Detecting Near-the-Injection-Site Sentinel Nodes in Head and Neck Melanomas With a High-Resolution Portable Gamma Camera
Detecting Near-the-Injection-Site Sentinel Nodes in Head and Neck Melanomas With a High-Resolution Portable Gamma Camera
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DOI：
10.1097/rlu.0000000000000370
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发表时间：
2015-01-01
影响因子：
10.6
通讯作者：
Olmos, Renato A. Valdes
中科院分区：
文献类型：
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作者：
Hellingman, Daan;de Wit-van der Veen, Linda J.;Olmos, Renato A. Valdes
背景：在头/颈部黑色素瘤中，平面淋巴闪烁扫描和/或 SPECT/CT 可能会漏掉注射部位附近的前哨淋巴结 (NIS-SN)。本研究的目的是建立便携式伽马相机 (PGC) 的性能，以在模拟体模设置中检测 NIS-SN，随后在计划进行 SN 手术的头颈黑色素瘤患者中检测。方法：使用 5 个充满 Technetium-99m-白蛋白纳米胶体的塑料 Eppendorf 管来模拟 4 个放射性示踪剂沉积部位（传统上注射到黑色素瘤患者中）和 1 个 NIS-SN。 PGC 与 2 个针孔准直器（2.5 和 4.0 mm）一起使用。相机放置在不同距离（范围 1.5Y15.5 厘米）时，图像采集时间为 1 分钟。将结果与传统的淋巴闪烁扫描和使用双头伽马相机以及伽马探针获得的 SPECT/CT 进行比较。此外，在 3 名头颈部黑色素瘤患者的病例系列中使用了相同的 PGC 设置。结果：当 PGC 定位在 1.5 cm 距离时，模拟 NIS-SN 与注射部位的区别是，距离 3 mm 的 2.5 mm 针孔和 5 mm 的 4 mm 针孔。平面淋巴闪烁扫描、SPECT/CT 和伽马探针描绘了 NIS-SN 与注射部位的距离分别为 7、10 和 22 mm。在所有 3 名患者中，PGC 描绘了 6 个 NIS-SN。结论：靠近皮肤放置的高分辨率 PGC 能够检测距离注射部位至少 3 毫米的 SN。有必要对该设备进行进一步的临床评估，以确定其在减少假阴性手术和潜在复发方面的附加值。
Background: In head/neck melanomas, near-the-injection-site sentinel nodes (NIS-SNs) may be missed on planar lymphoscintigraphy and/or SPECT/CT. The aim of the present study is to establish the performance of a portable gamma camera (PGC) to detect NIS-SNs in a simulation phantom set-up, and subsequently in head/neck melanoma patients scheduled for a SN procedure.Methods: Five plastic Eppendorf tubes filled with technetium-99m-albumin nanocolloid were used to simulate 4 radiotracer deposit sites, as traditionally injected in melanoma patients, and 1 NIS-SN. A PGC was used with 2 pinhole collimators (2.5 and 4.0 mm). Image acquisition time was 1 minute with the camera positioned at various distances (range 1.5Y15.5 cm). Results were compared with conventional lymphoscintigraphy and SPECT/CT acquired with a dual-head gamma camera as well with a gamma probe. Additionally, the same PGC setting was used in a case series of 3 patients with head/neck melanomas.Results: The simulated NIS-SN was differentiated from the injection site at a distance of 3 mm with the 2.5-mm pinhole and at 5 mm with the 4-mm pinhole when the PGC was positioned at 1.5 cm distance. Planar lymphoscintigraphy, SPECT/CT, and the gamma probe depicted the NIS-SN separated from the injection site at distances of 7, 10, and 22 mm, respectively. In all 3 patients, 6 NIS-SNs were depicted with the PGC.Conclusion: A high-resolution PGC, positioned close to the skin, is able to detect SNs at distances of at least 3 mm from the injection site. A further clinical evaluation of this device to establish its added value in reducing false-negative procedures and potential recurrences is necessary.