Technological innovation in the sentinel node procedure: towards 3-D intraoperative imaging

Olmos, Renato A. Valdés; Vidal-Sicart, Sergi; Nieweg, Omgo E.

doi:10.1007/s00259-010-1468-3

Cited by 32 publications

(17 citation statements)

References 6 publications

(7 reference statements)

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“…In summary, as has been previously indicated [15], 'better eyes are always welcome in radioguided surgery' to optimize disease management. The increasing indications for the SN procedure combined with the emerging techniques of radioguided surgeries further support the need for improved PGCs.…”

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confidence: 62%

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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confidence: 62%

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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“…The hand-held single-photon emission computed tomo graphy (Freehand-SPECT) is an extension of the gamma probe by additional use of a navigation unit to generate a three-dimensional (3D) presentation of the radiolabeled SLNs intraoperatively [20]. There are systems used as a top piece in addition to a normal gamma probe.…”

Section: Hand-held Spect For Three-dimensional Visualization Of the Smentioning

confidence: 99%

New Technologies in Breast Cancer Surgery

Thill

Baumann

2012

Breast Care

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Since breast-conserving surgery has become the gold standard for early breast cancer, the development of less radical or less burdensome technologies has been pressed for in order to preserve the patient from unnecessary harm through the operative procedure. Different technical approaches are under evaluation, and some of them are already being used in the clinical setting. The aim of this article is to present a perspective on future breast cancer surgery by shedding light on the current innovative and new techniques.

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“…Sentinel lymph node biopsy in the pelvic and HN area is, however, challenging and reserved for experienced centers owing to the complex anatomy of these regions and the limitations of standard technical equipment [14][15][16][17][18][19]: (a) The lymphatic system in these anatomic areas is complex and includes hundreds of LNs adjacent to vulnerable structures such as nerves or vessels. (b) Lymphatic drainage of HN or urogenital cancers may be unpredictable, and cancers may drain to aberrant and multiple nodal basins.…”

Section: Introductionmentioning

confidence: 99%

New technologies in radioguided surgery in complex anatomic areas

Bluemel

Herrmann

2016

Clin Transl Imaging

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Sentinel lymph node biopsy (SLNB) is the most common radioguided surgery procedure and standard of care for lymph node staging in clinically node-negative patients with melanoma and breast cancer. While SLNB has also emerged as a potential alternative to lymph node dissection for staging in patients with other solid malignancies, its use for this purpose has to date not been widely accepted owing to technical limitations in complex anatomic areas such as the head and neck and the pelvic region. However, new technologies have recently been developed to overcome these limitations. This review focuses on the new technologies that improve SLN localization in complex anatomic areas, including new diagnostic tracers ( 99m Tc-tilmanocept and hybrid tracers), preoperative SPECT/CT imaging, and scintigraphic threedimensional intraoperative imaging techniques.

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Technological innovation in the sentinel node procedure: towards 3-D intraoperative imaging

Cited by 32 publications

References 6 publications

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

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

New Technologies in Breast Cancer Surgery

New technologies in radioguided surgery in complex anatomic areas

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