ОСОБЕННОСТИ РАДИОНУКЛИДНОЙ ДИАГНОСТИКИ СИГНАЛЬНЫХ ЛИМФАТИЧЕСКИХ УЗЛОВ У БОЛЬНЫХ РАКОМ МОЛОЧНОЙ ЖЕЛЕЗЫ С ПОМОЩЬЮ НОВОГО ОТЕЧЕСТВЕННОГО РАДИОФАРМПРЕПАРАТА НА ОСНОВЕ ОКСИДА АЛЮМИНИЯ, МЕЧЕННОГО 99mТс

Abstract

Purpose: To study the possibility of using [99mТс]-Al2O3 for the diagnosis of sentinel lymph nodes (SLN) in patients with breast cancer, to analyze the results obtained in comparison with a phytate colloid labeled with 99mTc. Material and methods: The study included 86 patients with breast cancer. [99mTc]-phytate colloid (31 patients) and [99mТс]-Al2O3 (55 patients) were used as radiopharmaceutical. Results: The optimal time interval between the injection of [99mТс]-Al2O3 and the acquisition of a scintigraphic image was determined to be 18-20 hours, when the maximum possible number of lymph nodes (LNs) with the most optimal level of radioactivity for their detection is visualized. In the group of patients who were injected with [99mTc]-phytate colloid, SLN were visualized in 27 out of 31 patients, a total of 37 LNs were detected in this group. The median number of detected LNs in one patient was 1 [0–3], the intensity of accumulation of [99mTc]-phytate colloid according to single-photon emission computed tomography (SPECT) was 1.75% [0.5–4.3%], intraoperatively using gamma -probe – 2.95% [1.1–5.6%]. When [99mТс]-Al2O3 was used as radiopharmaceutical, SLNs were detected in 51 patients out of 55. In total, 111 LNs were detected in this group, the median number of detected LNs in one patient was 2 [0-6], the intensity of accumulation of [99mТс]-Al2O3 according to SPECT data – 6.1% [0.5–18.4%], intraoperatively – 7.2% [1.3–22.1%]. In the absence of radiopharmaceuticals accumulation in regional LNs (n=7 in total), 3 patients had total metastatic lesions of the SLN, in two of them other regional LNs were also affected by metastases. Conclusion: A comparative analysis of the indices of two radiopharmaceuticals shows that studies with [99mТс]-Al2O3 are characterized by statistically significantly higher accumulation rates in the SLN compared with [99mTc]-phytate colloid. The number of detected LNs when using [99mТс]-Al2O3 was also higher than in the group with [99mTc]-phytate colloid. As a result, when [99mТс]-Al2O3 is used, the method is characterized by higher sensitivity in detecting SLN (94.5%).