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An interactive 3D atlas of sentinel lymph nodes in breast cancer developed using SPECT/CT
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An interactive 3D atlas of sentinel lymph nodes in breast cancer developed using SPECT/CT
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Journal Article
An interactive 3D atlas of sentinel lymph nodes in breast cancer developed using SPECT/CT
2024
Overview
Background
The identification and assessment of sentinel lymph nodes (SLNs) in breast cancer is important for optimised patient management. The aim of this study was to develop an interactive 3D breast SLN atlas and to perform statistical analyses of lymphatic drainage patterns and tumour prevalence.
Methods
A total of 861 early-stage breast cancer patients who underwent preoperative lymphoscintigraphy and SPECT/CT were included. Lymphatic drainage and tumour prevalence statistics were computed using Bayesian inference, non-parametric bootstrapping, and regression techniques. Image registration of SPECT/CT to a reference patient CT was carried out on 350 patients, and SLN positions transformed relative to the reference CT. The reference CT was segmented to visualise bones and muscles, and SLN distributions compared with the European Society for Therapeutic Radiology and Oncology (ESTRO) clinical target volumes (CTVs). The SLN atlas and statistical analyses were integrated into a graphical user interface (GUI).
Results
Direct lymphatic drainage to the axilla level I (anterior) node field was most common (77.2%), followed by the internal mammary node field (30.4%). Tumour prevalence was highest in the upper outer breast quadrant (22.9%) followed by the retroareolar region (12.8%). The 3D atlas had 765 SLNs from 335 patients, with 33.3–66.7% of axillary SLNs and 25.4% of internal mammary SLNs covered by ESTRO CTVs.
Conclusion
The interactive 3D atlas effectively displays breast SLN distribution and statistics for a large patient cohort. The atlas is freely available to download and is a valuable educational resource that could be used in future to guide treatment.
Publisher
BioMed Central,BioMed Central Ltd,BMC
Subject
/ Aged
/ Breast Neoplasms - diagnostic imaging
/ Breast Neoplasms - pathology
/ Female
/ Humans
/ Imaging
/ Imaging, Three-Dimensional - methods
/ Lymphatic Metastasis - diagnostic imaging
/ Lymphoscintigraphy - methods
/ Medicine
/ Oncology
/ Sentinel Lymph Node - diagnostic imaging
/ Sentinel Lymph Node - pathology
/ Sentinel Lymph Node Biopsy - methods
/ Single Photon Emission Computed Tomography Computed Tomography - methods
/ SPECT-CT
