15 +/- 10-month follow-up. Whereas only 23 patients (17%) had chest pain and 31 (23%) had ischemic ST-segment depression during exercise, 94 (70%) had ischemia on SPECT (p < 0.001). On follow-up, 13 patients experienced a cardiac event: 7 were rehospitalized for unstable angina, 3 had recurrent AMI, and 3 died of cardiac causes. Ischemia on the sestamibi images identified 11 of these patients (85%), whereas chest pain identified only 3 (23%, p = 0.006), and electrocardiographic ischemia identified only 4 (31%, p = 0.017). The presence of either ischemia as seen on SPECT or defects in multiple vascular territories identified 12 patients (92%) with an event, including all who had cardiac death. By Cox regression analysis of clinical, stress, and image parameters, the number of ischemic defects on SPECT was the only significant correlate of a future event (chi-square = 4.62, p = 0.03), and patients with > or = 3 reversible sestamibi defects had an event rate of 38%. The extent of ischemia as seen on nuclear imaging remained a strong correlate (p = 0.008) of an event in the 54 patients (40%) who had received thrombolytic therapy. Thus, exercise technetium-99m sestamibi SPECT after AMI frequently reveals residual ischemia, and is better than clinical data, symptoms, and stress electrocardiographic data in identifying patients who will have a subsequent cardiac event.

Aged↗
PubMed2003

International prospective evaluation of scintimammography with (99m)technetium sestamibi.

BACKGROUND: The purpose of this study is to evaluate the efficacy of scintimammography with (99m)Technetium-Sestamibi for the diagnosis of breast cancer. METHODS: This was a multicenter prospective cohort clinical trial. A total of 1,734 women were enrolled of whom 1,243 had complete data upon study completion. RESULTS: The mean +/- standard error age of the patients is 56 +/-12 years (with a range of 19 to 94). Mammographic results were classified by the Breast Imaging Reporting and Data System (BIRADS) as 199 (16%) BIRADS 5, 149 (12%) BIRADS 4, 199 (16%) BIRADS 3, and 696 (56%) BIRADS 2 or 1. Scintimammography was positive for 322 (26%) of the patients and negative for 921 (76%). Histopathology showed malignancy for 201 (16%) of the patients. Sensitivity and specificity of scintimammography was estimated 93% and 87% respectively. A positive predictive value (PPV) of 58% with a negative predictive value of 98% were calculated. CONCLUSIONS: The present study suggests that scintimammography with (99m)Technetium-Sestamibi is highly accurate for the detection of breast cancer.

Adult↗
PubMedDate not supplied

Scintigraphic evaluation of tumors metastatic to the choroid using technetium-99m(V)-dimercaptosuccinic acid.

Technetium-99m(V)-dimercaptosuccinic acid scintigraphy was used to evaluate three patients with intraocular tumors who had metastatic breast, lung, and rectal carcinomas, respectively. At the time of initial examination, two patients had no known systemic cancer, but the scintigraphy results in one patient revealed the primary site and were highly suggestive of disseminated carcinomatosis in the other patient. In the third patient, scintigraphy was successful to confirm very small bilateral intraocular tumors and also other systemic lesions. Technetium-99m(V)-dimercaptosuccinic acid scintigraphy can be reliably employed in a very select group of patients with intraocular tumors where metastatic carcinoma is a serious diagnostic possibility against a primary intraocular malignancy. This safe and promising tumor-imaging agent has the ability to demonstrate the ocular lesions and other systemic foci simultaneously, information that would prove to be crucial in both the diagnosis and the management of the patient.

Adenocarcinoma↗
PubMed1996

Renal oncocytoma: preoperative diagnosis using technetium 99m sestamibi imaging.

OBJECTIVES: To determine if 99mTc-sestamibi (technetium 99m-methoxyisobutylisonitrile) can be used preoperatively to differentiate renal oncocytomas from other renal masses. METHODS: We performed 99mTc-sestamibi scans on 6 patients with various renal masses, using a standard technique. The diagnosis in each patient was determined either by radiologic methods. RESULTS: There was significantly increased uptake in the patient with the renal oncocytoma, whereas the other lesions had decreased uptake in comparison to normal kidney. This was determined visually and by mean pixel analysis. CONCLUSIONS: Technetium 99m sestamibi scanning appears to have a potential role in the nonoperative diagnosis of renal oncocytomas, in combination with pathologic fine-needle biopsy confirmation. More definitive pathologic experience is required before recommending standard use.

Adenoma, Oxyphilic↗
PubMed1980

Non-invasive estimation of duodenogastric reflux using technetium-99m p-butyl-iminodiacetic acid.

Post-gastrectomy symptoms of dyspepsia, epigastric pain, nausea, and bilious vomiting have been ascribed to duodenogastric reflux. A noninvasive method, using the radiopharmaceutical technetium-99m p-butyl-iminodiacetic acid, has been developed to observe biliary excretion scintigraphically and to monitor its excretion. 10 controls and 45 patients after stomach operations were given the radiopharmaceutical intravenously and were scanned every 5 min for an hour, after which the site of the stomach was determined by asking the patient to drink technetium-99m in solution. Reflux was noted in 1 control, in 4 of 13 patients after highly selective vagotomy, in 8 of 17 patients following truncal vagotomy and pyloroplasty, and in all of 15 patients after gastrectomy. The mean quantities of reflux in these four groups were 5%, 3.75%, 12.4%, and 44%, respectively. The study confirms that post-gastrectomy patients are more prone to enterogastric reflux and suggests that this form of scintigraphy may produce valuable clinical information.

Bile Reflux↗
PubMed2001

Technetium-99 in the Irish marine environment.

Technetium-99 activity concentrations in seawater and biota from Irish coastal waters are presented. Time series measurements of 99Tc in seawater and Fucus vesiculosus from the western Irish Sea show that activity concentrations have increased in line with the increase in discharges of 99Tc from Sellafield. The peak in activity concentrations in both seawater and Fucus vesiculosus occurred in 1997 approximately two years after the peak in 99Tc discharges. The highest activity concentration recorded in Fucus vesiculosus showed a 29-fold increase over the mean concentration for the period 1988-1993. Technetium-99 activity concentrations were measured in fish, lobsters, prawns, mussels and oysters landed at major fishing ports on the east and northeast coasts of Ireland between 1996 and 1998. Concentration factors for 99Tc in the brown seaweed Fucus vesiculosus and certain species of fish, crustaceans and molluscs from the Irish Sea were estimated. In general, these concentration factors were higher than those in the literature which were derived from laboratory studies, but agreed well with values which were based on field studies. The mean committed effective doses to Irish typical and heavy seafood consumers due to 99Tc in the period 1996-1998 were 0.061 and 0.24 microSv, respectively.

Animals↗
PubMed1991

Primary angioplasty in myocardial infarction: assessment of improved myocardial perfusion with technetium-99m isonitrile.

Technetium-99m-hexakis-2-methoxy-2-isobutyl-isonitrile (technetium-99m isonitrile) is a new radiopharmaceutical compound that reflects myocardial perfusion. Its kinetics, especially its lack of redistribution after intravenous administration, permits the assessment of changes in myocardial perfusion without delay of therapy. Tomographic images at rest were obtained immediately and 6 to 10 days later in 17 consecutive patients undergoing successful primary angioplasty during their first transmural myocardial infarction. Thirteen patients had anterior infarction. The initial (acute) defect size before angioplasty of 48 +/- 17% of the left ventricle decreased significantly (p less than 0.0001) to 29 +/- 19% on the late scans. There was no correlation between the time to therapy and the reduction in defect size. Twelve of the 17 patients, including 7 of the 11 patients treated after 4 h, demonstrated a definite reduction in the initial defect size. Eight patients with angiographically proved persistent coronary occlusion underwent a similar imaging sequence. The initial defect size in this group remained unchanged on the late scans (24 +/- 16% versus 26 +/- 18%, p = NS). Primary angioplasty is an effective approach toward salvaging myocardium; comparison with thrombolytic drug therapy must await the results of controlled clinical trials.

Angioplasty, Balloon, Coronary↗
PubMed1991

Effect of infarct location on myocardial salvage assessed by technetium-99m isonitrile.

To investigate the influence of infarct location on myocardial salvage, technetium-99m isonitrile was injected into 43 patients with a first myocardial infarction before early reperfusion therapy. Primary coronary angioplasty was performed in 22 patients and successful intravenous thrombolytic therapy was given to 15 patients, both within 6 h of the onset of chest pain. Patency of the infarct-related artery was confirmed by angiography in all 37 patients. In the remaining six patients (three with and three without early thrombolytic therapy) the infarct-related artery remained occluded. Single photon emission computed tomography was performed within 6 h of the administration of technetium-99m isonitrile and repeated at the time of hospital discharge. Radionuclide ejection fraction at discharge was significantly lower for patients with anterior infarction (0.41 +/- 0.12) than for those with inferior infarction (0.56 +/- 0.09, p less than 0.001). Early perfusion defect size, a measure of myocardium at risk, was greater in patients with anterior than in those with inferior infarction (52 +/- 9% vs. 18 +/- 10% of the left ventricle, p = 0.0001) as was final defect size (30 +/- 20% vs. 9 +/- 8%, p less than 0.01). The change in myocardial perfusion, an estimate of myocardial salvage, was also greater in patients with anterior infarction (24 +/- 16% vs. 10 +/- 7%, p less than 0.01). However, the proportion of jeopardized myocardium salvaged (salvage index) was not significantly different between patients with anterior or inferior infarction (0.49 +/- 0.34 vs. 0.59 +/- 0.35, p = NS).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

The specificity of technetium-labelled-leucocyte imaging of aortic grafts in the early postoperative period.

Radio-labelled-leucocyte imaging is becoming accepted as the investigation of choice when infection of prosthetic arterial bypass grafts is suspected. However, alternative sources of inflammation, such as haematoma and, perhaps, the healing and incorporation of newly inserted bypass grafts, are potential causes of false positive results. This study examines the use of technetium-labelled-leucocyte imaging during the postoperative in-hospital period following aortic bypass surgery. Two labelled-leucocyte scans were carried out serially in 20 patients randomly allocated to receive either of two types of Dacron aortic graft in regular use. The earlier scans were undertaken at 2-5 days after surgery and only two of these scans were positive. None of the later scans, undertaken at 7-10 days after surgery, was positive. None of the patients had a graft injection as evidenced by clinical features, leucocyte counts, and C-reactive protein measurements. These results suggest that recent surgery does not in itself significantly reduce the specificity of technetium-labelled-leucocyte imaging.

Aged↗
PubMed2002

Concordance and validation study of sentinel lymph node biopsy for breast cancer using subareolar injection of blue dye and technetium 99m sulfur colloid.

BACKGROUND: We have previously demonstrated the utility, accuracy, and advantages of a subareolar (SA) site of injection for blue dye compared with an intraparenchymal site. In later studies we advocated the additional use of preoperative SA-injected technetium 99m-labeled sulfur colloid as a directional aid in finding blue-stained sentinel lymph nodes (SLNs). Paramount to the usefulness of this dual-tracer, same-site technique is the degree to which SA-injected blue dye and SA-injected radiocolloid migrate concordantly and are deposited within the same sentinel nodes. The purpose of this study was to document the correlation and accuracy of SLN biopsy using blue dye and radiocolloid when both nodal markers are injected by the same SA route. STUDY DESIGN: Between September 1999 and February 2002 (29 months), 185 consecutive patients with 187 operable breast cancers underwent 187 attempted SLN biopsies by a dual-tracer, same-site injection technique using the SA approach for both agents. Unfiltered technetium 99m-labeled sulfur colloid (1 mCi [37 MBq]) was SA-injected 30 to 45 minutes preoperatively; and just after anesthetic induction, 3 mL of 1% isosulfan blue dye was injected by the same SA route. SLN biopsies or complete axillary dissections were carried out, and SLNs identified during these procedures were classified as containing both blue dye and radioactivity ("blue-hot" nodes), radioactivity alone ("hot-only" nodes), or blue dye alone ("blue-only" nodes). Cases were categorized and tabulated based on the presence or absence of these three types of SLNs. RESULTS: Of the 187 procedures, a SLN was identified successfully in 184 cases, indicating an SLN identification rate of 98.4% (95% confidence interval, 96.6% to 100.2%). In these 184 cases, a blue-hot node was present in 94.5% (n = 174 of 184). An SLN was positive in 50 cases, or 27.2% of the total group (n = 50 of 184). A blue-hot node was the only positive SLN in 43 of these 50 cases, or 86% of the node-positive cases. There were no false negatives in 20 confirmatory axillary node dissections carried out to document the findings of a negative SLN. A correlation analysis revealed that in 98.9% of cases (174 of 176), blue nodes were also radioactive ("blue-hot" case concordance = 98.9%). In 95.1% of cases (174 of 183), hot nodes had also taken up blue dye ("hot-blue" case concordance = 95.1%). CONCLUSIONS: Using SA injections of both blue dye and radiocolloid, we achieved an SLN identification rate of 98.4% (184 of 187 cases), a false-negative rate of 0% (0 of 20 cases), and an accuracy in predicting the malignant status of the axilla of 100% (70 of 70 cases). The case concordance rate ranged between 98.9% ("blue-hot concordance") and 95.1% ("hot-blue concordance"). The present study is the first to evaluate dual-tracer, same-site SA injections of blue dye and radiocolloid. By demonstrating a high case concordance rate, a high SLN identification rate, and a 0% false-negative rate, this study adds further support to the validity and accuracy of same-site SA injections of both blue dye and radiocolloid during SLN biopsy in breast cancer.

Adult↗