The Additional Value of SPECT/CT in Lymphatic Mapping in Breast Cancer and Melanoma

The recently introduced SPECT/CT integrates the physiologic data of SPECT with the anatomic data of CT into a single image. The purpose of this pilot studywas to explore the additional value of SPECT/CT in breast cancer patients and melanoma patients with inconclusive planar image findings. Methods: Thirty-one patients had planar lymphoscintigrams showing unexpected lymphatic drainage, 6 had lymphoscintigrams that were difficult to interpret, and 3 showed no drainage on planar imaging. SPECT/CT was performed immediately after delayed planar imaging. Results: In 4 patients, SPECT/CT showed 6 additional sentinel nodes, of which 2 were tumor-positive and led to upstaging and tailored management in 5 % of patients. SPECT/ CT depicted sentinel nodes in 3 patients whose delayed planar imaging had shown no drainage. Conclusion: SPECT/CT was of additional value in finding the exact anatomic location of sen-tinel nodes in patients with inconclusive planar image findings. SPECT/CT also detected sentinel nodes in addition to those found on planar images, and SPECT/CT detected sentinel nodes in patients whose planar images had shown none. Key Words: radionuclide imaging; breast neoplasms; mela-noma; sentinel lymph node biopsy; single-photon emission com-puted tomograph