Design and implementation of an integrated navigation system basedon intraoperative nuclear probes for open and minimally invasive surgey

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The aim of this joint research program between the Nuclear Medicine Department of the Klinikum rechts der Isar and the Chair for Computer Aided Medical Procedures at the Informatics faculty of the Technische Universität München is to investigate, design, and implement new integrated navigated procedures enabling handheld functional imaging in the operation room e.g. for sentinel lymph node detection, malignant tumor localization, and complete but minimal resection of tumors. The one dimensional signal of handheld nuclear probes will be combined with a 6D position and orientation localization system in order to create functional imaging probes that are capable to reconstruct a surface of a radioactivity distribution in 3D or provide functional volume information. Therefore, three different probes measuring beta, low and high energy gamma activity are used. Beta probes measure activity of tumor tracers in a very close vicinity to the surface allowing thus the control of resection border. Gamma probes measure gamma radiation that originates deep inside tissue allowing localization of cancer tracers (high energy probes) as well as tracers for sentinel lymph nodes (low energy probes). The combination of all available information e.g. preoperative acquired and registered SPECT/CT and PET/CT data, biometric data, etc. will be incorporated further in a sophisticated way in an integrated navigation solution for localization and resection of tumor and sentinel lymph nodes during surgery. The integrated process, user interface, and visualization will be designed for open and minimal invasive procedure, such as endoscopic and laparoscopic interventions.