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The lowest activity that could be detected in 3D-FHS-MGC was 0.08 MBq at a 36 mm source-detector depth. This dose lies well below the clinically reported SN activities of around 1 MBq [16]. Resolvability experiment simulating near-injection-site sentinel nodes The resolving power of near-injection-site SNs was evaluated for various injection site-to-SN distances and at various depths, and compared to conventional 2D-flatbed images. 3D-FHS-MGC acquisition took on average 121 sec (range 120-124) with an average reconstruction time of 32sec (range 16-61) and an average scanned VOI of 83.7% (range 78-91). Figure 5 shows the obtained resolvability curves for the evaluated modalities. At 60 mm source-detector depth none of the modalities was able to distinguish the SN placed at 10 Megestrol Acetate mm from the injection site, not even 2D-flatbed imaging. At 20 mm injection site-to-SN distance, with 2D-flatbed imaging the SN could already be visualized at 60 mm source-detector depth. 2D-MGC and 3D-FHS-MGC visualized selleck screening library the SN at 20 mm injection site-SN distance at 36 and 24 mm source-detector depth, respectively (Figure 5). Resolvability experiment clustered nodes To evaluate the ability of the declipseSPECT-MGC combination to resolve SNs in a cluster, a 3D-FHS-MGC scan (average acquisition time 91 sec (range 78-109); average reconstruction time 16 sec (range 9-22) and an average 62.0% scanned VOI (range 50-68)) was acquired of a simulated cluster (four hotspots within 10 mm from each other). The results of this experiment (Figure 6) show that in the current setup the 3D-FHS-MGC technology is not able to distinguish hotspots that are located within 10 mm from each other, except when the four sources contained a high amount of radioactivity (25 MBq; Figure 6C), and only at a depth of 4 mm. As seen in figure 6 the sources of lower activity (4��1 MBq (Figure 6A) or 4��0.5 MBq (Figure 6B)) are visualized as one single hotspot with 3D-FHS-MGC. Patient study In all ten breast cancer patients lymphoscintigraphy identified at least one axillary SN. Preoperative imaging revealed a total of 12 SNs (range 1-2 SNs per patient). The number of SNs visualized was the same on both early and late lymphoscintigrams. The average injection site-to-SN distance was 93 mm (range 38-150), as determined on the Gemcitabine late anterior lymphoscintigrams. Two of the ten patients presented with two axillary SNs in which the SN-SN distance was 33 mm and 11 mm, respectively (Figure 7B and ?and7C).7C). One patient presented with a cluster of 2-4 SNs that could not be separated with lymphoscintigraphy (Figure 7D). Figure 7 Clinical sentinel node resolvability. A. Patient presenting with a solitary SN in the axilla. I) 2D-flatbed image showing a clear SN. II) 3D-FHS-MGC overlay showing the same SN in the axilla. III) 3D navigation pointing towards the SN in the axilla. IV) ... 2D-MGC imaging took