Sentinel Lymph Node Biopsy for Breast Cancer Using Short Time Injection Protocol and Intraoperative Freehand SPECT Imaging

Papakonstantinou, Efthymia; Argentou, Maria Ioanna; Ακρίδα, Ιωάννα

doi:10.1016/j.ejso.2019.11.131

Cited by 8 publications

(3 citation statements)

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“…Count rate data from the probe's single detector are streamed to a fast reconstruction algorithm to generate a 3D (fhSPECT) image of the radiotracer distribution that is superimposed upon a live visible light video image of the patient. Declipse ® SPECT (also referred to here as probe fhSPECT) has been widely used in SLN mapping in a variety of cancers including breast [14,15] and melanoma [16][17][18]. It has also been successfully employed in localization of pre-operatively placed radioactive tumor markers such as the 125 I seeds used in breast cancer surgery [19].…”

Section: A Sentinel Lymph Node Mappingmentioning

confidence: 99%

Evaluation of Camera-Based Freehand SPECT in Preoperative Sentinel Lymph Node Mapping for Melanoma Patients

Kogler

Polemi

Nair

et al. 2020

Preprint

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Background Assessment of lymphatic status via sentinel lymph node (SLN) biopsy is an integral and crucial part of melanoma surgical oncology. The most common technique for sentinel node mapping is preoperative planar scintigraphy of an injected gamma-emitting lymphatic tracer followed by intraoperative node localization using a non-imaging gamma probe with auditory feedback. In recent years, intraoperative visualization of SLNs in 3-D has become possible by coupling the probe to an external system capable of tracking its location and orientation as it is read out, thereby enabling computation of the 3D distribution of the tracer (freehand SPECT). In this project, the non-imaging probe of the fhSPECT system was replaced by a unique handheld gamma camera containing an array of sodium iodide crystals optically coupled to an array of silicon photomultipliers. A feasibility study was performed in which preoperative SLN mapping was performed using camera fhSPECT and the number of detected nodes was compared to that visualized by lymphoscintigraphy, probe fhSPECT, and to the number ultimately excised under non-imaging probe guidance.Results Among five subjects, SLNs were detected in nine lymphatic basins, with one to five SLNs detected per basin. A basin-by-basin comparison showed that the number of SLNs detected using camera fhSPECT exceeded that using lymphoscintigraphy and probe fhSPECT in seven of nine basins and five of five basins, respectively (probe fhSPECT scans were not performed for four basins). It exceeded the number excised under non-imaging probe guidance for seven of nine basins. There were no basins for which the number of excised nodes exceeded the number detected by camera fhSPECT. Conclusions Freehand SPECT using a prototype silicon photomultiplier-based gamma camera demonstrates high sensitivity for detection of SLNs in a preoperative setting. Camera fhSPECT is a potential means for efficiently obtaining real-time 3D activity distribution maps in applications such as image-guided percutaneous biopsy, and surgical SLNB or radioguided tumor excision.

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Section: A Sentinel Lymph Node Mappingmentioning

confidence: 99%

Evaluation of Camera-Based Freehand SPECT in Preoperative Sentinel Lymph Node Mapping for Melanoma Patients

Kogler

Polemi

Nair

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Freehand SPECT has been successfully used for SLN mapping in a variety of cancers including breast [10,11] and melanoma [12][13][14][15], and has demonstrated identi cation of a higher number of SLNs compared to conventional gamma probe detection [10]. It has also been successfully employed in localization of pre-operatively placed radioactive tumor markers such as the 125 I seeds used in breast cancer surgery [16].…”

Section: A Sentinel Lymph Node Mappingmentioning

confidence: 99%

Evaluation of Camera-Based Freehand SPECT in Preoperative Sentinel Lymph Node Mapping for Melanoma Patients

Kogler

Polemi

Nair

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Assessment of lymphatic status via sentinel lymph node (SLN) biopsy is an integral and crucial part of melanoma surgical oncology. The most common technique for sentinel node mapping is preoperative planar scintigraphy of an injected gamma-emitting lymphatic tracer followed by intraoperative node localization using a non-imaging gamma probe with auditory feedback. In recent years, intraoperative visualization of SLNs in 3-D has become possible by coupling the probe to an external system capable of tracking its location and orientation as it is read out, thereby enabling computation of the 3D distribution of the tracer (freehand SPECT). In this project, the non-imaging probe of the fhSPECT system was replaced by a unique handheld gamma camera containing an array of sodium iodide crystals optically coupled to an array of silicon photomultipliers (SiPMs). A feasibility study was performed in which preoperative SLN mapping was performed using camera fhSPECT and the number of detected nodes was compared to that visualized by lymphoscintigraphy, probe fhSPECT, and to the number ultimately excised under non-imaging probe guidance.Results Among five subjects, SLNs were detected in nine lymphatic basins, with one to five SLNs detected per basin. A basin-by-basin comparison showed that the number of SLNs detected using camera fhSPECT exceeded that using lymphoscintigraphy and probe fhSPECT in seven of nine basins and five of five basins, respectively (probe fhSPECT scans were not performed for four basins). It exceeded the number excised under non-imaging probe guidance for seven of nine basins, and equaled the number excised for the other two basins. Conclusions Freehand SPECT using a prototype SiPM-based gamma camera demonstrates high sensitivity for detection of SLNs in a preoperative setting. Camera fhSPECT is a potential means for efficiently obtaining real-time 3D activity distribution maps in applications such as image-guided percutaneous biopsy, and surgical SLN biopsy or radioguided tumor excision.

show abstract

“…Freehand SPECT has been successfully used for SLN mapping in a variety of cancers including breast [10,11] and melanoma [12][13][14][15] and has demonstrated identification of a higher number of SLNs compared to conventional gamma probe detection [10]. It has also been successfully employed in localization of preoperatively placed radioactive tumor markers such as the 125 I seeds used in breast cancer surgery [16].…”

mentioning

confidence: 99%

Evaluation of camera-based freehand SPECT in preoperative sentinel lymph node mapping for melanoma patients

et al. 2020

View full text Add to dashboard Cite

Background Assessment of lymphatic status via sentinel lymph node (SLN) biopsy is an integral and crucial part of melanoma surgical oncology. The most common technique for sentinel node mapping is preoperative planar scintigraphy of an injected gamma-emitting lymphatic tracer followed by intraoperative node localization using a non-imaging gamma probe with auditory feedback. In recent years, intraoperative visualization of SLNs in 3D has become possible by coupling the probe to an external system capable of tracking its location and orientation as it is read out, thereby enabling computation of the 3D distribution of the tracer (freehand SPECT). In this project, the non-imaging probe of the fhSPECT system was replaced by a unique handheld gamma camera containing an array of sodium iodide crystals optically coupled to an array of silicon photomultipliers (SiPMs). A feasibility study was performed in which preoperative SLN mapping was performed using camera fhSPECT and the number of detected nodes was compared to that visualized by lymphoscintigraphy, probe fhSPECT, and to the number ultimately excised under non-imaging probe guidance. Results Among five subjects, SLNs were detected in nine lymphatic basins, with one to five SLNs detected per basin. A basin-by-basin comparison showed that the number of SLNs detected using camera fhSPECT exceeded that using lymphoscintigraphy and probe fhSPECT in seven of nine basins and five of five basins, respectively. (Probe fhSPECT scans were not performed for four basins.) It exceeded the number excised under non-imaging probe guidance for seven of nine basins and equaled the number excised for the other two basins. Conclusions Freehand SPECT using a prototype SiPM-based gamma camera demonstrates high sensitivity for detection of SLNs in a preoperative setting. Camera fhSPECT is a potential means for efficiently obtaining real-time 3D activity distribution maps in applications such as image-guided percutaneous biopsy, and surgical SLN biopsy or radioguided tumor excision.

show abstract

Sentinel Lymph Node Biopsy for Breast Cancer Using Short Time Injection Protocol and Intraoperative Freehand SPECT Imaging

Cited by 8 publications

References 0 publications

Evaluation of Camera-Based Freehand SPECT in Preoperative Sentinel Lymph Node Mapping for Melanoma Patients

Evaluation of Camera-Based Freehand SPECT in Preoperative Sentinel Lymph Node Mapping for Melanoma Patients

Evaluation of Camera-Based Freehand SPECT in Preoperative Sentinel Lymph Node Mapping for Melanoma Patients

Evaluation of camera-based freehand SPECT in preoperative sentinel lymph node mapping for melanoma patients

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