Derrek A Heuveling1, Stijn van Weert1, K Hakki Karagozoglu2, Remco de Bree3. 1. Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands. 2. Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Centre for Dentistry (ACTA), Amsterdam, The Netherlands. 3. Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands. Electronic address: r.bree@vumc.nl.
Abstract
RATIONALE: Inadequate intraoperative visualization of the sentinel node can hamper its harvest. Freehand SPECT is a 3D tomographic imaging modality based on the concepts of SPECT, which can be used for intraoperative visualization and navigation towards the sentinel node in order to improve its localization and removal during surgery. PATIENTS AND METHODS: The use of freehand SPECT was evaluated during 66 sentinel node biopsy procedures in early stage oral cancer patients. Intraoperative detection of sentinel nodes was compared with preoperative identified sentinel nodes on lymphoscinitigraphic examination. Additional value of freehand SPECT was subjectively scored by the surgeon directly following the biopsy procedure. RESULTS: Freehand SPECT was able to detect 94% of sentinel nodes intraoperatively. Most sentinel nodes not detected (7 out of 9) were located in level I of the neck. Freehand SPECT appeared to be of additional value for facilitating the intraoperative detection of the sentinel node in 24% of procedures. CONCLUSION: The use of the freehand SPECT system is feasible in the intraoperative detection of sentinel nodes in early stage oral cancer. Freehand SPECT provides helpful information facilitating the SN biopsy procedure in a quarter of cases. However, freehand SPECT cannot detect all SNs which are located in the vicinity of the injection site.
RATIONALE: Inadequate intraoperative visualization of the sentinel node can hamper its harvest. Freehand SPECT is a 3D tomographic imaging modality based on the concepts of SPECT, which can be used for intraoperative visualization and navigation towards the sentinel node in order to improve its localization and removal during surgery. PATIENTS AND METHODS: The use of freehand SPECT was evaluated during 66 sentinel node biopsy procedures in early stage oral cancerpatients. Intraoperative detection of sentinel nodes was compared with preoperative identified sentinel nodes on lymphoscinitigraphic examination. Additional value of freehand SPECT was subjectively scored by the surgeon directly following the biopsy procedure. RESULTS: Freehand SPECT was able to detect 94% of sentinel nodes intraoperatively. Most sentinel nodes not detected (7 out of 9) were located in level I of the neck. Freehand SPECT appeared to be of additional value for facilitating the intraoperative detection of the sentinel node in 24% of procedures. CONCLUSION: The use of the freehand SPECT system is feasible in the intraoperative detection of sentinel nodes in early stage oral cancer. Freehand SPECT provides helpful information facilitating the SN biopsy procedure in a quarter of cases. However, freehand SPECT cannot detect all SNs which are located in the vicinity of the injection site.
Authors: Christina Bluemel; Domenico Rubello; Patrick M Colletti; Remco de Bree; Ken Herrmann Journal: Eur J Nucl Med Mol Imaging Date: 2015-04-28 Impact factor: 9.236
Authors: Matthias N van Oosterom; Hervé Simon; Laurent Mengus; Mick M Welling; Henk G van der Poel; Nynke S van den Berg; Fijs Wb van Leeuwen Journal: Am J Nucl Med Mol Imaging Date: 2016-01-28
Authors: Gijs H KleinJan; Baris Karakullukçu; W Martin C Klop; Thijs Engelen; Nynke S van den Berg; Fijs W B van Leeuwen Journal: EJNMMI Res Date: 2017-08-17 Impact factor: 3.138