Concordance between freehand SPECT and conventional scintigraphy for sentinel lymph node detection in breast cancer.

INTRODUCTION: 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). MATERIALS AND 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). CONCLUSION: 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.

[Contribution of intraoperative scintigraphy to the detection of intrathyroidal parathyroid adenoma]. / Aportación de la gammagrafía intraoperatoria en la detección del adenoma paratiroideo intratiroideo.

The intrathyroidal parathyroid adenomas (IPA) represent a rare cause of primary hyperparathyroidism whose location difficults appropriate surgical removal. We present the case of a patient diagnosed of parathyroid adenoma by presurgical scintigraphy in which finally during the parathyroidectomy, the lesion location was intrathyroidal. We consider that the intrasurgical parathyroid scintigraphy with (99m)Tc-MIBI by portable gammacamera is useful in the parathyroid adenomas removal and essential in the case of IPA.

[Interstitial nephritis demonstrated by 67Ga-citrate scintigraphy within a diagnosis of fever of unknown origin]. / Nefritis intersticial demostrada mediante gammagrafía con 67Ga-citrato en el contexto de fiebre de origen desconocido.

We present a clinical case of a 54-year-old woman that was admitted in our hospital with the diagnosis of fever of unknown origin. All the laboratory tests and imaging techniques did not manage to establish the fever's aetiology until a (67)Ga-citrate scan was performed and kidney uptake was observed, which lead to the clinical suspicion of drug-induced interstitial nephritis. The renal biopsy confirmed the diagnosis. This finding allowed corticoid therapy and cure.