Evaluation of surgical gamma probes for radioguided sentinel node localisation (original) (raw)
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Surgical Gamma Probe for Identification of Sentinel Lymph Node
Surgical gamma probes have been widely used in oriented surgery, to locate the sentinel lymph nodes in breast cancer and malignant melanoma during the surgery. In this technique, the intra-operative localisation of the sentinel lymph node is carried out using a surgical gamma probe. A radiotracer, such as colloidal suspensions of 99m Tc in human albumin emitting γ-rays of 140 keV is administered (in the tumour site or close) in the patient, before operation, and the radiotracer travels from the tumour to the sentinel lymph node. Then the probe measures the labelled radioactivity, identifying and locating the sentinel lymph node once a visually occult disease, in order to remove it surgically. In this work, a pilot group of surgical gamma probes were developed at IPEN/CNEN-SP with high nationalisation indices, included the detector set. The probes final sizes were 14.0 mm diameter and 170 mm long and their characteristics were compared with imported probes and finally they were used in actual surgeries.
Evaluation of surgical gamma probes for sentinel node localization in cervical and vulvar cancer
Nuclear medicine review. Central & Eastern Europe, 2005
Sentinel node (SN) scintigraphy for cervical and vulvar cancer guides the gynaecological oncologist in finding the metastatic lymph nodes during lymphadenectomy. The role of the surgical gamma probe in the sentinel node concept in gynaecological oncology is to localise (SN) both intra-operatively and transcutaneously. Intra-operative hand-held collimated gamma probes are increasingly used for detection of the sentinel lymph node. A comparative evaluation of hand held gamma probes: Neoprobe 1,500, Europrobe, Gamma Finder, Gamma Ray Prospector GRP1 and GPR2 was performed using different detection methods. Laboratory tests were performed in which sensitivity, spatial resolution and angular sensitivity were evaluated. The results for each gamma probe were summarised and discussed. Awareness of a gamma probeís capabilities and limitations should be considered in the appropriate selection of a device.
Breast (Edinburgh, Scotland), 2016
Access to nuclear medicine department for sentinel node imaging remains an issue in number of hospitals in the UK and many parts of the world. Sentinella(®) is a portable imaging camera used intra-operatively to produce real time visual localisation of sentinel lymph nodes. Sentinella(®) was tested in a controlled laboratory environment at our centre and we report our experience on the first use of this technology from UK. Moreover, preoperative scintigrams of the axilla were obtained in 144 patients undergoing sentinel node biopsy using conventional gamma camera. Sentinella(®) scans were done intra-operatively to correlate with the pre-operative scintigram and to determine presence of any residual hot node after the axilla was deemed to be clear based on the silence of the hand held gamma probe. Sentinella(®) detected significantly more nodes compared with CGC (p < 0.0001). Sentinella(®) picked up extra nodes in 5/144 cases after the axilla was found silent using hand held gamma...
Journal of Cancer Science and Clinical Therapeutics, 2019
Background: The use of intraoperative mobile gamma camera that provide real-time intraoperative images of the sentinel lymph node (SLN), in combination with hand held gamma probe, is assumed to increase the accuracy of yielding the SLN, in early breast cancer patients, with more proper site localization. Purpose: To assess the added value of intraoperative mobile gamma camera in combination with hand held gamma probe in detection of SLN(s) in early stage breast cancer patients. Methods: It was a prospective study on 30 patients, with breast cancer scheduled SLN. biopsy in the National Cancer Institute, Cairo University, Egypt. From January 2015 till December 2015. A new device (intraoperative mobile gamma camera) was used in conjunction with a gamma probe in early stage breast cancer patients
Clinical applications of gamma-detection probes – radioguided surgery
European Journal of Nuclear Medicine, 1999
& p . 1 : Radioguided surgery (RGS) is a surgical technique that enables the surgeon to identify tissue "marked" by a radionuclide before surgery, based on the tissue characteristics, the radioactive tracer and its carrying molecule, or the affinity of both. Thus, yet another tool has been added to the inspection and palpation traditionally used by the surgeon. Current clinical applications of radioguided surgery are: radioimmunoguided surgery (RIGS) for colon cancer, sentinel-node mapping for malignant melanoma (which has become state-ofthe-art), sentinel-node mapping for breast, vulvar and penile cancer, and detection of parathyroid adenoma and bone tumour (such as osteid osteoma). Although the same gamma-detecting probe (GDP) may be used for all these applications, the carrier substance and the radionuclide differ. MoAb and peptides are used for RIGS, sulphur colloid for sentinel-node mapping, iodine-125 for RIGS, technetium-99m for sentinel node, parathyroid and bone. The mode of injection also differs, but there are some common principles of gamma-guided surgery. RIGS enables the surgeon to corroborate tumour existence, find occult metastases, and assess the margins of resection; this may result in a change on the surgical plan. Sentinel lymph-node (SLN) scintigraphy for melanoma guides the surgeon to find the involved lymph nodes for lymph-node dissection. SLN for breast cancer is being investigated with promising results. This procedure has also changed the outlook of lymph-node pathology by giving the pathologist designated tissue samples for more comprehensive examination. Gamma-guided surgery will result in more accurate and less unnecessary surgery, better pathology and, hopefully, in better patient survival. & k w d : Key words: Radioimmunoguided surgery -Sentinel lymph node -Gamma-detecting probe Eur J Nucl Med (1999) 26 (Suppl): S26-S35
European Journal of Nuclear Medicine and Molecular Imaging, 2008
Purpose The role of the radioguided occult lesion localisation (ROLL) technique in breast cancer has been increasing in recent years. One of the important drawbacks of such a technique is radiotracer spillage within the mammary gland that makes the precise lesion resection difficult, and this requires the use of a hook-wire collocation to reach the lesion. The possibility of obtaining an intraoperative image of the specimen could help to confirm whether the lesion is correctly removed. Some types of portable gamma cameras have been designed, but up to now, intraoperative use has been confined to surgery of parathy-roid adenomas and sentinel lymph node location. The aim of the study was to value the usefulness of an intraoperative gamma camera to assess the resection of non-palpable breast lesions. Materials and methods The study involved 42 women diagnosed with non-palpable early breast cancer. Lymphoscintigraphy was performed on the day before surgery by injection of 99m Tc-labelled nanocolloid. During surgery a gamma probe was used to guide the surgeon, and afterwards images of the surgical bed and the tumoral specimen were acquired by means of a portable gamma camera, fitted with a pinhole collimator. A 99m Tc pointer was used to draw an outline image around the specimen. Results On lymphoscintigraphy, radiotracer was concentrated in 31 cases. During surgery, all lesions were removed. In the images acquired by the portable gamma camera, the lesion was centred inside the surgical specimen in 23 of 42 cases, non-centred in 15 and in contact in 4 cases. Congruence of 60% was found between the intraoperative images and the histopathological results. The posterior margin was the most frequently involved. The whole acquisition time for the tumoral specimen with its margins was 5 min at most. Conclusion The use of portable gamma cameras in theatre is in an early phase. The short period of time required during the surgical procedure will allow the surgical team to improve this technique until it can replace hand-held probes. The intraoperative acquisition of such images can predict the involvement of surgical margins, avoiding future surgical procedures.
Sentinel lymph node detection through radioguided surgery in patients with breast cancer
Brazilian Archives of …, 2008
Biopsy of the sentinel lymphnode (SLNB), the first lymphnode to receive lymphatic drainage from the primary tumor, accurately predicts the axillary lymph node status and, when negative, obviates the need for axillary lymphadenectomy (AL). The aim of this study was, to verify the SLN localization in breast cancer through preoperative lymphoscintigraphy and intraoperative gamma-probe, as well as to demonstrate the benefits of such techniques in preventing complications of AL. Medical records of 228 patients with breast carcinoma, who were underwent SLN localization and, radioguided surgery, from March 2005 to December 2007 were analyzed retrospectively. Data regarding age, tumor characteristic, breast involved, type of surgery, radiopharmaceutical drainage pattern, axillary assessment (SLNB or AL) and number of lymph nodes dissected were collected. It was ascertained that radioguided surgery is a selective method of axillary assessment in breast cancer, which makes this technique a safe alternative to radical assessment of total dissection of axillary lymph nodes and its subsequent complications.
Introducing the GammaPen: All-in-One Gamma Probe for Sentinel Lymph Node Biopsy
Frontiers in Biomedical Technologies, 2021
Purpose: Using an itra-operative gamma probe after injection of radiotracer during surgery helps the surgeon to identify the sentinel lymph node of regional metastasis through the detection of radiation. This work reports the design and specification of an integrated gamma probe (GammaPen), developed by our company. Materials and Methods: GammaPen is a compact and fully integrated gamma probe. The detector module consists of a thallium-activated Cesium Iodide (CsI (Tl)) scintillator, and a Silicon Photo Multiplier (SiPM), shielded using Tungsten housing. Probe sensitivity, spatial resolution and angular resolution in air and water, and side and back shielding effectiveness were measured to evaluate the performance of the probe based on NEMA NU3 standard. Results: The sensitivity of the probe in the air/water at distances of 10, 30, and 50 mm is 18784/176800, 3500/3050, and 1575/1104 cps/MBq. The spatial and angular resolutions in the air/scattering medium are 40/47 mm and 77/87 degr...