Introducing navigation during melanoma-related sentinel lymph node procedures in the head-and-neck region
Abstract Background Intraoperative sentinel node (SN) identification in patients with head-and-neck malignancies can be challenging due to unexpected drainage patterns and anatomical complexity. Here, intraoperative navigation-based guidance technologies may provide outcome. In this study, gamma cam...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2017-08-01
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| Series: | EJNMMI Research |
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| Online Access: | http://link.springer.com/article/10.1186/s13550-017-0312-1 |
| _version_ | 1811338595543285760 |
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| author | Gijs H. KleinJan Baris Karakullukçu W. Martin C. Klop Thijs Engelen Nynke S. van den Berg Fijs W. B. van Leeuwen |
| author_facet | Gijs H. KleinJan Baris Karakullukçu W. Martin C. Klop Thijs Engelen Nynke S. van den Berg Fijs W. B. van Leeuwen |
| author_sort | Gijs H. KleinJan |
| collection | DOAJ |
| description | Abstract Background Intraoperative sentinel node (SN) identification in patients with head-and-neck malignancies can be challenging due to unexpected drainage patterns and anatomical complexity. Here, intraoperative navigation-based guidance technologies may provide outcome. In this study, gamma camera-based freehandSPECT was evaluated in combination with the hybrid tracer ICG-99mTc-nanocolloid. Materials and methods Eight patients with melanoma located in the head-and-neck area were included. Indocyanine green (ICG)-99mTc-nanocolloid was injected preoperatively, whereafter lymphoscintigraphy and SPECT/CT imaging were performed in order to define the location of the SN(s). FreehandSPECT scans were generated in the operation room using a portable gamma camera. For lesion localization during surgery, freehandSPECT scans were projected in an augmented reality video-view that was used to spatially position a gamma-ray detection probe. Intraoperative fluorescence imaging was used to confirm the accuracy of the navigation-based approach and identify the exact location of the SNs. Results Preoperatively, 15 SNs were identified, of which 14 were identified using freehandSPECT. Navigation towards these nodes using the freehandSPECT approach was successful in 13 nodes. Fluorescence imaging provided optical confirmation of the navigation accuracy in all patients. In addition, fluorescence imaging allowed for the identification of (clustered) SNs that could not be identified based on navigation alone. Conclusions The use of gamma camera-based freehandSPECT aids intraoperative lesion identification and, with that, supports the transition from pre- to intraoperative imaging via augmented reality display and directional guidance. |
| first_indexed | 2024-04-13T18:13:26Z |
| format | Article |
| id | doaj.art-881efde2b2fd445abb272442be49e457 |
| institution | Directory Open Access Journal |
| issn | 2191-219X |
| language | English |
| last_indexed | 2024-04-13T18:13:26Z |
| publishDate | 2017-08-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | EJNMMI Research |
| spelling | doaj.art-881efde2b2fd445abb272442be49e4572022-12-22T02:35:49ZengSpringerOpenEJNMMI Research2191-219X2017-08-01711810.1186/s13550-017-0312-1Introducing navigation during melanoma-related sentinel lymph node procedures in the head-and-neck regionGijs H. KleinJan0Baris Karakullukçu1W. Martin C. Klop2Thijs Engelen3Nynke S. van den Berg4Fijs W. B. van Leeuwen5Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical HospitalDepartment of Head and Neck Oncology, The Netherlands Cancer Institute–Antoni van Leeuwenhoek HospitalDepartment of Head and Neck Oncology, The Netherlands Cancer Institute–Antoni van Leeuwenhoek HospitalInterventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical HospitalInterventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical HospitalInterventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical HospitalAbstract Background Intraoperative sentinel node (SN) identification in patients with head-and-neck malignancies can be challenging due to unexpected drainage patterns and anatomical complexity. Here, intraoperative navigation-based guidance technologies may provide outcome. In this study, gamma camera-based freehandSPECT was evaluated in combination with the hybrid tracer ICG-99mTc-nanocolloid. Materials and methods Eight patients with melanoma located in the head-and-neck area were included. Indocyanine green (ICG)-99mTc-nanocolloid was injected preoperatively, whereafter lymphoscintigraphy and SPECT/CT imaging were performed in order to define the location of the SN(s). FreehandSPECT scans were generated in the operation room using a portable gamma camera. For lesion localization during surgery, freehandSPECT scans were projected in an augmented reality video-view that was used to spatially position a gamma-ray detection probe. Intraoperative fluorescence imaging was used to confirm the accuracy of the navigation-based approach and identify the exact location of the SNs. Results Preoperatively, 15 SNs were identified, of which 14 were identified using freehandSPECT. Navigation towards these nodes using the freehandSPECT approach was successful in 13 nodes. Fluorescence imaging provided optical confirmation of the navigation accuracy in all patients. In addition, fluorescence imaging allowed for the identification of (clustered) SNs that could not be identified based on navigation alone. Conclusions The use of gamma camera-based freehandSPECT aids intraoperative lesion identification and, with that, supports the transition from pre- to intraoperative imaging via augmented reality display and directional guidance.http://link.springer.com/article/10.1186/s13550-017-0312-1Virtual realityAugmented realitySurgical navigationSentinel nodeMelanomaFluorescence |
| spellingShingle | Gijs H. KleinJan Baris Karakullukçu W. Martin C. Klop Thijs Engelen Nynke S. van den Berg Fijs W. B. van Leeuwen Introducing navigation during melanoma-related sentinel lymph node procedures in the head-and-neck region EJNMMI Research Virtual reality Augmented reality Surgical navigation Sentinel node Melanoma Fluorescence |
| title | Introducing navigation during melanoma-related sentinel lymph node procedures in the head-and-neck region |
| title_full | Introducing navigation during melanoma-related sentinel lymph node procedures in the head-and-neck region |
| title_fullStr | Introducing navigation during melanoma-related sentinel lymph node procedures in the head-and-neck region |
| title_full_unstemmed | Introducing navigation during melanoma-related sentinel lymph node procedures in the head-and-neck region |
| title_short | Introducing navigation during melanoma-related sentinel lymph node procedures in the head-and-neck region |
| title_sort | introducing navigation during melanoma related sentinel lymph node procedures in the head and neck region |
| topic | Virtual reality Augmented reality Surgical navigation Sentinel node Melanoma Fluorescence |
| url | http://link.springer.com/article/10.1186/s13550-017-0312-1 |
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