Clinical Usefulness of a Novel Freehand 3D Imaging Device for Radio-Guided Intraoperative Sentinel Lymph Node Detection in Malignant Melanoma

被引:17
作者
Sulzbacher, Lena [1 ,7 ]
Klinger, Markus [1 ,7 ]
Scheurecker, Christine [2 ]
Wacha, Michael [3 ]
Shamiyeh, Andreas [3 ]
Malek, Michael [4 ]
Colletti, Patrick M. [5 ]
Rubello, Domenico [6 ]
Gabriel, Michael [7 ]
机构
[1] Johannes Kepler Univ Linz, Dept Nucl Med & Endocrinol, Gen Hosp Linz, Fac Med, A-4021 Linz, Austria
[2] Johannes Kepler Univ Linz, Dept Dermatol, Linz Gen Hosp, Fac Med, A-4021 Linz, Austria
[3] Johannes Kepler Univ Linz, Surg Dept 2, Linz Gen Hosp, Fac Med, A-4021 Linz, Austria
[4] Johannes Kepler Univ Linz, Dept Oral & Maxillofacial Surg, Linz Gen Hosp, Fac Med, A-4021 Linz, Austria
[5] Univ So Calif, Dept Radiol, Los Angeles, CA USA
[6] Santa Maria Misericordia Hosp, Nucl Med & PET CT Ctr, Rovigo, Italy
[7] Med Univ Innsbruck, Univ Clin Nucl Med, A-6020 Innsbruck, Austria
关键词
1ST EXPERIENCES; BIOPSY; SPECT; NECK; HEAD; TOMOGRAPHY; NAVIGATION;
D O I
10.1097/RLU.0000000000000882
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Introduction Patients with invasive malignant melanoma are commonly referred for sentinel lymph node (SLN) detection. A recently proposed 3D tomographic imaging modality is freehand SPECT (declipseSPECT). This "bedside system" was originally developed to enable minimal-invasive image-guided surgery. The aim of this retrospective analysis was to assess the clinical use of this freehand detector device for image-guided lymphatic mapping in melanoma patients. Materials and Methods Thirty-nine patients (12 female and 27 male subjects) were included (age, 30-79 years). All of them had at least one location of melanoma with tumoral stage pT1b or greater in 37 and pTx in 2 patients in different sites of the body (abdomen in 4, back in 14, head and neck in 5, lower extremity in 6, and upper extremity in 10 patients). Lymphoscintigraphy was performed with 65 to 127 MBq Tc-99m-nanocolloid. A 2-day protocol was applied with SPECT-CT acquisition (Brightview XCT, Philips) at day 1 and surgery using radio-guided freehand SPECT at day 2. SPECT-CT data were integrated into the 3D navigation system to enable fast and direct localization of the SLN by displaying the depth of the node from the skin surface and lateral margins in relation to the gamma probe. Results Comparable preoperative imaging and intraoperative localization was observed in 18 patients. In 14 cases, more lymph nodes were resected than detected by SPECT-CT including 1 patient without evidence of an SLN because this node was located close to the primary right ear tumor. In 10 of these patients, intraoperative freehand SPECT revealed additional sites of lymph nodes. In 7 cases, more findings were detected by SPECT-CT than surgically removed. The procedure was safe and easy to perform, and the time of surgical intervention using freehand SPECT was in the range of 36 to 133 minutes (mean time, 66.56 minutes). Conclusions Freehand SPECT detected more SLN compared with SPECT-CT, and the tracking system provided precise anatomical localization of the radioactive-labeled SLNs.
引用
收藏
页码:E436 / E440
页数:5
相关论文
共 27 条
  • [1] Freehand SPECT for image-guided sentinel lymph node biopsy in breast cancer
    Bluemel, Christina
    Schnelzer, Andreas
    Okur, Asli
    Ehlerding, Alexandra
    Paepke, Stefan
    Scheidhauer, Klemens
    Kiechle, Marion
    [J]. EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING, 2013, 40 (11) : 1656 - 1661
  • [2] Feasibility of Intraoperative Navigation to the Sentinel Node in the Groin Using Preoperatively Acquired Single Photon Emission Computerized Tomography Data: Transferring Functional Imaging to the Operating Room
    Brouwer, Oscar R.
    van den Berg, Nynke S.
    Matheron, Hanna M.
    Wendler, Thomas
    van der Poel, Henk G.
    Horenblas, Simon
    Olmos, Renato A. Valdes
    van Leeuwen, Fijs W. B.
    [J]. JOURNAL OF UROLOGY, 2014, 192 (06) : 1810 - 1816
  • [3] Engelen T, 2015, AM J NUCL M IN PRESS, V5
  • [4] Hybrid Integration of Real-time US and Freehand SPECT: Proof of Concept in Patients with Thyroid Diseases
    Freesmeyer, Martin
    Opfermann, Thomas
    Winkens, Thomas
    [J]. RADIOLOGY, 2014, 271 (03) : 856 - 861
  • [5] Evaluation of the use of freehand SPECT for sentinel node biopsy in early stage oral carcinoma
    Heuveling, Derrek A.
    van Weert, Stijn
    Karagozoglu, K. Hakki
    de Bree, Remco
    [J]. ORAL ONCOLOGY, 2015, 51 (03) : 287 - 290
  • [6] Assessment of Lymphatic Drainage Patterns and Implications for the Extent of Neck Dissection in Head and Neck Melanoma Patients
    Klop, W. Martin C.
    Veenstra, Hidde J.
    Vermeeren, Lenka
    Nieweg, Omgo E.
    Balm, Alfons J. M.
    Lohuis, Peter J. F. M.
    [J]. JOURNAL OF SURGICAL ONCOLOGY, 2011, 103 (08) : 756 - 760
  • [7] Image-guided surgical navigation in otology
    Kohan, Darius
    Jethanamest, Daniel
    [J]. LARYNGOSCOPE, 2012, 122 (10) : 2291 - 2299
  • [8] Leiter U, 2015, ANN SURG ON IN PRESS, V25
  • [9] Short-term morbidity associated with sentinel lymph node biopsy in cutaneous malignant melanoma
    Ling, Adrian
    Dawkins, Rosie
    Bailey, Michael
    Leung, Michael
    Cleland, Heather
    Serpell, Jonathan
    Kelly, John
    [J]. AUSTRALASIAN JOURNAL OF DERMATOLOGY, 2010, 51 (01) : 13 - 17
  • [10] American Society of Clinical Oncology guideline recommendations for sentinel lymph node biopsy in early-stage breast cancer
    Lyman, GH
    Giuliano, AE
    Somerfield, MR
    Benson, AB
    Bodurka, DC
    Burstein, HJ
    Benson, AB
    Bodurka, DC
    Burstein, HJ
    Cochran, AJ
    Cody, HS
    Edge, SB
    Galper, S
    Hayman, JA
    Kim, TY
    Perkins, CL
    Podoloff, DA
    Sivasubramaniam, VH
    Turner, RR
    Wahl, R
    Weaver, DL
    Wolff, AC
    Winer, EP
    [J]. JOURNAL OF CLINICAL ONCOLOGY, 2005, 23 (30) : 7703 - 7720