Sexual HealthIntraoperative Radioguidance With A Portable Gamma Camera: New Technique For Laparoscopic Sentinel Node Localisation In Urological Malignancies
UroToday.com - Our first results of sentinel node mapping with intraoperative radioguidance in urological tumors are described in our abstract. We selected this movie to show the whole imaging procedure. In a patient with prostate cancer, the radiopharmaceutical is injected in 4 depots into the prostate. After tracer administration, planar lymphoscintigraphy is performed after 15 minutes and in 2 hours is followed by a SPECT/CT. After fusion of corresponding SPECT and CT slices, the two-dimensional fusion images show the location of the sentinel nodes.
These images are also available during surgery. For intraoperative sentinel node localization a laparoscopic gamma ray detection probe and a portable gamma camera are used. The portable gamma camera visualizes the radiopharmaceutical within the sentinel nodes as well as a Iodine-seed used as pointer. This Iodine-seed is attached to the top of the gamma probe before laparoscopy, enabling visualization of this Iodine-seed on screen of the portable gamma camera (shown as a green circle). If this green circle matches with the sentinel node (radiopharmaceutical signal) on screen, exact localization of the sentinel node is found and this sentinel node can be excised. Post-excision monitoring shows if the signal of the sentinel node has disappeared and will also show if there is remaining radioactivity. In this way accurate excision of the sentinel nodes can be confirmed.
After excision, the portable gamma camera is used for ex-vivo monitoring, showing the amount of radioactivity within each excised node.
Written by L.Vermeeren, R.A. Valdē©s Olmos, W. Meinhardt, A. Bex, H.G. van der Poel, W.V. Vogel, F. Sivro, C.A. Hoefnagel, and S. Horenblas as part of Beyond the Abstract on UroToday.com.
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