Detecting Near-the-Injection-Site Sentinel Nodes in Head and Neck Melanomas With a High-Resolution Portable Gamma Camera

Abstract

A high-resolution PGC, positioned close to the skin, is able to detect SNs at distances of at least 3 mm from the injection site. A further clinical evaluation of this device to establish its added value in reducing false-negative procedures and potential recurrences is necessary.

EANM practice guidelines for lymphoscintigraphy and sentinel lymph node biopsy in melanoma

“…Also, SLNs may be hidden by the injection site, as is often observed in malignancies in the head and neck region (shine-through phenomenon). In these challenging settings, using three-dimensional imaging and navigation [97][98][99] or a portable gamma camera [100][101][102] may improve intraoperative detection of SLNs.…”

Role of intraoperative sentinel node imaging in head and neck cancer

“…Aside from fhSPECT navigation, there are other possibilities for intraoperative sentinel node imaging such as portable gamma cameras [21][22][23][24] and fusion ultrasound/…”

New technologies in radioguided surgery in complex anatomic areas

“…Moreover, they provide a visual real-time feedback when localizing SLNs and confirming their successful resection. For the most frequently used portable gamma camera (Sentinella, Oncovision, Valencia, Spain), promising results have been published for SLNB in HN malignancies [36][37][38][39] and urogenital cancers [40][41][42][43][44][45]. Portable gamma cameras can reliably detect deep-lying nodes and SLNs with only low tracer accumulation.…”

“…Unlike a gamma probe, intraoperative imaging can identify SLNs lying next to the injection site or distinguish multiple SLNs located next to each other [39,46]. Recently, a simulation model demonstrated that SLNs can be detected at a distance of 3 mm from the injection site owing to the high resolution of the pinhole collimated system [39]. Mobile large FOV gamma cameras may be used if a complex anatomic region is to be covered within one image acquisition [34].…”

“…Portable gamma cameras can reliably detect deep-lying nodes and SLNs with only low tracer accumulation. Unlike a gamma probe, intraoperative imaging can identify SLNs lying next to the injection site or distinguish multiple SLNs located next to each other [39,46]. Recently, a simulation model demonstrated that SLNs can be detected at a distance of 3 mm from the injection site owing to the high resolution of the pinhole collimated system [39].…”