A Protocol for Imaging Axillary Lymph Nodes in Patients Undergoing Breast-Specific γ-Imaging

The development of small-field-of-view, breast-optimized, gamma-camera designed for breast scintigraphy has resulted in improved breast lesion detection-particularly for lesions smaller than 1 cm. However, unlike with the standard gamma-camera, these images do not include the axilla within the field of view. Methods: Because of the effectiveness of breast scintigraphy using Tc-99m-sestamibi in the detection of axillary lymph node metastases, this article describes the development of an axillary imaging protocol for these small-field-of-view systems. Results: In addition, it describes how the improved resolution of these systems affects imaging of the axilla and reports observed, normal variants. Conclusion: Last, several example patient cases are discussed, describing both the impact and the limitations of this imaging protocol.