Estimation of radioactivity in single photon emission computed tomography for sentinel lymph node biopsy in a torso phantom study

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Objectives: Number of lymph nodes to be removed are determined from residual counts. Estimating residual radioactivity in lymphatic nodes before a biopsy in advance is useful for reducing surgical operation time. The purpose of this study was to estimate total radioactivity of a small hot spot in single-photon emission computed tomography (SPECT) of a torso phantom. Methods: Cross-calibration study was performed to convert counts in SPECT images to radioactivity. A simulation study was performed to estimate the size of volume of interest (VOI) covering a hot spot corrupted with full width at half maximum (FWHM) between 8 and 16 mm. The estimation of total radioactivity was validated in a torso phantom study using small sources. Results: True radioactivity was approximately equal to integrated values of hot spots using the VOI with a diameter of 40 mm in our simulation study. The difference was less than18% in cases of more than 9.4 kBq. Conclusions: The total radioactivity in small sources simulating a typical sentinel node was estimated from SPECT images using a VOI of 40 mm in a torso phantom study. Because the difference from actual values were less than 10% on average when radioactivities were more than 9.4 kBq, the total radioactivity of a lymph node can be estimated in a clinical examination.

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