SPECT–CT Fusion Imaging Radionuclide Lymphoscintigraphy: Potential for Limb Lymphedema Assessment and Sentinel Node Detection In Breast Cancer

  • Alain P. Pecking
  • W. Wartski
  • R. V. Cluzan
  • D. Bellet
  • J. L. Albérini
Part of the Cancer Treatment and Research book series (CTAR, volume 135)

Radionuclide lymphoscintigraphy (RNL) has progressively superseded lymphangiography and may be considered as the most advanced method for the assessment of the limb lymphatic system (1, 2).As a safe, noninvasive, and physiological method, RNL is commonly used in lymphology for the evaluation of limb lymphedemas and in oncology for the detection of the sentinel node (SN) (3, 4).However, conventional planar imaging sometimes failed to preoperatively identify the exact localization of the detected lymph nodes (5). Since 2000 (6), hybrid cameras combining a dual head gamma camera with a low-dose radiograph tube mounted on the same gantry were developed, and image fusion has been successfully introduced in clinical practice.We report our experience of this new imaging method in lymphology and oncology, particularly for the SN detection in patients with breast cancer.


Sentinel Node Sentinel Node Mapping Popliteal Node Sentinel Node Detection Dual Head Gamma Camera 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Pecking AP, Cluzan RV, Desprez-Curely JP, Guérin P.: (1986) Functional study of the limb lymphatic system. Phlebology 1, 129–133.Google Scholar
  2. 2.
    Pecking AP, Cluzan RV, Desprez-Curely JP, Guérin P.: (1986) Indirect lymphoscintigraphy in patients with limb edemas. Phlebology 1, 215–217.Google Scholar
  3. 3.
    Monon DL, Wen DR, Wong JH, et al: (1992) Technical details of intraoperative lymphatic mapping for early Stage melanoma. Arch Surg 127:392–399.Google Scholar
  4. 4.
    Krag DN, Weaver DL, Alex JC, et al: (1993) Surgical resection and radiolocalization of the sentinel lymph node in breast cancer using a gamma probe. Surg OncoI2:335–340.Google Scholar
  5. 5.
    Hill AD, Tran KN, Akhursl T, et al: (1999) Lessons learned from 500 cases of lymphatic mapping for breast cancer. Ann Surg 229:528–535.PubMedCrossRefGoogle Scholar
  6. 6.
    Bocher M, Balan A, Krausz Y, et al: (2000) gamma camera mounted anatomical Xray tomography: technology, system characteristic and first images. Eur J Nucl med 27:619–627 2000.PubMedCrossRefGoogle Scholar
  7. 7.
    Kretschmer T, Altenvoerde G, Meller J, et al: (2003) Dynamic Iymphoscintigraphy and image fusion of SPECT and pelvic CT-scans allow mapping of aberrant pelvic sentinel lymph nodes in mahgnam melanoma. Eur J Cancer 39:175–183.PubMedCrossRefGoogle Scholar
  8. 8.
    Even-Sapir E, Leonan H, Lievshitz G, et al: (2003) Lymphoscintigraphy for sentinel node mapping using a hybrid SPECT/CT system. J Nucl Med 44:1413–142.PubMedGoogle Scholar
  9. 9.
    Wagner A, Schicho K, Glaser C, et al: (2004) SPECT–CT for topographic mapping of sentinel lymph nodes prior to gamma probe-guided biopsy in head and neck squamous cell carcinoma. J Craniomaxillofac Surg 32:343–349.PubMedGoogle Scholar
  10. 10.
    Kizu H, Takayama T, Fukuda M, et al: (2005) Fusion of SPECT and multidetector CT images for accurate localization of pelvic sentinel lymph nodes in prostate cancer patients. J. Nucl Med Technol 33:78–82.PubMedGoogle Scholar
  11. 11.
    Zhang WJ, Zheng R, Wu LY, et al: (2006) Clinical application of sentinel lymph node detection to early stage cervical cancer. Ai Zheng 25:224–228.PubMedGoogle Scholar
  12. 12.
    Sherif A, Garske V, Torre Mde L, et al: (2006) Hybrid SPECT. CT: an additional technique for sentinel node detection of patients with invasive bladder cancer. Eur Urol 50:83–91.PubMedCrossRefGoogle Scholar
  13. 13.
    Lerman H, Metser U.l, Lievshitz G, et al: (2006) lymphoscintigraphic sentinel node identification in patients with breast cancer: the role of SPECT–CT Eur Nucl Med Mol Imaging 33:329–337.Google Scholar
  14. 14.
    Husarik DB, Steinert HC. (2007) Single Photon Emission Tomography/Computed Tomography for sentinel node mapping in breast cancer. Semin Nucl Med. 37:29–33.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Alain P. Pecking
    • 1
  • W. Wartski
    • 1
  • R. V. Cluzan
    • 1
  • D. Bellet
    • 1
  • J. L. Albérini
    • 1
  1. 1.Centre Rene HugueninFrance

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