BKG: Our group has built several prototypes of imaging probe (IP); IP is a small field of view (FOV), High resolution (HR) hand held gamma camera. All the prototypes we have built were used in radioguided surgery, giving noticeable experience to our team. Present IP shows 4 inch2 FOV, 2mm spatial resolution and can be handled by a single operator. AIM: To verify with a multicenter study if our last prototype of IP shows advantages on current lymphoscyntigraphy ( LYS) in detecting sentinel node (SN) in breast cancer (BC). Methods: (A) device: 4inch2 FOV, 2x2x5 mm CsI crystals coupled with position sensitive Photo- multiplier (PSPMT) and integrated with tungsten blade, square hole collimator. very fast home made electronics. IP provides on line images on a sterilizable computer screen. IP is battery operated for wireless use in operator hall. Five US and EU patents cover this IP ( B) Patients: 140 patients with T1 BC, who underwent Anger camera LYS after 99mTc nanocollTM intra-dermal injection, were divided in two age, body mass index, cancer size matched groups of 70 pts each: series A (SA) and series B (SB). During operation SN was detected with a common Gamma Probe (GP) in SA, with IP in SB. A sterile 57Co source signalled the node position to the surgeons. Surgeons removed radioactive nodes without exceeding four nodes. Results: 96 SN were taken off in SA, 124 in SB ( P<0.01).GP detected SN in 68/70 pts of SA, 26 of whom showed multiple nodes (MSN). IP detected SN on all the 70 pts of SB. 43/70 patients of SB showed MSN, four of them showed more than 2 nodes. Immunohistochemistry detected15 N+ patients ( 21,4 %) in SA and 20 N+ pts (28,6%) in SB ( P<0.05). 11 patients of SA showed invasion on the hottest nodes, 4 on successive nodes. 5 pts showed only micro-metastases. In the SB 8 pts showed only micro-metastases ( NS). 14 invasions were on hot, 5 on second, 1 on third, 1on 4th node. Conclusions: Intra-operator HR images detect multiple SN and in more patients than Anger camera and GP do. The number of nodes with micrometastases, is higher with IP than with GP, the difference is at moment not significant, probably due to the scarce number of observations
Hand held, high resolution camera in operator theatre. Preliminary results of a multicenter study on Breast cancer sentinel node
Massari R;Soluri A;
2008
Abstract
BKG: Our group has built several prototypes of imaging probe (IP); IP is a small field of view (FOV), High resolution (HR) hand held gamma camera. All the prototypes we have built were used in radioguided surgery, giving noticeable experience to our team. Present IP shows 4 inch2 FOV, 2mm spatial resolution and can be handled by a single operator. AIM: To verify with a multicenter study if our last prototype of IP shows advantages on current lymphoscyntigraphy ( LYS) in detecting sentinel node (SN) in breast cancer (BC). Methods: (A) device: 4inch2 FOV, 2x2x5 mm CsI crystals coupled with position sensitive Photo- multiplier (PSPMT) and integrated with tungsten blade, square hole collimator. very fast home made electronics. IP provides on line images on a sterilizable computer screen. IP is battery operated for wireless use in operator hall. Five US and EU patents cover this IP ( B) Patients: 140 patients with T1 BC, who underwent Anger camera LYS after 99mTc nanocollTM intra-dermal injection, were divided in two age, body mass index, cancer size matched groups of 70 pts each: series A (SA) and series B (SB). During operation SN was detected with a common Gamma Probe (GP) in SA, with IP in SB. A sterile 57Co source signalled the node position to the surgeons. Surgeons removed radioactive nodes without exceeding four nodes. Results: 96 SN were taken off in SA, 124 in SB ( P<0.01).GP detected SN in 68/70 pts of SA, 26 of whom showed multiple nodes (MSN). IP detected SN on all the 70 pts of SB. 43/70 patients of SB showed MSN, four of them showed more than 2 nodes. Immunohistochemistry detected15 N+ patients ( 21,4 %) in SA and 20 N+ pts (28,6%) in SB ( P<0.05). 11 patients of SA showed invasion on the hottest nodes, 4 on successive nodes. 5 pts showed only micro-metastases. In the SB 8 pts showed only micro-metastases ( NS). 14 invasions were on hot, 5 on second, 1 on third, 1on 4th node. Conclusions: Intra-operator HR images detect multiple SN and in more patients than Anger camera and GP do. The number of nodes with micrometastases, is higher with IP than with GP, the difference is at moment not significant, probably due to the scarce number of observationsI documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
