Atlas of lymphoscintigraphy and sentinel node mapping. A pictorial case-based approach

Abstract

Published under the aegis of the “Radioguided Surgery” Study Group of the Italian Association of Nuclear Medicine (AIMN), this Atlas aims to disseminate knowledge about Nuclear Medicine lymphoscintigraphy procedures in the evaluation of the lymphatic system and detection in disease, most of all in cancer. Lymphoscintigraphy, as stated by the Editors in their preface to the book “is a nuclear medicine imaging procedure that provides information about the functional status of the lymphatic system”. “Born” as a procedure aimed to study peripheral oedema and lymph effusion, lymphoscintigraphy is nowadays particularly employed in the detection of sentinel nodes. Sentinel nodes are those representing the first station encountered by cancerous lymph on its way to systemic diffusion. Evaluation of these nodes by means of radio-guided biopsy helps to affirm or rule out that cancer lymph spread is under way locally or further along at other echelon nodes. In order to fully appreciate the importance of this assertion the reader needs to deeply understand basic concepts on lymphatic system anatomy, function, pathophysiology and lymphoscintigraphy procedures (radiopharmaceutical use and technical instrumentation) all described in the first three chapters of the book. The opening chapters are followed by two chapters on the clinical evaluation of patients affected by oedema of the extremities and by diseases causing lymphoedema or intracavitary lymph effusion. The following 8 chore chapters are designed to describe and make clear to the reader the sentinel node biopsy use of in surgical oncology by means of planar static and dynamic lymphoscintigraphy coupled with SPECT/CT fusion imaging modalities. These chapters deal with different sorts of malignancies; the most interesting are those on breast cancer and coetaneous melanoma. BOOK REVIEW RECENSIONE

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