Intraoperative gamma imaging of axillary sentinel lymph nodes in breast cancer patients

被引:16
作者
Aarsvod, John N.
Greene, Carmen M.
Mintzer, Robert A.
Grant, Sandra F.
Styblo, Toncred M.
Alazraki, Naomi P.
Patt, Bradley E.
Caravaglia, Gina M.
Li, Joshua
Iwanczyk, Jan S.
机构
[1] Atlanta VA Med Ctr, Nucl Med Serv, Decatur, GA USA
[2] Emory Univ, Atlanta, GA 30322 USA
[3] Georgia Inst Technol, Atlanta, GA 30332 USA
[4] Photon Imaging Inc, Northridge, CA USA
来源
PHYSICA MEDICA-EUROPEAN JOURNAL OF MEDICAL PHYSICS | 2006年 / 21卷
关键词
intraoperative imaging; sentinel lymph node; breast cancer;
D O I
10.1016/S1120-1797(06)80030-X
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 [临床医学]; 100207 [影像医学与核医学]; 1009 [特种医学];
摘要
Sentinel lymph node (SLN) biopsy is now standard practice in the management of many breast cancer patients. Localization protocols vary in complexity and rates of success. The least complex involve only intraoperative gamma counting of radiotracer uptake or intraoperative visualization of blue-dye uptake; the most complex involve preoperative gamma imaging, intraoperative counting and intraoperative dye visualization. Intraoperative gamma imaging may improve some protocols. This study was conducted to obtain preliminary experience and information regarding intraoperative imaging. Sixteen patients were enrolled: 8 in a protocol that included intraoperative counting and dye visualization (probe/dye), 8 in a protocol that involved intraoperative imaging, counting and dye visualization (camera/probe/dye). Preoperative imaging of all 16 patients was performed using a GE 500 gamma camera with a LEAP collimator (300 cpm/mu Ci). The results of this imaging were not, however, given to the surgeon until the surgeon had completed the procedures required for the study. A Care Wise C-Trak probe was used for intraoperative counting. A Gamma Medica Inc. GammaCAM/OR (12.5 x 12.5 cm FOV) with a LEHR collimator (135 cpm/mu Ci) was used for intraoperative imaging. Times from start of surgery to external detection of a radioactive focus and to completion of excision of SLNs were recorded. Foci were detected preoperatively via imaging in 16/16 patients. Intraoperative external detection using the probe was accomplished in less than 4 min (mean = 1.5 min) in 15/16 patients, and via intraoperative imaging in 6/8 patients. The average time for completion of excision of nodes was 19 min for probe/dye and 28 min for camera/probe/dye. In one-probe/dye case, review of the preoperative images prompted the surgeon to resume axillary dissection and remove one additional SLN.
引用
收藏
页码:76 / 79
页数:4
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