Clinical evaluation of a novel intraoperative handheld gamma camera for sentinel lymph node biopsy
Clinical evaluation of a novel intraoperative handheld gamma camera for sentinel lymph node biopsy
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DOI：
10.1016/j.ejmp.2013.10.005
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发表时间：
2014-05-01
影响因子：
3.4
通讯作者：
Levin, Craig S.
中科院分区：
文献类型：
--
作者：
Olcott, Peter;Pratx, Guillem;Levin, Craig S.
目的：术前淋巴结造影（PLS）结合术中γ探针（GP）定位是定位黑色素瘤和乳腺癌前哨淋巴结（SLN）的标准程序。在这项研究中，我们评估了一种新的术中手持伽马相机（IHGC）的能力，以图像SLNs在surgery.Methods：IHGC是一个小视场的摄像机优化的实时成像淋巴引流模式。与传统相机不同，IHGC可以在几秒钟内以自由运行的方式获取有用的图像，并在患者周围手动移动以找到合适的节点视图。39例黑色素瘤和11例乳腺癌患者接受了改良的SLN活检方案，其中使用IHGC对GP定位的淋巴结进行成像。IHGC也被用来定位其他节点，不能发现与GP。结果：去除104放射性SLN证实了离体GP计数。在体内，相对淋巴结检测灵敏度为88.5（82.3，94.6）%，IHGC（与GP结合使用）和94.2 GP单独给药时为（89.7，98.7）%，差异无统计学意义（McNemar检验，p = 0.24）。小放射性前哨淋巴结可以在术中使用IHGC可视化，曝光时间为20 s或更短，与GP相比，节点检测灵敏度没有显著差异。IHGC是GP的有用补充，特别是对于单独使用GP难以定位的SLN。(C)2013年意大利医学协会。由爱思唯尔有限公司出版。保留所有权利。
Objective: Preoperative lymphoscintigraphy (PLS) combined with intraoperative gamma probe (GP) localization is standard procedure for localizing the sentinel lymph nodes (SLN) in melanoma and breast cancer. In this study, we evaluated the ability of a novel intraoperative handheld gamma camera (IHGC) to image SLNs during surgery.Methods: The IHGC is a small-field-of-view camera optimized for real-time imaging of lymphatic drainage patterns. Unlike conventional cameras, the IHGC can acquire useful images in a few seconds in a free-running fashion and be moved manually around the patient to find a suitable view of the node. Thirty-nine melanoma and eleven breast cancer patients underwent a modified SLN biopsy protocol in which nodes localized with the GP were imaged with the IHGC. The IHGC was also used to localize additional nodes that could not be found with the GP.Results: The removal of 104 radioactive SLNs was confirmed ex vivo by GP counting. In vivo, the relative node detection sensitivity was 88.5 (82.3, 94.6)% for the IHGC (used in conjunction with the GP) and 94.2 (89.7, 98.7)% for the GP alone, a difference not found to be statistically significant (McNemar test, p = 0.24).Conclusion: Small radioactive SLNs can be visualized intraoperatively using the IHGC with exposure time of 20 s or less, with no significant difference in node detection sensitivity compared to a GP. The IHGC is a useful complement to the GP, especially for SLNs that are difficult to locate with the GP alone. (C) 2013 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.