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CT Based Lymphatic Mapping and Localization of Sentinel Lymph Node for Breast Cancer Patients

Author: YangLong
Tutor: WuZuo；PengWeiJun；LiuGuangYu；ZhangJiaXin
School: Fudan University
Course: Oncology
Keywords: Breast Cancer Sentinel lymph node CT lymphatic development (CT-LG) Locate
CLC: R737.9
Type: Master's thesis
Year: 2010
Downloads: 40
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Abstract

Objective: To evaluate the CT lymphangiography (LG) to show the feasibility of early breast cancer patients with sentinel lymph node (SLN). Analysis of CT imaging in sentinel lymph nodes with the traditional method of positioning the sentinel lymph node consistency; the observed positioning in the complications and adverse reactions; explore a simple operation, sentinel lymph node localization method easier to promote. Analysis of the relationship between CT lymph node imaging and postoperative clinical and pathological information. Methods: 25 cases puncture confirmed axillary palpation-negative breast cancer patients line CT-LG check. Drainage of lymphatic axillary direction pointing from the injection site on the first one or imaging lymph SLN. Breast tissue localization needle (interv.), of which 21 patients underwent CT-guided sentinel lymph node puncture positioning research. All patients underwent preoperative 24h the areola subcutaneous or the peritumoral injection isotope preoperative 5min areola subcutaneous or peritumoral injection Meilan. The surgical observed puncture lymph radionuclide uptake and blue dye. Postoperative analysis of CT imaging in sentinel lymph nodes, the results contrast with sentinel lymph node biopsy (SLNB), equal to the number in order to comply more and less than were overestimated and underestimated. Imaging quality based on the reorganization of the volume is divided into Ⅰ and Ⅱ lymph tube imaging; and body mass index (BMI) ≥ 25 were obese. Of results rows Fisher exact test. Results: The first part: all enrolled patients have at least found a sentinel lymph node. 21 positioning patients to obtain a total of 51 sentinel lymph node. The success rate of sentinel lymph node localization method, the sensitivity, specificity, and the traditional method consistency was 85.7% (18/21), 83% (5/6), 86.7% (13/15), 85.7% (18/21). During positioning and median follow-up of 10 months, no patients with any form of adverse reactions. CT positioning pin auxiliary outpost biopsy average time was shortened from 20 minutes to 16 minutes. Part II: (1) 25 patients, 5 cases of local excision surgery; BMI lt; 25 and 20 cases, and ≥ 25 were five cases. CT-LG, (2) 25 patients were seen SLN imaging, of which 84.0% (21 cases) the image quality in patients with grade Ⅰ, 16.7% (4 cases) for grade Ⅱ. Obese patients with CT-LG imaging quality is poor, the difference was statistically significant (P lt; 0.05). (3) 25 patients with a total of 56 SLN and 45 lymphatic. SLNB control, 36.0% (9 cases) in patients with two types of results, overestimation and underestimation, respectively, 28.0% (7 cases) and 36.0% (9 cases). The main reason the two results are inconsistent with the obesity factors and partial resection, both differences were statistically significant (P lt; 0.05). (4) SLNB negative SLN confirmed 18 cases (52), 7 patients (15) positive SLN, corresponding to a total of 56 CT-LG SLN imaging, including negative 43, positive 13. The shape round in the proportion of negative and positive SLN were 32.6% (14/43) and 76.9% (10/13), the difference was statistically significant (P lt; 0.05). Chuo filling defect in the proportion of negative and positive SLN were 9.3% (4/43) and 23.1 (3/13), but the edge of the area showed irregular filling defect only positive in 30.8% (4/13) SLN appear. 3 (2) SLN around with multiple small lymph nodes, histological tumor cell invasion. Conclusion: 1.CT guided sentinel lymph node mapping node positioning method with the traditional outpost of good consistency; 2.CT-LG with methylene blue to achieve than satisfied with the results of sentinel lymph node (90% success rate above); 3 CT Lymphoscintigraphy patients with obesity and lumps Bureau cut history there is a correlation, further study of the pathological diagnosis applications still require large sample.

CT Based Lymphatic Mapping and Localization of Sentinel Lymph Node for Breast Cancer Patients

Abstract

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