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3.17. Evaluation of radionuclide scintimammography

Static breast scintigraphy (scintimammography) is used to diagnose tumor processes in the breast and axillary nodes.

The evaluation of this simple static scintigraphy consists of two stages:

Saving studies

We perform scintigraphic examination after iv application of 700 MBq 99m Tc-MIBI.

Recommended storage mode:

matrix 128 128, 16 bits, preselection min. 200,000 imp.

Picture 1: Left breast - side 2nd: Marking 3rd: Right breast - side 4th: Marking

Picture 5: Left breast - AP 6 .: Marking 7 .: Right breast - AP 8 .: Marking

This order of projections corresponds to the default preset in the MAMOGR program, so it is not necessary to permute the order of projections when evaluating it.

Study evaluation

First we call up the required scintigraphic study in the basic menu PROCESSING (if it consists of several studies, we select them one by one and use the “Next” command to combine them into one for evaluation). We will launch a comprehensive program MAMOGR - static scintimammography .

Sequence of projections and visual evaluation

The display shows the stacked images and describes the projection names in the default order: L.prs-lateral - Marking - P.prs-lateral - Marking - L.prs-AP - Marking - P.prs-AP - Marking (displayed only as many projections as there were images). If the projection order agrees and we want to keep all the images, we will answer the program question "Projection order okay?" positive. Otherwise (negative response) to specify sequentially poky n y actual assignment program names of images projected. In this way, it is possible not only to change the order of projections, but also to select certain images and reject others for further display, processing and documentation. If we have displayed images with the corresponding assignment of projections, a visual evaluation begins, and we can use both the implicit standard formulation of the normal evaluation, eg:

After application of the 99m-Tc-MIBI radioindicator on scintigrams, we do not observe
any deposits of pathological deposition of the radioindicator in the breasts or axillae, which would indicate a
tumor process.

Normal finding by radionuclide scintimammography.

or a non-standard free text of a pathological finding.

Final protocol

The display then shows all selected images, and we can set their optimal modulation (LT / UT). In the box below we can edit the text of the verbal description of the scintigraphic images and the conclusion. Finally, we can print a report containing (in addition to basic information such as the patient's name) the relevant images, the text of the verbal evaluation, the conclusion and the signature - Fig.3.17.1.

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