SPHP Radiology Protocols

Radiology Protocols

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Reverse Axillary Mapping

Reverse Axillary Mapping

  1. Preparation
    1. No patient preparation
  2. Isotope administration
    1. Patient will receive four, 0.25 mCi subcutaneous injections of Tc99m filtered sulfur colloid to lower third of forearm.
    2. Physician assistant will perform the injection
  3. Camera Parameters Planar Imaging
    1. Dynamic Flow
      1. LEHR collimators used for imaging
      2. Matrix: 256X256
  • Zoom : 1.23
  1. Camera peaked at Tc99m with a 15% window
  2. 20 seconds X 15 frames
  3. Detector 1 is used for imaging
  1. Statics
    1. LEHR collimators used for imaging
    2. Matrix: 128X128
  • Zoom: 1.23
  1. Camera peaked at Tc99m with a 15% window
  2. 5 minutes per image
  3. Detector 1 is used for imaging
  1. Scanning protocol
    1. Patient will lay on the table so the lower third of forearm is easily accessible to the physician assistant
    2. A Co57 flood source will be placed on detector below patient
    3. Physician Assistant will inject in the lower third of forearm and the patient will be placed under the camera
    4. A lead shield is placed covering the injection site
    5. Dynamic flow images will be taken immediately after injection
    6. After the dynamic flow images, resume take static images following the flow of the radiotracer to lymph nodes
    7. If no lymph nodes show after 30 minutes of imaging confer with the radiologist about continuing images and follow their instructions
    8. When imaging is completed, mark the lymph nodes seen unless specified by the ordering physician.
  2. Post processing/Display/Archive
    1. All acquired images will be adjusted for optimal viewing and appropriate labeling.
    2. Images will be sent to the PAC’s system
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