Breast Lymphoscintigraphy: Why Oblique Views
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Question
This breast lymphoscintigraphy includes both anterior and oblique views of the axilla. What is the PRIMARY reason for acquiring images in more than one projection?
- ATo double the imaging time per view so that enough counts are collected in the sentinel node for accurate quantification of radiotracer uptake
- BRadiation safety protocols require two projections to confirm that tracer has cleared sufficiently from the injection site before the patient is released
- CMultiple views help localize the sentinel lymph node in three dimensions and separate it from the injection site, giving the surgeon accurate depth and position information
- DComparing both projections allows the technologist to identify bilateral axillary sentinel nodes by detecting asymmetry between the two sides
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C. Multiple views help localize the sentinel lymph node in three dimensions and separate it from the injection site, giving the surgeon accurate depth and position information
Acquiring anterior and oblique (or lateral) views during lymphoscintigraphy serves two purposes: (1) it allows the sentinel node to be separated from the bright injection site, which can otherwise overlap the node on a single anterior view; and (2) it gives the surgeon three-dimensional localization of the sentinel node before the procedure. The technologist typically marks the skin over the sentinel node using a transmission marker or a radioactive point source, and the oblique view confirms the exact position. This information guides the surgeon's gamma probe intraoperatively.
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