Pashazadeh Ali, Friebe Michael
Chair for Catheter Technologies and Image Guided Procedures, Otto-von-Guericke University, Magdeburg, Germany.
Department of Radiology and Nuclear Medicine, Medical Faculty, Otto-von-Guericke University, INKA, Building 53, Rotgerstrasse 9, 39104 Magdeburg, Germany.
Biomed Tech (Berl). 2020 Jan 28;65(1):1-10. doi: 10.1515/bmt-2018-0016.
Radioguided surgery (RGS) is the use of radiation detection probes and handheld gamma cameras in surgery rooms to identify radioactively labeled lesions inside the body with an aim to improve surgical outcome. In today's surgery, application of these devices is a well-established practice, which provides surgeons with real-time information to guide them to the site of a lesion. In recent years, there have been several major improvements in the technology and design of gamma probes and handheld gamma cameras, enhancing their applications in surgical practices. Handheld gamma cameras, for example, are now moving from single-modality to dual-modality scanners that add anatomical data to the physiologic data, and with that provide more clinical information of the tissue under study. Also, in the last decade, a radioguided surgical technique based on the Cerenkov radiation was introduced, with more improved sensitivity in identifying radioactively labeled lesions. Additionally, recent advances in hybrid tracers have led to more efficient detection of lesions labeled with these tracers. Besides, it seems that combining medical robotics and augmented reality technology with current radioguided surgical practices potentially will change the delivery and performance of RGS in the near future. The current paper aims to give an overview of the physics of RGS and summarizes recent advances in this field that have a potential to improve the application of radioguided surgical procedures in the management of cancer.
放射性引导手术（RGS）是在手术室中使用辐射探测探头和手持式伽马相机来识别体内放射性标记的病变，目的是改善手术效果。在当今的手术中，应用这些设备已是一种成熟的做法，可为外科医生提供实时信息，引导他们找到病变部位。近年来，伽马探头和手持式伽马相机的技术和设计有了几项重大改进，增强了它们在手术实践中的应用。例如，手持式伽马相机现在正从单模态扫描仪向双模态扫描仪发展，后者在生理数据的基础上增加了解剖学数据，从而提供了更多有关所研究组织的临床信息。此外，在过去十年中，引入了一种基于切伦科夫辐射的放射性引导手术技术，在识别放射性标记病变方面具有更高的灵敏度。此外，混合示踪剂的最新进展已使对用这些示踪剂标记的病变的检测更加高效。此外，将医疗机器人技术和增强现实技术与当前的放射性引导手术实践相结合，似乎在不久的将来可能会改变RGS的实施方式和性能。本文旨在概述RGS的物理学原理，并总结该领域的最新进展，这些进展有可能改善放射性引导手术程序在癌症治疗中的应用。
