Potential role of a new hand-held miniature gamma camera in performing minimally invasive parathyroidectomy

Ferrer-Rebolleda, J.; Fernández, Norberto Cassinello; Lledó, Salvador

doi:10.1007/s00259-006-0239-7

Cited by 52 publications

(34 citation statements)

References 13 publications

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“…Various 99m Tc radiocolloids are used for this technique. In breast cancer, the doses of injected radiopharmaceuticals have been reported to be 5-10 MBq (18), [10][11][12][13][14][15][16][17][18][19][20], and 3.7-111 MBq (20). Similar doses (15-111 MBq) have been used for the procedure in patients who have oral cancer (21)(22)(23)(24)(25).…”

Section: Discussionmentioning

confidence: 99%

“…Several reports of handheld small g-cameras have been published (1,(8)(9)(10)(11)(12)(13)(14)(15), but studies to date have not verified the effectiveness of small g-cameras in depicting nodes with increased radioactivities in the clinical setting of sentinel lymph node biopsy. In this study, we aimed to confirm our earlier results regarding the basic performance of the SSGC and to extend the preliminary findings by using the camera in an animal study and a clinical setting.…”

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confidence: 99%

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Evaluation of the Efficacy of a Small CdTe γ-Camera for Sentinel Lymph Node Biopsy

Tsuchimochi¹,

Hayama²,

Oda³

et al. 2008

J Nucl Med

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We previously reported the basic performance of a prototype small cadmium telluride (CdTe) g-camera (SSGC) intended for use in radioguided surgeries. In this study, we sought to confirm the favorable previous results and to extend the preliminary findings to examine the efficacy of the SSGC in an animal study and a clinical setting for sentinel lymph node biopsy. Methods: The prototype SSGC (1,024 pixels; field of view, 44.8 · 44.8 mm), equipped with a parallel-hole collimator, was used in both animal and clinical studies. 99m Tc-phytate (18.5 MBq) was injected into the tongues and legs of 6 rabbits. In the clinical study, 74 MBq of 99m Tc-phytate was injected into peritumoral regions in 8 patients with oral cancer. The detection of hot nodes by the SSGC was compared with that by a conventional scintillation g-camera (CGC). Results: The SSGC detected 29 hot nodes in images of 6 rabbits after injection. The number of hot nodes was the same as the number seen in CGC studies, but the CGC required a longer acquisition time to produce comparable images. There were no differences between the SSGC and the CGC in terms of activity ratios and hot node-to-background ratios. The biodistribution of 99m Tc-phytate in removed tissues was evaluated by contact radiography, and radioactivity was assayed with a g-well counter. The mean 6 SD radioactivity in specimens was 0.15% 6 0.15%, with a range of 0.01%-0.62%. In the clinical study, the SSGC detected 30 hot nodes with a 5-to 60-s acquisition time at 4 h after injection. The SSGC documented all hot nodes depicted by the CGC at 4 h after injection. Conclusion: The SSGC showed significant potential for the detection of sentinel lymph nodes in lymphoscintigraphy. The results of the studies suggested that the SSGC facilitates the exploration of hot nodes in sentinel lymph node biopsy.Key Words: lymphoscintigraphy; oncology; semiconductor g-camera; CdTe; handheld g-camera; sentinel lymph node biopsy; radioguided surgery; oral cancer Radi oguided surgery has been accomplished with the use of g-probes, primarily for sentinel lymph node biopsy.However, g-probes can provide only radioactivity counts and variable-pitch audio output based on the intensity of the detected radioactivity. Allowing the surgeon to see the spatial distribution of the increased radioactivity could result in more accurate delineation of the surgical field, thus facilitating the surgery. Therefore, we developed a prototype small semiconductor g-camera (SSGC) that provides images of radioactivities for surgical use (1).For radioguided surgery, the g-camera should be miniaturized or handheld to facilitate its application in the restricted space of a surgical field. A semiconductor detector containing cadmium telluride (CdTe) or cadmium zinc telluride (CdZnTe) has shown excellent performance and quality for imaging (2-7). The semiconductor detector is considered to be the most suitable for miniaturization because it does not require the relatively massive photomultiplier tube that characterizes a traditional scintil...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Evaluation of the Efficacy of a Small CdTe γ-Camera for Sentinel Lymph Node Biopsy

Tsuchimochi¹,

Hayama²,

Oda³

et al. 2008

J Nucl Med

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“…The gamma camera allowed them to intraoperatively identify and remove parathyroid adenomas in all cases. Ortega et al (2007) made an intra-operative comparison of the utility of a conventional intraoperative probe and a new-generation portable gamma camera. In addition, they determined ioPTHi so as to verify the total extirpation of parathyroid tissue.…”

Section: Portable Gamma Cameramentioning

confidence: 99%

Radio-Guided Surgery and Intraoperative iPTH Determination in the Treatment of Primary Hyperparathyroidism

García-Talavera¹,

García-Talavera²

2012

Hyperparathyroidism

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“…For instance in the detection of parathyroid adenomas [12]. It might be easier to detect ectopic than nonectopic parathyroid adenomas, due to the high background usually present in the thyroid area.…”

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Portable gamma cameras: the real value of an additional view in the operating theatre

Duch

2011

Eur J Nucl Med Mol Imaging

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It has been a long time since the preliminary portable gamma cameras (PGCs) were developed [1]. During the last decade some PGCs have become available for clinical practice, and can be used in open surgery or with laparoscopy, providing information that can be combined with that coming from conventional or laparoscopic gamma probes. Some of these PGCs are not designed specifically for radioguided surgery (Dilon 6800 gamma camera, a model optimized to perform breast-specific gamma imaging, or Cardiotom 3D mobile gamma camera, optimized to perform myocardial perfusion scintigraphy), but other models are focused on sentinel node (SN) procedures [2][3][4].In this issue of the journal, Vidal-Sicart et al.[5] report on the use of the Sentinella S102 (Oncovision) camera, which is a compact scintillation camera with a 50×50× 4 mm 3 CsI crystal optically coupled through a light guide to a flat panel type position-sensitive photomultiplier tube. This model is connected to a computer via USB, which processes the output signals and provides energy to the detector system. It has three interchangeable pin-hole collimators with apertures of diameter 1.0, 2.5 and 4 mm, and is mounted in a support to facilitate transport to the operating theatre. This support also incorporates a touchsensitive screen, which allows images to be viewed with ease throughout the surgical process. The intrinsic spatial resolution is approximately 2 mm and the energy resolution is 13% at 140 keV [6]. This PGC is provided with laser devices, which can help centre the image acquisitions, and it can also acquire images from dual isotopes. It is able to use a pointer (i.e. of iodine-125) to help localize hot spots seen on the screen.The main application of these devices is in SN procedures. SNs are widely used in breast cancer, melanoma and head and neck cancer, but in the last decade, their use has expanded to additional indications, with more sophistication and complexity in the technique, including indications in urology, gynaecology and gastroenterology. The addition of PGCs has improved the SN technique, particularly when intraoperative tracer injection is needed or in laparoscopic SN localization [7][8][9].In breast cancer, the main indication for a SN procedure worldwide, usually no laparoscopic technique and no intraoperative tracer injection is needed. The utility of the PGC in breast cancer remains only when no conventional gamma camera is available, and in particular in cases with extra-axillary drainage. In breast cancer, the use of PGCs in radioguided occult lesion localization combined with a conventional gamma probe has been described [7].In head and neck cancers the usefulness of the PGC seems more clear, because of the unpredictable lymphatic drainage and the possibility of comparing the preoperative image and the intraoperative image in order to ensure that no SN is missed. This is made possible by PGCs as they can give an overview of all radioactive hot spots within the surgical field. Prior SPECT images may be mandatory in head and nec...

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Potential role of a new hand-held miniature gamma camera in performing minimally invasive parathyroidectomy

Abstract: The hand-held MGC is a useful instrument in MIP for PHPT. It may be used to complement the standard tools used to date, or may even replace them, at least in selected cases of single adenomas.

Cited by 52 publications

References 13 publications

Evaluation of the Efficacy of a Small CdTe γ-Camera for Sentinel Lymph Node Biopsy

Evaluation of the Efficacy of a Small CdTe γ-Camera for Sentinel Lymph Node Biopsy

Radio-Guided Surgery and Intraoperative iPTH Determination in the Treatment of Primary Hyperparathyroidism

Portable gamma cameras: the real value of an additional view in the operating theatre

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