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Lymphoscintigraphy
Published in Michael Ljungberg, Handbook of Nuclear Medicine and Molecular Imaging for Physicists, 2022
Rimma Axelsson, Maria Holstensson, Ulrika Estenberg
The gamma probe procedure can be improved by the addition of a small imaging device that can be used during the surgery. As with conventional gamma cameras, there is a trade-off between good spatial resolution and good sensitivity [40]. There are a few prototypes of hand-held gamma cameras described in the literature [41]. CrystalCam is a commercially available semiconductor (CdZnTe) handheld gamma camera with a 40×40 mm2 field of view and a pixel pitch of 2.46 mm. The physical size of the handheld unit is 60×60×160 mm3, the weight is <800 g and the energy resolution is <7 per cent at 140keV [42]. SurgeoSight is another commercially available portable gamma camera mounted on a movable mechanical arm. It has a pixelated CsI(Na) scintillation crystal, a 42×42 mm2 field of view, a pixel size of 1.2 mm and an energy resolution of 20 per cent at 140keV [43, 44].
Breast Cancer: Surgical Perspectives
Published in Raymond Taillefer, Iraj Khalkhali, Alan D. Waxman, Hans J. Biersack, Radionuclide Imaging of the Breast, 2021
Patricia J. Eubanks, Hernan I. Vargas, Stanley R. Klein
Giuliano et al. report 95.6% accuracy in predicting axillary nodal status in 114 cases in which a sentinel node was identified (65% of the time) [54]. They noted a significant learning curve and subsequently found 100% predictability in the latter part of the study. Albertini et al. report the ability to locate the sentinel lymph node 92% of the time using Isosulfan Blue in combination with technetium-labeled sulfur colloid [55]. They found that all patients with positive axillary lymph nodes had positive sentinel nodes. The technique of sentinel lymph node mapping involves injecting the breast at the tumor site with Isosulfan Blue dye (and radiolabeled colloid). The radioactive colloid allows gamma probe assistance in locating the sentinel lymph node and enhances detection of the first nodal basin [56].
Sentinel node biopsy
Published in John Dudley Langdon, Mohan Francis Patel, Robert Andrew Ord, Peter Brennan, Operative Oral and Maxillofacial Surgery, 2017
Moni Abraham Kuriakose, Nirav Pravin Trivedi
Lymphatic metastasis generally follows an orderly and predictable pattern of progression beginning with the sentinel lymph node. It has been demonstrated that the status of the sentinel node predicts the presence of metastasis in the remainder of the nodal basin. Lymphoscintigraphy is now established as a reliable and minimally invasive technique of identifying the sentinel nodes in solid tumours. Since the original description to stage patients with cutaneous melanoma, biopsy of the sentinel lymph node has replaced routine elective lymph node dissection in many anatomical regions that include the head and neck. Initial attempts at lymph node mapping using the vital dye, isosulphan blue, failed to localize the sentinel nodes in about 20% of cases. The introduction of the handheld gamma probe has improved sensitivity to over 93%. This technique is now being increasingly used to evaluate cancer of the breast, colon and vulva, and it is redefining the standard of care for these treatment sites.
Practical aspects of sentinel node biopsy in oral cavity cancer: all nodes that emit a signal are important
Published in Acta Oto-Laryngologica, 2021
Elina Panula, Jussi Hirvonen, Tero Vahlberg, Aleksi Schrey, Heikki Irjala
Sentinel node detection followed the standard procedure: 1 day before surgery, 37MBq of technetium-labeled nanocolloid was injected at four submucosal sites around the tumor and images were taken with SPECT-CT. For this study, we evaluated the number and brightness of sentinel lymph nodes (SLN) found on preoperative imaging with those found with a gamma probe at surgery the next day. These characteristics were compared with the pathological status of the sentinel nodes. Histopathological analyses were performed according to the international protocol [4]. SPECT-CT images and gamma probe readings were analyzed and compared from patients with malignant diagnoses from SNB. Delay to re-treatment was also analyzed. All patients with recurrent disease were analyzed and the effect of smoking and alcohol consumption was investigated.
In vivo trafficking of a tumor-targeting IgE antibody: molecular imaging demonstrates rapid hepatobiliary clearance compared to IgG counterpart
Published in OncoImmunology, 2021
Francis Man, Alexander Koers, Panagiotis Karagiannis, Debra H. Josephs, Heather J. Bax, Amy E. Gilbert, Tihomir S. Dodev, Silvia Mele, Giulia Chiaruttini, Silvia Crescioli, Jitesh Chauhan, Julia E. Blower, Margaret S. Cooper, James Spicer, Sophia N. Karagiannis, Philip J. Blower
Indium-111 (30–180 MBq) in 60–300 µL of 0.1 M hydrochloric acid (Curium, UK) was added to the DTPA-conjugated antibody (200–700 μg at 2–3 mg/mL in 0.2 M NH4OAc, pH 6) and incubated for 30 min at room temperature. Labeling efficiency was measured by radio-thin layer chromatography (radio-TLC) and high-performance liquid chromatography (radio-HPLC). Radio-TLC was performed on ITLC-SA paper strips (Varian) with a mobile phase of 0.1 M sodium citrate (pH 5) with 5 mM EDTA. The strips were analyzed using a Mini-Scan™ radioTLC linear scanner (LabLogic Systems) equipped with a gamma probe (LabLogic B-FC-3200). Radio-HPLC was performed on an Agilent 1200 system using a size-exclusion chromatography column (BioSep SEC-s2000, 300 × 7.8 mm, 5 μm particle size, 145 Å pore size; Agilent) and phosphate-buffered saline pH 7.4 containing 0.2 mM EDTA as mobile phase (1 mL/min). Signals were detected with a G1314B UV detector (Agilent) and a gamma probe (LabLogic B-FC-3200). As radiolabeling efficiencies of >94% were found, no post-labeling purification was required.
Impact of Non-Steroidal Anti-Inflammatory Drugs on Recurrence and Survival after Melanoma Surgery: A Cohort Study
Published in Cancer Investigation, 2020
Bruno Luís de Castro Araujo, Jadivan Leite de Oliveira, José Francisco Neto Rezende, Washington Silva Noguera, Andréia Cristina de Melo, Luiz Claudio Santos Thuler
SLNB was performed as described elsewhere (21). This technique was employed to detect clinically occult nodal involvement. Before going to the operating room, technetium(99mTc) phytate radioisotope was injected around the primary melanoma or the scar of a previous resection, and subsequently, lymphoscintigraphy of the whole body and specific areas with planar or tomographic scans was performed for sentinel node mapping. After the administration of anesthesia, the patent blue dye was injected. During the procedure, the sentinel lymph nodes were located using both the gamma probe and visual lymphatic dye drainage. All blue-stained nodes and all nodes with greater than 10% of the hottest node’s radioactivity were resected. Melanoma wide margin resections were performed when appropriate, and simultaneously, complete regional lymphadenectomy was executed based on the results of the SLNB frozen section analysis.