A Practical Technique to Improve Visualization of Sentinel Nodes in the Axillary Region on Breast Lymphoscintigraphy: Medial Breast Traction by Patient

(A and B) Anterior (A) and lateral (B) ^99mTc-tilmanocept lymphoscintigraphy transmission images demonstrate focal area of increased uptake superior and posterior to injection site on lateral view. Focus of uptake inferolateral to injection site on anterior view is in lower position than uptake on lateral view in relation to injection site, suggesting it may not correspond to uptake on lateral view. (C and D) Repeat anterior (C) and lateral (D) images during medial breast traction by patient displaces superimposed injection site medially and clearly demonstrate sentinel node in axillary region on anterior view. Focal uptake inferolateral to injection site on anterior view is likely secondary to contamination.

(A) Anterior ^99mTc-tilmanocept lymphoscintigraphy image demonstrates focal areas of increased uptake superior to injection site. Sentinel node is not clearly identified. (B) Lateral image demonstrates lymph channels and sentinel node. (C and D) Repeat anterior (C) and lateral (D) images during medial breast traction demonstrate marked improvement of visualization of lymph channels and sentinel node on anterior view.

(A and B) Anterior (A) and lateral (B) ^99mTc-tilmanocept lymphoscintigraphy images demonstrate focal areas of increased uptake superior and posterior to injection site, which likely represent lymph channels and axillary sentinel node. (C and D) Repeat anterior (C) and lateral (D) images during medial breast traction demonstrate marked improvement of visualization of lymph channels and sentinel node on anterior and lateral views.