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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Am+J+Nucl+Med+Mol+Imaging
2015 ; 5
(3
): 233-45
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
The next evolution in radioguided surgery: breast cancer related sentinel node
localization using a freehandSPECT-mobile gamma camera combination
#MMPMID26069857
Engelen T
; Winkel BM
; Rietbergen DD
; KleinJan GH
; Vidal-Sicart S
; Olmos RA
; van den Berg NS
; van Leeuwen FW
Am J Nucl Med Mol Imaging
2015[]; 5
(3
): 233-45
PMID26069857
show ga
Accurate pre- and intraoperative identification of the sentinel node (SN) forms
the basis of the SN biopsy procedure. Gamma tracing technologies such as a gamma
probe (GP), a 2D mobile gamma camera (MGC) or 3D freehandSPECT (FHS) can be used
to provide the surgeon with radioguidance to the SN(s). We reasoned that
integrated use of these technologies results in the generation of a "hybrid"
modality that combines the best that the individual radioguidance technologies
have to offer. The sensitivity and resolvability of both 2D-MGC and 3D-FHS-MGC
were studied in a phantom setup (at various source-detector depths and using
varying injection site-to-SN distances), and in ten breast cancer patients
scheduled for SN biopsy. Acquired 3D-FHS-MGC images were overlaid with the
position of the phantom/patient. This augmented-reality overview image was then
used for navigation to the hotspot/SN in virtual-reality using the GP. Obtained
results were compared to conventional gamma camera lymphoscintigrams. Resolution
of 3D-FHS-MGC allowed identification of the SNs at a minimum injection site (100
MBq)-to-node (1 MBq; 1%) distance of 20 mm, up to a source-detector depth of 36
mm in 2D-MGC and up to 24 mm in 3D-FHS-MGC. A clinically relevant dose of
approximately 1 MBq was clearly detectable up to a depth of 60 mm in 2D-MGC and
48 mm in 3D-FHS-MGC. In all ten patients at least one SN was visualized on the
lymphoscintigrams with a total of 12 SNs visualized. 3D-FHS-MGC identified 11 of
12 SNs and allowed navigation to all these visualized SNs; in one patient with
two axillary SNs located closely to each other (11 mm), 3D-FHS-MGC was not able
to distinguish the two SNs. In conclusion, high sensitivity detection of SNs at
an injection site-to-node distance of 20 mm-and-up was possible using 3D-FHS-MGC.
In patients, 3D-FHS-MGC showed highly reproducible images as compared to the
conventional lymphoscintigrams.