背景：對腫瘤外科而言，前哨淋巴結取樣切片已成爲淋巴結分期關鍵角色。由於腸胃內臟複雜的淋巴路徑，造成前哨淋巴結定位分辨困難。本研究探討多角度投射術前淋巴造影法之可行性。病患與方法：我們收案31名已被診斷胃、腸癌患者，於術前接受1 mCi鎝－99m-硫膠體或鎝－99m-植酸經內視鏡黏膜下注射，三小時復分別接受180或360度多角度投射造影於胃、大腸直腸癌患者，隔天患者即接受開刀，並於手術中以輻射偵測探頭取樣。結果：31名患者中，有13位胃癌及18位大腸直腸癌，其臨床腫塊(T)分級多介於第二級及第三級之間。以多角度投射造影定位法偵測前哨淋巴結之偵測率分別爲62%及39%。根據初步結果淋巴結吸收分佈與腫瘤位置具相關性，且提供三度空間分佈關係。由於爲點光源造影，斷層影像分析則須進一步程式修定。結論：多角度投射淋巴造影法對腸胃癌術前前哨淋巴結定位可提供輔助。

Background: Sentinel lymph node biopsy plays a pivot role in nodal staging in surgical oncology. Because of the complicated lymphatic drainage system around the gastroenteric region, it is often difficult to localize and identify the sentinel nodes clinically. In this study, we proposed the use of presurgical lymphoscintigraphic mapping by multiple-angle projection (MAP) method to enhance the detection of sentinel nodes. Methods: Thirty-one patients who were diagnosed with gastric or colorectal cancer were enrolled in this study. All of them received a submucosal injection of either 1-mCi 99mTc-sulfur colloids (99mTc-SC) or 99mTc-phytate via endoscope, three hours after the injection, 180 or 360 degrees arc multiple-angle projections acquisition, two imaging protocols were applied to gastric or colorectal cancer patients, respectively. On the basis of the mapping location, sentinel lymph node biopsy was performed the next day by probe identification during surgery. Results: A total of thirty-one patients were enrolled in this study, 13 of them had gastric cancer and 18 of them had colorectal cancer. Most of the enrolled patients were staged within T2-T3 cancer. Sixty-two percent of the gastric cancer patients and 39% of the colorectal cancer patients had detectable sentinel lymph nodal activity on multiple-angle projection mapping image. Of those with detectable nodal activity, there was not only a good correlation between tumor location and sentinel lymph nodal distribution, but also good marking numbers of regional involved sentinel nodes in different orientation via multiple-projection mapping image. Reconstruction techniques need to be developed in the future. Conclusion: Presurgical lymphoscintigraphic mapping by multiple-angle projection method is an adjuvant technique to provide 3-D information and localize the sentinel lymph nodes in gastroenteric cancer.