Department of Nuclear Medicine, Antoni van Leeuwenhoek Hospital, Netherlands Cancer Institute, Amsterdam, The Netherlands.
J Nucl Med. 2011 May;52(5):741-4. doi: 10.2967/jnumed.110.085068. Epub 2011 Apr 15.
We evaluated a portable γ-camera for sentinel node identification during laparoscopic sentinel lymphadenectomy for prostate cancer.
We analyzed the portable γ-camera for intraoperative sentinel node visualization in 55 patients after (99m)Tc injection, preoperative planar lymphoscintigraphy, and SPECT/CT.
Sixteen percent of 178 nodes seen on SPECT/CT could not be detected with the portable γ-camera. A seed pointer was useful for localizing sentinel nodes intraoperatively in 27% of patients. Seventeen additional sentinel nodes (2 tumor-positive nodes) were removed by monitoring after excision. The location of each sentinel node was significantly associated with the ability to detect it intraoperatively.
Intraoperative imaging leads to excision of more radioactive nodes and can determine the residual radioactivity after excision. The use of a radioactive source as a pointer enables efficient identification of nodes in difficult locations (paraaortic nodes) and in patients with a high body mass index.
我们评估了一种便携式γ相机，用于在腹腔镜下前列腺癌前哨淋巴结切除术中识别前哨淋巴结。
我们分析了在 (99m)Tc 注射后、术前平面淋巴闪烁显像和 SPECT/CT 后，对 55 例患者进行术中前哨淋巴结可视化的便携式γ相机。
SPECT/CT 上可见的 178 个淋巴结中有 16%无法用便携式γ相机检测到。种子指针可用于在 27%的患者中术中定位前哨淋巴结。切除后通过监测切除了 17 个额外的前哨淋巴结（2 个肿瘤阳性淋巴结）。每个前哨淋巴结的位置与术中检测到的能力显著相关。
术中成像导致切除更多放射性节点，并可确定切除后残留的放射性。放射性源用作指针可有效识别困难位置（主动脉旁淋巴结）和高体重指数患者的节点。
