Real-time ultrasound and freehand-SPECT

Winkens, Thomas; Opfermann, Thomas; Elsner, Peter; Runnebaum, Ingo B.; Darr, A.; Freesmeyer, Martin

doi:10.3413/nukmed-0680-14-06

Cited by 29 publications

(8 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Two recently developed techniques for improved SN identification peri-operatively are SPECT-US [38, 39], and near infrared light fluorescence imaging [40–44]. SPECT-US displays the location of a radio-active SN in the US images; making it easier for the surgeon to locate SN’s in anatomically challenging area’s such as the cervical and occipital area; or to guide radiologists for FNAC [38, 39].…”

Section: Introductionmentioning

confidence: 99%

“…SPECT-US displays the location of a radio-active SN in the US images; making it easier for the surgeon to locate SN’s in anatomically challenging area’s such as the cervical and occipital area; or to guide radiologists for FNAC [38, 39]. Near infrared light fluorescence imaging is conducted with Indocyanine green as tracer, which can be combined with 99Tc nano-colloids to form a hybrid tracer [41].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Gamma probe and ultrasound guided fine needle aspiration cytology of the sentinel node (GULF) trial - overview of the literature, pilot and study protocol

et al. 2017

View full text Add to dashboard Cite

BackgroundSentinel node (SN) biopsy (SNB) detects clinically occult metastases of breast cancer and melanoma in 20–30%. Wound infections, seroma and lymph edema occur in up to 10%. Targeted ultrasound (US) of the SN, (with fine needle aspiration cytology (FNAC) if appropriate) has been investigated as a minimally invasive alternative, but reported sensitivity rates are too low to replace SNB. Our hypothesis is that the use of a handheld gamma probe concomitant with US may improve sensitivity.Our aim is to provide an overview of the current literature on preoperative nodal staging of clinical N0 melanoma patients, report on a pilot, and present a study protocol for a minimally invasive alternative to the SNB: Gamma probe and Ultrasound guided Fine needle aspiration cytology of the sentinel node (GULF trial).MethodsThe GULF trial is a multicenter open single arm observational trial. Newly diagnosed cT1b-4N0M0 cutaneous melanoma or cT1-3N0M0 breast cancer patients, aged >18 years, presenting for SNB are eligible. 120 patients will be included for preoperative targeted gamma probe guided US and FNAC of the SN. Afterwards all patients proceed to surgical SNB. Primary endpoint is the sensitivity of FNAC. Secondary endpoints include SN identification rate and the histopathological compatibility of Core Needle Biopsy and FNAC vs. SNB. Secondary endpoints were investigated in a pilot with 10 FNACs and marker placements, and 10 FNACs combined with Core Needle Biopsy.ResultsA pilot in 20 patients showed that SN identification rate was 90%, supporting the feasibility of this technique.DiscussionThere is broad experience with US (in combination with FNAC) prior to SNB, but sensitivity and specificity are too low to completely abandon SNB. Promising alternative techniques potentially will replace SNB in the future but more evidence is needed in the form of prospective studies. Accurate identification of the SN for US-FNAC has been proven feasible in our pilot. When adequate sensitivity can be reached, US-FNAC provides a minimally invasive alternative for the surgical SNB procedure.Trial registrationThe GULF trial is registered in the Netherlands Trial Registry (NTR), ID: NRT5193. May 1st 2015.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-017-3236-2) contains supplementary material, which is available to authorized users.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Gamma probe and ultrasound guided fine needle aspiration cytology of the sentinel node (GULF) trial - overview of the literature, pilot and study protocol

et al. 2017

View full text Add to dashboard Cite

show abstract

“…10 Recently, the fusion of these 3D nuclear images with US, making SN visualization on US possible, was introduced. 11,12 In this setup, functional (fully 3D freehand SPECT) and anatomic (2D ultrasound) information are combined in real-time.…”

mentioning

confidence: 99%

“…Freesmeyer et al 11,12 showed that freehand SPECT-US was feasible and technically successful in patients with breast cancer, melanoma, and thyroid disease. However, some technical limitations were shown in freehand SPECT quality and fusion precision.…”

mentioning

confidence: 99%

Fusion of Freehand SPECT and Ultrasound to Perform Ultrasound-Guided Fine-Needle Aspiration Cytology of Sentinel Nodes in Head and Neck Cancer

Bree

Pouw

Heuveling³

et al. 2015

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

BACKGROUND AND PURPOSE:Criteria for ultrasound-guided fine-needle aspiration cytology (USgFNAC) for the detection of occult lymph node metastasis in patients with clinically negative head and neck cancer are based on the morphology of cervical lymph nodes. To improve the selection of lymph nodes for USgFNAC, we examined the feasibility of fused freehand single-photon emission tomography ultrasound-guided fine-needle cytology (freehand SPECT-USgFNAC) of sentinel nodes in patients with early stage oral and head and neck skin cancer.

show abstract

“…The most established RGS form of this, and the only one being applied in vivo yet, is freehand SPECT [97]. Combining this technology with a tracked US device, intraoperative freehand SPECT/US has also made it to patients [114][115][116][117]. Preclinical research has also been performed to investigate freehand imaging of beta emissions [95,118], high-energy gamma emissions [119], or even freehand PET imaging using a coincidence or time-offlight principle with multiple detectors [120,121].…”

Section: Y)mentioning

confidence: 99%

How molecular imaging will enable robotic precision surgery

Wendler

Leeuwen

Navab

et al. 2021

Eur J Nucl Med Mol Imaging

View full text Add to dashboard Cite

Molecular imaging is one of the pillars of precision surgery. Its applications range from early diagnostics to therapy planning, execution, and the accurate assessment of outcomes. In particular, molecular imaging solutions are in high demand in minimally invasive surgical strategies, such as the substantially increasing field of robotic surgery. This review aims at connecting the molecular imaging and nuclear medicine community to the rapidly expanding armory of surgical medical devices. Such devices entail technologies ranging from artificial intelligence and computer-aided visualization technologies (software) to innovative molecular imaging modalities and surgical navigation (hardware). We discuss technologies based on their role at different steps of the surgical workflow, i.e., from surgical decision and planning, over to target localization and excision guidance, all the way to (back table) surgical verification. This provides a glimpse of how innovations from the technology fields can realize an exciting future for the molecular imaging and surgery communities.

show abstract

Real-time ultrasound and freehand-SPECT

Cited by 29 publications

References 40 publications

Gamma probe and ultrasound guided fine needle aspiration cytology of the sentinel node (GULF) trial - overview of the literature, pilot and study protocol

Gamma probe and ultrasound guided fine needle aspiration cytology of the sentinel node (GULF) trial - overview of the literature, pilot and study protocol

Fusion of Freehand SPECT and Ultrasound to Perform Ultrasound-Guided Fine-Needle Aspiration Cytology of Sentinel Nodes in Head and Neck Cancer

How molecular imaging will enable robotic precision surgery

Contact Info

Product

Resources

About