A hand-held imaging probe for radio-guided surgery:: physical performance and preliminary clinical experience
A hand-held imaging probe for radio-guided surgery:: physical performance and preliminary clinical experience
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DOI：
10.1007/s00259-002-1064-2
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发表时间：
2003-03-01
影响因子：
9.1
通讯作者：
Charon, Y
中科院分区：
文献类型：
--
作者：
Pitre, S;Ménard, L;Charon, Y
放射性药物化合物的特异性的改进已经被开发小型探测器以帮助外科医生在手术期间定位肿瘤组织的兴趣的高涨所证实。本研究报告的主要技术特点和物理特性的一种新的手持式伽马相机，专门用于准确和实时的术中成像。并报告了首次临床经验。POCI（围手术期紧凑型成像仪）摄像机由一个头部模块组成，该模块由一个高分辨率可互换铅准直器和一个光学耦合到增强型位置敏感二极管的CsI（Na）晶体板组成。目前的原型具有40毫米直径的视野，外径为9.5厘米，长度为9厘米，重量为1.2公斤。通过锝-99m体模测量评价整体探测器成像特性。选择三名先前计划接受前哨淋巴结检测的乳腺癌患者进行初步临床经验。使用POCI相机获得的淋巴盆术前图像与使用非成像伽马探头进行的常规经皮探查进行比较。在空气和散射介质中研究了半峰全宽（FWHM）空间分辨率;当体模与准直器接触时，POCI相机显示出3.2 mm的FWHM。相应的灵敏度为290 cps/MBq。初步临床结果显示POCI能够预测所有前哨淋巴结的数量和位置。在1例病例中，在术中图像上检测到伽马探头遗漏的2个深部放射性结节。这一非常初步的经验表明，POCI摄像机的物理性能足以用于无线电引导手术。这些结果足以鼓励进一步的评价研究，旨在确定术中成像设备的具体和最佳的临床作用。
Improvements in the specificity of radiopharmaceutical compounds have been paralleled by an upsurge of interest in developing small detectors to assist surgeons in localizing tumour tissue during surgery. This study reports the main technical features and physical characteristics of a new hand-held gamma camera dedicated to accurate and real-time intra-operative imaging. First clinical experience is also reported. The POCI (Peroperative Compact Imager) camera consists of a head module composed of a high-resolution interchangeable lead collimator and a CsI(Na) crystal plate optically coupled to an intensified position-sensitive diode. The current prototype has a 40-mm diameter field of view, an outer diameter of 9.5 cm, a length of 9 cm and a weight of 1.2 kg. Overall detector imaging characteristics were evaluated by technetium-99m phantom measurements. Three patients with breast cancer previously scheduled to undergo sentinel lymph node detection were selected for the preliminary clinical experience. Preoperative images of the lymphatic basin obtained using the POCI camera were compared with conventional transcutaneous explorations using a non-imaging gamma probe. The full-width at half-maximum (FWHM) spatial resolution was investigated in both air and scattering medium; when the phantom was placed in contact with the collimator, the POCI camera exhibited a 3.2 mm FWHM. The corresponding sensitivity was 290 cps/MBq. The preliminary clinical results showed that POCI was able to predict the number and location of all SLNs. In one case, two deep radioactive nodes missed by the gamma probe were detected on the intra-operative images. This very initial experience demonstrates that the physical performance of the POCI camera is adequate for radio-guided surgery. These results are sufficiently encouraging to prompt further evaluation studies designed to determine the specific and optimal clinical role of intra-operative imaging devices.