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Sentinel node detection in patients with breast cancer is routinely performed in our department. Images frequently show star-shaped activity at the site of injection caused by septum penetration. These star-shaped artifacts could possibly impair visualization of nearby sentinel nodes. The aim of this study was to determine whether sentinel node detection in patients with breast cancer can be improved using a medium-energy all-purpose (ME) collimator instead of a low-energy all-purpose (LEAP) collimator. For this purpose, 15 patients were studied and a phantom study was performed. The LEAP collimator was used for a dynamic study immediately after injection, and both the LEAP and the ME collimators were used for static studies. A total of 20 sentinel nodes were found with both collimators. All sentinel nodes were found in the axilla. To separate sentinel nodes from the injection site, the ME collimator gave the best results in 4 of 15 patients, but only within the first hour after injection. To separate 2 nearby sentinel nodes from each other, the LEAP collimator gave the best results in 3 of 15 patients. Our conclusion is that the LEAP collimator gave better results than the ME collimator as a result of the better resolution and the higher sensitivity. Use of the ME collimator did not improve sentinel node detection.

A 5-week-old male infant with complete situs inversus and suspected asplenia underwent Tc-99m sulfur colloid and Tc-99m heat-denatured red blood cell (RBC) imaging to evaluate possible spleen function. The heat-denatured Tc-99m-labeled RBC scan revealed intense uptake in the normal-shaped right-side spleen, whereas the Tc-99m sulfur colloid scan showed only slight uptake in the reticuloendothelial system (RES). Therefore, the patient received antipneumococcal vaccination and antibiotic prophylaxis to prevent infections in the future.