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International Journal of Computer Assisted Radiology and Surgery

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02-07-2018 | Original Article

Clinical use of an opto-nuclear probe for hybrid sentinel node biopsy guidance: first results

Authors: Sergi Vidal-Sicart, Antonio Seva, Francisco Campos, Núria Sánchez, Immaculada Alonso, Jaume Pahisa, Xavier Caparrós, Andrés Perissinotti, Pilar Paredes, Fijs W. van Leeuwen

Published in: International Journal of Computer Assisted Radiology and Surgery | Issue 2/2019

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Abstract

Introduction

Guidelines advocate the use of combined detection techniques to achieve optimal results for sentinel node (SN) biopsy. The fluorescent and radioactive (dual-) tracer ICG-^99mTc-nanocolloid has been shown to facilitate SN biopsy in several indications. It was reported that an opto-nuclear probe permitted the detection of near-infrared fluorescence and gamma-rays. The aim of the current study was to evaluate this device in a large patient group and to test it in both open and laparoscopic surgery implications.

Methods

Thirty-three patients scheduled for SN biopsy with the dual-tracer were retrospectively analyzed. Pre-operative lymphoscintigraphy was performed in all patients; in 18 patients (55%), a SPECT/CT scan was also performed. Radioactive and fluorescent signatures in the SNs were assessed in vivo and ex vivo using the opto-nuclear probe.

Results

One or more SNs were identified in all patients (identification rate 100%). Planar lymphoscintigraphic images revealed 95 hot spots that were considered as SNs. This number increased to 103 SNs when SPECT/CT was used. During surgery, 106 SNs were excised. In vivo, the fluorescence mode of the opto-nuclear probe was able to locate 79 SNs (74.5%). When the gamma-ray detection option of the same probe was used, this number increased to 99 SNs (93.3%). Ex vivo analysis revealed fluorescence in 93.3% of the excised nodes and radioactivity in 95.2%.

Conclusions

This study underlines the feasibility of using the dual-tracer/opto-nuclear probe combination for SN resections. The use of the opto-nuclear technology has been extended to laparoscopic surgery. This study also underlines the fluorescence tracing can complement traditional radio-tracing approaches.

previous article Dual-room CT with a sliding gantry for intraoperative imaging: feasibility and workflow analysis of an interdisciplinary concept

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Title: Clinical use of an opto-nuclear probe for hybrid sentinel node biopsy guidance: first results
Authors: Sergi Vidal-Sicart
Antonio Seva
Francisco Campos
Núria Sánchez
Immaculada Alonso
Jaume Pahisa
Xavier Caparrós
Andrés Perissinotti
Pilar Paredes
Fijs W. van Leeuwen
Publication date: 02-07-2018
Publisher: Springer International Publishing
Published in: International Journal of Computer Assisted Radiology and Surgery / Issue 2/2019
Print ISSN: 1861-6410
Electronic ISSN: 1861-6429
DOI: https://doi.org/10.1007/s11548-018-1816-5

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Abstract

Introduction

Methods

Results

Conclusions

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