BREAST SCINTIGRAPHY

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Information about BREAST SCINTIGRAPHY
Science-Technology

Published on November 3, 2008

Author: tamersamiabdou

Source: authorstream.com

Slide 1: Breast Scintigraphy Done By Tamer Samy Breast Anatomy : Breast Anatomy 1- Each breast has 15-20 sections called LOBES. 2- These lobes have many small lobules, which end in dozens of tiny bulbs that can produce milk. 3-The lobes, lobules and bulbs are linked by thin tubes called ducts. 4- These ducts lead to the nipple at the end of the breast. 5- The space between lobules and ducts occupied by fat. Cont. Anatomy : Cont. Anatomy 6- Blood supply for the breast come from the perforating branches of internal thoracic artery and intercostal artery. 7- There are no muscles in the breast but they are covering the ribs underlying each breast. Definition of Breast Scintigraphy : Definition of Breast Scintigraphy It is a non-invasive imaging modality by using radioactive substance to detect breast carcinoma and get information about tumor cell viability. Indications for Breast Scintigraphy : Indications for Breast Scintigraphy 1- Detection of breast cancer when mammography is doubtful. 2- Assistance in identifying bilateral breast cancer. 3- Evaluation and prediction of tumor response to chemotherapy for breast carcinoma. Method & Procedures : Method & Procedures 1- Patient Preparation a- No special preparation for the scan. b- The procedure should be explained well to the patient by the technologist before the scan. 2- Radiopharmaceuticals a- Tc99m-Sestamibi (20-30mCi) intravenous injection. b- Injection should be in contra-lateral arm vein of the breast with suspected abnormality. c- In case of bilateral breast disease, the injection should be administered in the foot vein. Cont. Method & Procedure : Cont. Method & Procedure 3- Acquisition Parameters a- A standard Gamma Camera with low energy high resolution collimator. b- Energy peak of 140Kev (Tc99m) with 20% window. c- Matrix size of 128×128 or more to improve the image resolution. 4- Patient positioning a- Patient lays in prone position on a designed table (with 2 opening) to provide access to the breast and free movement. Cont. Method & Procedure : Cont. Method & Procedure b- The breast to be imaged will be placed through the opening in the table. c- To prevent cross-talk between the two breasts, one breast will be elevated up and the other breast will be inserted through the open in the table. 5- Imaging views a- Prone lateral view of the suspected breast for 10min acq. with marker on the nipple. b- prone lateral view of the contra-lateral breast for 10min acq. with marker on the nipple. Cont. Method & Procedure : Cont. Method & Procedure c- Anterior supine or upright chest image including both breasts and both axilla. d- SPECT is optimal. 6- Processing a- For planner images no specific processing, only masking the high activity areas from the internal organs (due to normal distribution of Tc99m-Sestamibi). b- SPECT processing if done. Source Of Error In The Scan : Source Of Error In The Scan 1- Small lesions < 1cm can be missed by breast scintigraphy. 2- Extravasation of tracer result in abnormal uptake in the axillary region (lymph nodes). 3- Post surgery uptakes. 4- Post radiotherapy uptakes. 5- Patient motion. 6- Contra-lateral cross-talk if both breast are dependent during the scan. Comparison Between Breast Scintigraphy & Breast Mammography : Comparison Between Breast Scintigraphy & Breast Mammography Breast Scintigraphy Vs. Mammography : Breast Scintigraphy Vs. Mammography Conclusion : Conclusion The breast Scintigraphy can be very helpful in the detection of breast cancer in and also can be helpful in monitoring of response to chemotherapy and radiotherapy in suspected breast cancer patients. Slide 15: Thanks For Attention

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