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Contribution of dynamic sentinel lymphoscintigraphy images to the diagnosis of patients with malignant skin neoplasms in the upper and lower extremities
The aim of the present study was to confirm the contribution of dynamic images in sentinel lymphoscintigraphy in malignant skin neoplasms: precisely, to investigate if dynamic images were necessary and to observe if dynamic images could reduce the areas needed for biopsy and dissection. Twenty-five...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4221556/ https://www.ncbi.nlm.nih.gov/pubmed/25392795 http://dx.doi.org/10.1186/2193-1801-3-625 |
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author | Miura, Hiroyuki Ono, Shuichi Shibutani, Koichi Seino, Hiroko Tsushima, Fumiyasu Kakehata, Shinya Hirose, Katsumi Fujita, Hiromasa Kakuta, Akihisa Aoki, Masahiko Hatayma, Yoshiomi Kawaguchi, Hideo Sato, Mariko Takai, Yoshihiro Kaneko, Takahide Sawamura, Daisuke |
author_facet | Miura, Hiroyuki Ono, Shuichi Shibutani, Koichi Seino, Hiroko Tsushima, Fumiyasu Kakehata, Shinya Hirose, Katsumi Fujita, Hiromasa Kakuta, Akihisa Aoki, Masahiko Hatayma, Yoshiomi Kawaguchi, Hideo Sato, Mariko Takai, Yoshihiro Kaneko, Takahide Sawamura, Daisuke |
author_sort | Miura, Hiroyuki |
collection | PubMed |
description | The aim of the present study was to confirm the contribution of dynamic images in sentinel lymphoscintigraphy in malignant skin neoplasms: precisely, to investigate if dynamic images were necessary and to observe if dynamic images could reduce the areas needed for biopsy and dissection. Twenty-five patients with malignant skin neoplasms of the lower (n = 21) and upper (n = 4) extremities were retrospectively investigated. Images were evaluated by two independent reviewers, an expert in diagnostic radiology and nuclear medicine and a diagnostic radiologist in training. Visualized hot spots were assessed to be sentinel nodes using only static planar images. Next, both static planar and dynamic images were assessed. Reviewers scored diagnostic confidence values of determined sentinel nodes as follows: 0, cannot be decided; 1, possible; 2, probable; and 3, definitive. Patterns of lymphatic drainage were categorized into six different pathways: (1) inguinal type, (2) popliteal type, (3) inguinal and popliteal type, (4) axillary type, (5) cubital type, and (6) axillary and cubital type. In cases in the lower extremities, with dynamic images, the expert reviewer changed assessment in three cases and the trainee reviewer changed it in one case. There were no cases in which a decision was changed to be the same between both reviewers. Although the average diagnostic confidence value of assessment is usually higher with dynamic images, significant differences were not present. In cases of the upper extremities, both reviewers changed their assessment in one patient. By mutual agreement, cases in which assessment was changed with dynamic images were the inguinal and popliteal type, and the axillary and cubital type. The expert reviewer noticed lymphatic channels only visualized on dynamic images and changed assessment. Determination of whether or not a lymph node is a sentinel node depends on visualization of the lymphatic network. In the present circumstances, all biopsies of hot spots determined to be lymph nodes should not be excluded. However, excessive biopsies should be avoided as much as possible. It is necessary to use dynamic images alongside skillful observation. |
format | Online Article Text |
id | pubmed-4221556 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-42215562014-11-12 Contribution of dynamic sentinel lymphoscintigraphy images to the diagnosis of patients with malignant skin neoplasms in the upper and lower extremities Miura, Hiroyuki Ono, Shuichi Shibutani, Koichi Seino, Hiroko Tsushima, Fumiyasu Kakehata, Shinya Hirose, Katsumi Fujita, Hiromasa Kakuta, Akihisa Aoki, Masahiko Hatayma, Yoshiomi Kawaguchi, Hideo Sato, Mariko Takai, Yoshihiro Kaneko, Takahide Sawamura, Daisuke Springerplus Research The aim of the present study was to confirm the contribution of dynamic images in sentinel lymphoscintigraphy in malignant skin neoplasms: precisely, to investigate if dynamic images were necessary and to observe if dynamic images could reduce the areas needed for biopsy and dissection. Twenty-five patients with malignant skin neoplasms of the lower (n = 21) and upper (n = 4) extremities were retrospectively investigated. Images were evaluated by two independent reviewers, an expert in diagnostic radiology and nuclear medicine and a diagnostic radiologist in training. Visualized hot spots were assessed to be sentinel nodes using only static planar images. Next, both static planar and dynamic images were assessed. Reviewers scored diagnostic confidence values of determined sentinel nodes as follows: 0, cannot be decided; 1, possible; 2, probable; and 3, definitive. Patterns of lymphatic drainage were categorized into six different pathways: (1) inguinal type, (2) popliteal type, (3) inguinal and popliteal type, (4) axillary type, (5) cubital type, and (6) axillary and cubital type. In cases in the lower extremities, with dynamic images, the expert reviewer changed assessment in three cases and the trainee reviewer changed it in one case. There were no cases in which a decision was changed to be the same between both reviewers. Although the average diagnostic confidence value of assessment is usually higher with dynamic images, significant differences were not present. In cases of the upper extremities, both reviewers changed their assessment in one patient. By mutual agreement, cases in which assessment was changed with dynamic images were the inguinal and popliteal type, and the axillary and cubital type. The expert reviewer noticed lymphatic channels only visualized on dynamic images and changed assessment. Determination of whether or not a lymph node is a sentinel node depends on visualization of the lymphatic network. In the present circumstances, all biopsies of hot spots determined to be lymph nodes should not be excluded. However, excessive biopsies should be avoided as much as possible. It is necessary to use dynamic images alongside skillful observation. Springer International Publishing 2014-10-22 /pmc/articles/PMC4221556/ /pubmed/25392795 http://dx.doi.org/10.1186/2193-1801-3-625 Text en © Miura et al.; licensee Springer. 2014 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. |
spellingShingle | Research Miura, Hiroyuki Ono, Shuichi Shibutani, Koichi Seino, Hiroko Tsushima, Fumiyasu Kakehata, Shinya Hirose, Katsumi Fujita, Hiromasa Kakuta, Akihisa Aoki, Masahiko Hatayma, Yoshiomi Kawaguchi, Hideo Sato, Mariko Takai, Yoshihiro Kaneko, Takahide Sawamura, Daisuke Contribution of dynamic sentinel lymphoscintigraphy images to the diagnosis of patients with malignant skin neoplasms in the upper and lower extremities |
title | Contribution of dynamic sentinel lymphoscintigraphy images to the diagnosis of patients with malignant skin neoplasms in the upper and lower extremities |
title_full | Contribution of dynamic sentinel lymphoscintigraphy images to the diagnosis of patients with malignant skin neoplasms in the upper and lower extremities |
title_fullStr | Contribution of dynamic sentinel lymphoscintigraphy images to the diagnosis of patients with malignant skin neoplasms in the upper and lower extremities |
title_full_unstemmed | Contribution of dynamic sentinel lymphoscintigraphy images to the diagnosis of patients with malignant skin neoplasms in the upper and lower extremities |
title_short | Contribution of dynamic sentinel lymphoscintigraphy images to the diagnosis of patients with malignant skin neoplasms in the upper and lower extremities |
title_sort | contribution of dynamic sentinel lymphoscintigraphy images to the diagnosis of patients with malignant skin neoplasms in the upper and lower extremities |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4221556/ https://www.ncbi.nlm.nih.gov/pubmed/25392795 http://dx.doi.org/10.1186/2193-1801-3-625 |
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