Table of Contents
International Journal of Molecular Imaging
Volume 2011, Article ID 298102, 10 pages
Research Article

Hybrid Modality Fusion of Planar Scintigrams and CT Topograms to Localize Sentinel Lymph Nodes in Breast Lymphoscintigraphy: Technical Description and Phantom Studies

1Graduate School of Biomedical Sciences, The University of Texas Health Sciences Center at Houston, Houston, TX 77030, USA
2Division of Diagnostic Imaging, Department of Imaging Physics, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA
3Department of Radiology, University of Washington, Seattle, Washington 98195, USA
4Department of Radiology, Oregon Health and Science University, Portland, OR 97239, USA
5Centre for Oncology and Molecular Medicine (COMM), University of Dundee—Ninewells Hospital and Medical School, Dundee DD1 9SY, Scotland
6Division of Diagnostic Imaging, Department of Nuclear Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA

Received 20 August 2010; Accepted 11 October 2010

Academic Editor: Hongming Zhuang

Copyright © 2011 Renée L. Dickinson et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Lymphoscintigraphy is a nuclear medicine procedure that is used to detect sentinel lymph nodes (SLNs). This project sought to investigate fusion of planar scintigrams with CT topograms as a means of improving the anatomic reference for the SLN localization. Heretofore, the most common lymphoscintigraphy localization method has been backlighting with a 57Co sheet source. Currently, the most precise method of localization through hybrid SPECT/CT increases the patient absorbed dose by a factor of 34 to 585 (depending on the specific CT technique factors) over the conventional 57Co backlighting. The new approach described herein also uses a SPECT/CT scanner, which provides mechanically aligned planar scintigram and CT topogram data sets, but only increases the dose by a factor of two over that from 57Co backlighting. Planar nuclear medicine image fusion with CT topograms has been proven feasible and offers a clinically suitable compromise between improved anatomic details and minimally increased radiation dose.