Evaluation of camera-based freehand SPECT in preoperative sentinel lymph node mapping for melanoma patients

Kogler, Annie K.; Polemi, Andrew M.; Nair, Surabhi; Majewski, Stanislaw; Dengel, Lynn T.; Slingluff, Craig L.; Kross, Brian; Lee, S. J.; McKisson, J. E.; McKisson, John; Weisenberger, Andrew G.; Welch, Benjamin L.; Wendler, Thomas; Matthies, Philipp; Traub, Joerg; Witt, Michael; Williams, Mark B.

doi:10.1186/s13550-020-00729-8

Evaluation of camera-based freehand SPECT in preoperative sentinel lymph node mapping for melanoma patients

Journal Article · Wed Nov 11 00:00:00 EST 2020 · EJNMMI Research

DOI:https://doi.org/10.1186/s13550-020-00729-8· OSTI ID:1728599

Kogler, Annie K. ^[1]; Polemi, Andrew M. ^[1]; Nair, Surabhi ^[1]; Majewski, Stanislaw ^[1]; Dengel, Lynn T. ^[1]; Slingluff, Craig L. ^[1]; Kross, Brian ^[2]; Lee, S. J. ^[2]; McKisson, J. E. ^[2]; McKisson, John ^[2]; Weisenberger, Andrew G. ^[2]; Welch, Benjamin L. ^[3]; Wendler, Thomas ^[4]; Matthies, Philipp ^[4]; Traub, Joerg ^[4]; Witt, Michael ^[4]; ^[1]

Univ. of Virginia, Charlottesville, VA (United States)
Thomas Jefferson National Accelerator Facility (TJNAF), Newport News, VA (United States)
Dilon Diagnostics, Newport News, VA (United States)
SurgicEye, GmbH, Munich (Germany)

Assessment of lymphatic status via sentinel lymph node (SLN) biopsy is an integral and crucial part of melanoma surgical oncology. The most common technique for sentinel node mapping is preoperative planar scintigraphy of an injected gamma-emitting lymphatic tracer followed by intraoperative node localization using a non-imaging gamma probe with auditory feedback. In recent years, intraoperative visualization of SLNs in 3D has become possible by coupling the probe to an external system capable of tracking its location and orientation as it is read out, thereby enabling computation of the 3D distribution of the tracer (freehand SPECT). In this project, the non-imaging probe of the fhSPECT system was replaced by a unique handheld gamma camera containing an array of sodium iodide crystals optically coupled to an array of silicon photomultipliers (SiPMs). A feasibility study was performed in which preoperative SLN mapping was performed using camera fhSPECT and the number of detected nodes was compared to that visualized by lymphoscintigraphy, probe fhSPECT, and to the number ultimately excised under non-imaging probe guidance. Among five subjects, SLNs were detected in nine lymphatic basins, with one to five SLNs detected per basin. A basin-by-basin comparison showed that the number of SLNs detected using camera fhSPECT exceeded that using lymphoscintigraphy and probe fhSPECT in seven of nine basins and five of five basins, respectively. (Probe fhSPECT scans were not performed for four basins.) It exceeded the number excised under non-imaging probe guidance for seven of nine basins and equaled the number excised for the other two basins. Freehand SPECT using a prototype SiPM-based gamma camera demonstrates high sensitivity for detection of SLNs in a preoperative setting. Camera fhSPECT is a potential means for efficiently obtaining real-time 3D activity distribution maps in applications such as image-guided percutaneous biopsy, and surgical SLN biopsy or radioguided tumor excision.

View Accepted Manuscript (DOE)

Research Organization:: Thomas Jefferson National Accelerator Facility, Newport News, VA (United States)

Sponsoring Organization:: USDOE Office of Science (SC), Nuclear Physics (NP)

Grant/Contract Number:: AC05-06OR23177

OSTI ID:: 1728599

Report Number(s):: DOE/OR--23177-5090; JLAB-PHY--20-3281

Journal Information:: EJNMMI Research, Journal Name: EJNMMI Research Journal Issue: 1 Vol. 10; ISSN 2191-219X

Publisher:: Springer OpenCopyright Statement

Country of Publication:: United States

Language:: English

References (33)

Usefulness of a solid-state gamma camera for sentinel node identification in patients with breast cancer Motomura, Kazuyoshi; Noguchi, Atsushi; Hashizume, Terumi Journal of Surgical Oncology, Vol. 89, Issue 1 https://doi.org/10.1002/jso.20162	journal	January 2004
What is a sentinel node? Re-evaluating the 10% rule for sentinel lymph node biopsy in melanoma Kroon, Hidde M.; Lowe, Lori; Wong, Sandra Journal of Surgical Oncology, Vol. 95, Issue 8 https://doi.org/10.1002/jso.20729	journal	January 2007
Less false-negative sentinel node procedures in melanoma patients with experience and proper collaboration: False-Negative Sentinel Node Biopsy Veenstra, Hidde J.; Wouters, Michel J. W. M.; Kroon, Bin B. R. Journal of Surgical Oncology, Vol. 104, Issue 5 https://doi.org/10.1002/jso.21967	journal	May 2011
Radioguided occult lesion localisation in breast cancer using an intraoperative portable gamma camera: first results Paredes, P.; Vidal-Sicart, S.; Zanón, G. European Journal of Nuclear Medicine and Molecular Imaging, Vol. 35, Issue 2 https://doi.org/10.1007/s00259-007-0640-x	journal	November 2007
First demonstration of 3-D lymphatic mapping in breast cancer using freehand SPECT Wendler, Thomas; Herrmann, Ken; Schnelzer, Andreas European Journal of Nuclear Medicine and Molecular Imaging, Vol. 37, Issue 8 https://doi.org/10.1007/s00259-010-1430-4	journal	March 2010
The use of a portable gamma camera for preoperative lymphatic mapping: a comparison with a conventional gamma camera Vidal-Sicart, Sergi; Vermeeren, Lenka; Solà, Oriol European Journal of Nuclear Medicine and Molecular Imaging, Vol. 38, Issue 4 https://doi.org/10.1007/s00259-010-1682-z	journal	December 2010
Freehand SPECT for image-guided sentinel lymph node biopsy in breast cancer Bluemel, Christina; Schnelzer, Andreas; Okur, Asli European Journal of Nuclear Medicine and Molecular Imaging, Vol. 40, Issue 11 https://doi.org/10.1007/s00259-013-2473-0	journal	June 2013
Intraoperative 3-D imaging improves sentinel lymph node biopsy in oral cancer Bluemel, Christina; Herrmann, Ken; Kübler, Alexander European Journal of Nuclear Medicine and Molecular Imaging, Vol. 41, Issue 12 https://doi.org/10.1007/s00259-014-2870-z	journal	July 2014
SPECT/CT in imaging sentinel nodes Navalkissoor, Shaunak; Wagner, Thomas; Gnanasegaran, Gopinath Clinical and Translational Imaging, Vol. 3, Issue 3 https://doi.org/10.1007/s40336-015-0113-3	journal	February 2015
Revisiting the “10% rule” in breast cancer sentinel lymph node biopsy: an approach to minimize the number of sentinel lymph nodes removed Dutta, Ranjan; Kluftinger, Andreas; MacLeod, Michael The American Journal of Surgery, Vol. 203, Issue 5 https://doi.org/10.1016/j.amjsurg.2012.01.010	journal	May 2012
A novel technique for localization and excisional biopsy of small or Ill-defined pulmonary lesions Daniel, Thomas M.; Altes, Talissa A.; Rehm, Patrice K. The Annals of Thoracic Surgery, Vol. 77, Issue 5 https://doi.org/10.1016/j.athoracsur.2003.10.099	journal	May 2004
Hot or not? The 10% rule in sentinel lymph node biopsy for malignant melanoma revisited Murphy, A. D.; Britten, A.; Powell, B. Journal of Plastic, Reconstructive & Aesthetic Surgery, Vol. 67, Issue 3 https://doi.org/10.1016/j.bjps.2013.11.008	journal	March 2014
Transferring innovative freehand SPECT to the operating room: First experiences with sentinel lymph node biopsy in malignant melanoma Mihaljevic, A. L.; Rieger, A.; Belloni, B. European Journal of Surgical Oncology (EJSO), Vol. 40, Issue 1 https://doi.org/10.1016/j.ejso.2013.09.005	journal	January 2014
Intraoperative sentinel node imaging versus SPECT/CT in oral cancer – A blinded comparison Schilling, Clare; Gnansegaran, Gopinath; Thavaraj, Selvam European Journal of Surgical Oncology, Vol. 44, Issue 12 https://doi.org/10.1016/j.ejso.2018.08.026	journal	December 2018
Sentinel Lymph Node Biopsy for Breast Cancer Using Short Time Injection Protocol and Intraoperative Freehand SPECT Imaging Papakonstantinou, Efthymia; Argentou, Maria Ioanna; Akrida, Ioanna European Journal of Surgical Oncology, Vol. 46, Issue 2 https://doi.org/10.1016/j.ejso.2019.11.131	journal	February 2020
Performance of a PSPMT based detector for scintimammography Williams, Mark B.; Goode, Allen R.; Galbis-Reig, Victor Physics in Medicine and Biology, Vol. 45, Issue 3 https://doi.org/10.1088/0031-9155/45/3/315	journal	February 2000
A self-assembled multimodal complex for combined pre- and intraoperative imaging of the sentinel lymph node Buckle, Tessa; van Leeuwen, Anne C.; Chin, Patrick T. K. Nanotechnology, Vol. 21, Issue 35 https://doi.org/10.1088/0957-4484/21/35/355101	journal	August 2010
Radioguided Occult Lesion Localization Techniques for Nonpalpable Breast Cancer Identification Mastoraki, Aikaterini; Tsakali, Athina; Mastoraki, Sotiria Journal of Gynecologic Surgery, Vol. 33, Issue 3 https://doi.org/10.1089/gyn.2017.0003	journal	June 2017
Handheld single photon emission computed tomography (handheld SPECT) navigated video-assisted thoracoscopic surgery of computer tomography-guided radioactively marked pulmonary lesions Müller, Joachim; Putora, Paul Martin; Schneider, Tino Interactive CardioVascular and Thoracic Surgery, Vol. 23, Issue 3 https://doi.org/10.1093/icvts/ivw136	journal	May 2016
Lymphatic Drainage Patterns on Early Versus Delayed Breast Lymphoscintigraphy Performed after Injection of Filtered Tc-99m Sulfur Colloid in Breast Cancer Patients Undergoing Sentinel Lymph Node Biopsy Babiera, Gildy V.; Delpassand, Ebrahim S.; Breslin, Tara M. Clinical Nuclear Medicine, Vol. 30, Issue 1 https://doi.org/10.1097/00003072-200501000-00003	journal	January 2005
SPECT/CT in sentinel node imaging Wagner, Thomas; Buscombe, John; Gnanasegaran, Gopinath Nuclear Medicine Communications, Vol. 34, Issue 3 https://doi.org/10.1097/MNM.0b013e32835c5a24	journal	January 2013
Clinical Usefulness of a Novel Freehand 3D Imaging Device for Radio-Guided Intraoperative Sentinel Lymph Node Detection in Malignant Melanoma Sulzbacher, Lena; Klinger, Markus; Scheurecker, Christine Clinical Nuclear Medicine, Vol. 40, Issue 9 https://doi.org/10.1097/RLU.0000000000000882	journal	January 2015
Intraoperative 3D Navigation for Single or Multiple 125I-Seed Localization in Breast-Preserving Cancer Surgery Pouw, Bas; de Wit-van der Veen, Linda J.; van Duijnhoven, Frederieke Clinical Nuclear Medicine, Vol. 41, Issue 5 https://doi.org/10.1097/RLU.0000000000001081	journal	January 2016
Intraoperative Imaging Guidance for Sentinel Node Biopsy in Melanoma Using a Mobile Gamma Camera Dengel, Lynn T.; More, Mitali J.; Judy, Patricia G. Annals of Surgery, Vol. 253, Issue 4 https://doi.org/10.1097/SLA.0b013e3181f9b709	journal	January 2011
Development and Characterization of a Round Hand-Held Silicon Photomultiplier Based Gamma Camera for Intraoperative Imaging Popovic, Kosta; McKisson, Jack E.; Kross, Brian IEEE Transactions on Nuclear Science, Vol. 61, Issue 3 https://doi.org/10.1109/TNS.2014.2308284	journal	June 2014
Introducing navigation during melanoma-related sentinel lymph node procedures in the head-and-neck region KleinJan, Gijs H.; Karakullukçu, Baris; Klop, W. Martin C. EJNMMI Research, Vol. 7, Issue 1 https://doi.org/10.1186/s13550-017-0312-1	journal	August 2017
Multi-Institutional Melanoma Lymphatic Mapping Experience: The Prognostic Value of Sentinel Lymph Node Status in 612 Stage I or II Melanoma Patients Gershenwald, Jeffrey E.; Thompson, William; Mansfield, Paul F. Journal of Clinical Oncology, Vol. 17, Issue 3 https://doi.org/10.1200/JCO.1999.17.3.976	journal	March 1999
Lymphatic Mapping and Sentinel Lymph Node Biopsy in Patients With Melanoma: A Meta-Analysis Valsecchi, Matias E.; Silbermins, Damian; de Rosa, Nicole Journal of Clinical Oncology, Vol. 29, Issue 11 https://doi.org/10.1200/JCO.2010.33.1884	journal	April 2011
Feasibility of Sentinel Node Biopsy in Head and Neck Melanoma Using a Hybrid Radioactive and Fluorescent Tracer Brouwer, Oscar R.; Klop, W. Martin C.; Buckle, Tessa Annals of Surgical Oncology, Vol. 19, Issue 6 https://doi.org/10.1245/s10434-011-2180-7	journal	December 2011
Intraoperative Imaging with a Portable Gamma Camera May Reduce the False-Negative Rate for Melanoma Sentinel Lymph Node Surgery Leong, Stanley P.; Wu, Max; Lu, Ying Annals of Surgical Oncology, Vol. 25, Issue 11 https://doi.org/10.1245/s10434-018-6685-1	journal	August 2018
3D scintigraphic imaging and navigation in radioguided surgery: freehand SPECT technology and its clinical applications Bluemel, Christina; Matthies, Philipp; Herrmann, Ken Expert Review of Medical Devices, Vol. 13, Issue 4 https://doi.org/10.1586/17434440.2016.1154456	journal	February 2016
Precise Localization of Sentinel Lymph Nodes and Estimation of Their Depth Using a Prototype Intraoperative Mini -Camera in Patients with Breast Cancer Mathelin, C.; Salvador, S.; Huss, D. Journal of Nuclear Medicine, Vol. 48, Issue 4 https://doi.org/10.2967/jnumed.106.036574	journal	April 2007
The Usefulness of a Preoperative Compact Imager, a Hand-Held -Camera for Breast Cancer Sentinel Node Biopsy: Final Results of a Prospective Double-Blind, Clinical Study Kerrou, K.; Pitre, S.; Coutant, C. Journal of Nuclear Medicine, Vol. 52, Issue 9 https://doi.org/10.2967/jnumed.111.090464	journal	August 2011

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