유방특이감마영상검사에서 액와부 영상 획득 방법에 대한 연구

Technical Details Imaging Axillary Lymph Nodes in Breast-Specific Gamma Imaging

Purpose : The initial Breast-Specific Gamma Imaging (BSGI) protocol included bilateral breast imaging with 2 views of each breast-craniocaudal (CC) and mediolateral oblique (MLO). Furthermore, Axillary lymph nodes view can be acquired easily. The most meaningful prognosis factor for prediction of breast cancer is whether or not the breast cancer has metastasized to the lymph nodes. However, axillary view doesn't conduct in clinical. This article collates a diverse data of BSGI and describes technical details to acquire optimal imaging. Materials and Methods : A retrospective review was performed on 343 patients who had undergone BSGI between May 2011 and March 2012. Patients who had undergone BSGI received intravenous injection of 740 MBq (20 mCi) ⁹⁹ᵐTc-sestamibi. Results : The following contents are the technical details for optimal axillary imaging. ⁹⁹ᵐTc-sestamibi should be administered using an indwelling venous catheter or scalp needle followed by 10 cc of saline to flush to reduce extravasation and vascular trapping. After administration, patients raise their arm over their head and exercise with stress ball for 1 full minute. A lead shield attached to the gamma camera is removed and patients axilla is placed as close as possible to the camera at a 90° angle. A lead apron is placed across the shoulder to reduce background from other organs. Acquisition time is enough for 120 sec~180 sec. Conclusion: If patients undergo bilateral axillary imaging as a standard with CC, MLO views, it could improve cancer treatment. Result of this study could maximize efficiency axillary imaging of breast cancer patients.