Use of lymphoscintigraphy in radiation treatment of primary breast cancer in the context of lymphedema risk reduction

Indra J. Das, Andrea L Cheville, Joshua Scheuermann, Shyam M. Srinivas, Abass Alavi, Lawrence J. Solin

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Purpose: The goal of this study was to determine the feasibility of SPECT/CT scintigraphic method for mapping lymphatic drainage for radiation therapy of breast cancer. Materials and methods: Thirty-six patients were enrolled in a SPECT/CT lymphoscintigraphy study. 99mTc sulfur colloid (1 mCi) was injected intradermally in the ipsilateral arm. After 5-8 h post-injection, the SPECT/CT scans were taken and analyzed on a GE eNTRGRA system. The SPECT/CT images were co-registered in the treatment planning system (TPS). The original treatment plan was recreated for nodal dosimetry. Intensity modulated radiation therapy (IMRT) planning was performed for reducing lymph node dose for reducing arm lymphedema. Results: The number of lymph nodes varied from 0 to 10 with a mean value of 3.4 ± 5.4 nodes. The location of nodes varied in the axillary, supraclavicular, and breast regions depending upon the surgical procedure and the extent of the disease. The prescribed radiation dose to the breast varied from 45 to 50.4 Gy depending on the disease pattern in 32 evaluated patients having CT data. The dose to lymph nodes varied from 0 to 61.8 Gy depending upon the location and the radiation technique used. SPECT/CT study in conjunction with IMRT plan showed that it is possible to decrease nodal dose and thereby potentially reduce the risk of developing arm lymphedema. Conclusions: The SPECT/CT device provides a novel method to map the lymph nodes in the radiation treatment fields that could be used to tailor the radiation dose.

Original languageEnglish (US)
Pages (from-to)293-298
Number of pages6
JournalRadiotherapy and Oncology
Volume100
Issue number2
DOIs
StatePublished - Aug 2011

Fingerprint

Lymphoscintigraphy
Lymphedema
Risk Reduction Behavior
Radiation
Breast Neoplasms
Lymph Nodes
Arm
Breast
Radiotherapy
Therapeutics
Lymphatic Irradiation
Colloids
Sulfur
Single Photon Emission Computed Tomography Computed Tomography
Drainage
Equipment and Supplies
Injections

Keywords

  • Breast cancer
  • IMRT
  • Lymph nodes
  • Lymphedema
  • Radiation treatment
  • Scintigraphy
  • SPECT/CT

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Hematology

Cite this

Use of lymphoscintigraphy in radiation treatment of primary breast cancer in the context of lymphedema risk reduction. / Das, Indra J.; Cheville, Andrea L; Scheuermann, Joshua; Srinivas, Shyam M.; Alavi, Abass; Solin, Lawrence J.

In: Radiotherapy and Oncology, Vol. 100, No. 2, 08.2011, p. 293-298.

Research output: Contribution to journalArticle

Das, Indra J. ; Cheville, Andrea L ; Scheuermann, Joshua ; Srinivas, Shyam M. ; Alavi, Abass ; Solin, Lawrence J. / Use of lymphoscintigraphy in radiation treatment of primary breast cancer in the context of lymphedema risk reduction. In: Radiotherapy and Oncology. 2011 ; Vol. 100, No. 2. pp. 293-298.
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