Abstract：
BACKGROUND: Freehand SPECT can be a useful imaging technique for preoperative planning of sentinel lymph node biopsy (SLNB) as it allows localization of the sentinel node by 3D and real-time tomographic imaging and determines its depth after a few minutes of scanning. The aim of the study was to evaluate the correlation between the number of detected SNs between freehand SPECT images and lymphoscintigraphy (LS).
METHODS: 100 patients with a diagnosis of invasive breast cancer and no clinical evidence of lymph node involvement prospectively underwent SLNB. The preoperative study included freehand SPECT imaging at 15min after injection and LS imaging at 25 and 60-90min after injection (early and late). The observed agreement was analyzed and a concordance study was performed between the number of SNs detected with freehand SPECT and LS.
RESULTS: The observed agreement in the detection of SNs between freehand SPECT and early LS was 72%; between freehand SPECT and late LS was 85%; and between early and late LS was 87%. In the concordance study, there was moderate concordance between freehand SPECT and early LS (kappa coefficient: 0.42); moderate-high concordance between freehand SPECT and late LS (kappa coefficient: 0.60); and moderate-high concordance between early and late LS (kappa coefficient: 0.70), with no significant differences between them (p-value=0.16).
CONCLUSIONS: Freehand SPECT showed a moderate-high concordance with conventional imaging studies and could be a valid alternative for the presurgical study of SLNB in breast cancer.
METHODS: 100 patients with a diagnosis of invasive breast cancer and no clinical evidence of lymph node involvement prospectively underwent SLNB. The preoperative study included freehand SPECT imaging at 15min after injection and LS imaging at 25 and 60-90min after injection (early and late). The observed agreement was analyzed and a concordance study was performed between the number of SNs detected with freehand SPECT and LS.
RESULTS: The observed agreement in the detection of SNs between freehand SPECT and early LS was 72%; between freehand SPECT and late LS was 85%; and between early and late LS was 87%. In the concordance study, there was moderate concordance between freehand SPECT and early LS (kappa coefficient: 0.42); moderate-high concordance between freehand SPECT and late LS (kappa coefficient: 0.60); and moderate-high concordance between early and late LS (kappa coefficient: 0.70), with no significant differences between them (p-value=0.16).
CONCLUSIONS: Freehand SPECT showed a moderate-high concordance with conventional imaging studies and could be a valid alternative for the presurgical study of SLNB in breast cancer.
摘要：
背景：徒手SPECT可以是一种用于前哨淋巴结活检（SLNB）术前规划的有用成像技术，因为它允许通过3D和实时断层成像定位前哨淋巴结，并在扫描几分钟后确定其深度。该研究的目的是评估徒手SPECT图像与淋巴闪烁显像（LS）之间检测到的SN数量之间的相关性。
方法：100例诊断为浸润性乳腺癌且无淋巴结受累的临床证据的患者接受SLNB治疗。术前研究包括注射后15分钟的徒手SPECT成像和注射后25和60-90分钟的LS成像（早期和晚期）。分析了观察到的一致性，并在徒手SPECT和LS检测到的SN数量之间进行了一致性研究。
结果：徒手SPECT和早期LS之间在SNs检测中观察到的一致性为72％；徒手SPECT和晚期LS之间的一致性为85％；早期和晚期LS之间的一致性为87％。在一致性研究中，徒手SPECT和早期LS之间存在中等一致性（kappa系数：0.42）；徒手SPECT和晚期LS之间存在中等高度一致性（kappa系数：0.60）；早期和晚期LS之间存在中等高度一致性（kappa系数：0.70）。它们之间没有显著差异(p值=0.16)。
结论：徒手SPECT显示与常规影像学检查的中度-高度一致性，可能是乳腺癌SLNB术前研究的有效替代方法。
方法：100例诊断为浸润性乳腺癌且无淋巴结受累的临床证据的患者接受SLNB治疗。术前研究包括注射后15分钟的徒手SPECT成像和注射后25和60-90分钟的LS成像（早期和晚期）。分析了观察到的一致性，并在徒手SPECT和LS检测到的SN数量之间进行了一致性研究。
结果：徒手SPECT和早期LS之间在SNs检测中观察到的一致性为72％；徒手SPECT和晚期LS之间的一致性为85％；早期和晚期LS之间的一致性为87％。在一致性研究中，徒手SPECT和早期LS之间存在中等一致性（kappa系数：0.42）；徒手SPECT和晚期LS之间存在中等高度一致性（kappa系数：0.60）；早期和晚期LS之间存在中等高度一致性（kappa系数：0.70）。它们之间没有显著差异(p值=0.16)。
结论：徒手SPECT显示与常规影像学检查的中度-高度一致性，可能是乳腺癌SLNB术前研究的有效替代方法。
