New technologies in radioguided surgery in complex anatomic areas

Abstract

Sentinel lymph node biopsy (SLNB) is the most common radioguided surgery procedure and standard of care for lymph node staging in clinically node-negative patients with melanoma and breast cancer. While SLNB has also emerged as a potential alternative to lymph node dissection for staging in patients with other solid malignancies, its use for this purpose has to date not been widely accepted owing to technical limitations in complex anatomic areas such as the head and neck and the pelvic region. However, new technologies have recently been developed to overcome these limitations. This review focuses on the new technologies that improve SLN localization in complex anatomic areas, including new diagnostic tracers ( 99m Tc-tilmanocept and hybrid tracers), preoperative SPECT/CT imaging, and scintigraphic threedimensional intraoperative imaging techniques.