ORIGINAL ARTICLE   

The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2019 March;63(1):56-61

DOI: 10.23736/S1824-4785.17.02789-3

Copyright © 2015 EDIZIONI MINERVA MEDICA

language: English

Is there a role for a handheld gamma camera (TReCam) in the SNOLL breast cancer procedure?

Alexandre BRICOU ¹ ✉, Marie-Alix DUVAL ^{2, 3}, Léna BARDET ¹, Amélie BENBARA ¹, Grégoire MOREAUX ¹, Françoise LEFEBVRE ², Laurent MÉNARD ², Laurent PINOT ², Yves CHARON ², Iulia TENGHER BARNA ⁴, Michaël SOUSSAN ⁵, Nicolas SELLIER ⁶, Emmanuel BARRANGER ⁷

¹ Department of Gynecology, AP-HP, Jean-Verdier Hospital, Bobigny University, Bondy, France; ² Laboratory of Imaging and Modeling in Neurobiology and Oncology (IMNC), IN2P3 National Institute of Nuclear and Particle Physics, National Center for Scientific Research (CNRS), Orsay, France; ³ University of Evry Val d’Essonne, Evry, France; ⁴ Department of Pathology, AP-HP, Jean-Verdier Hospital, Bobigny University, Bondy, France; ⁵ Department of Nuclear Medicine, AP-HP, Avicenne Hospital, Bobigny University, Bobigny, France; ⁶ Department of Radiology, AP-HP, Jean-Verdier Hospital, Bobigny University, Bondy, France; ⁷ Breast and Gynecological Surgical Oncology Unit, Centre Antoine Lacassagne, University of Nice-Sophia-Antipolis, Nice, France

BACKGROUND: Sentinel node and occult lesion localization (SNOLL) calls for a combination of two specific procedures: intraoperative detection of sentinel lymph node (SLN) and radio-guided occult lesion localization (ROLL). The safety and benefits of radio-guided localization in the surgical treatment of non-palpable breast cancer have been confirmed. The aim of this study was to evaluate the potential role for an intra-operative handheld tumor resection gamma camera (TReCam) in SNOLL procedures.
METHODS: Fifteen patients were enrolled. The SNOLL procedure was performed in all patients with conventional lymphoscintigraphy (LS). TReCam was used to obtain nuclear imaging in the operating theater. Concordance between LS and TReCam images, duration of use and assessment of difficulties in data acquisition with TReCam were reported.
RESULTS: Concordance for tumor localization between single-detector gamma probe and TReCam was excellent (15/15). The number of radioactive SLNs visualized between LS and TReCam was equivalent in 53.3% of cases (8/15). TReCam was considered to be very easy-to-use (12/15) or easy-to-use (3/15). Average duration of acquisition with TReCam was 4 minutes and 45 seconds for the SLN procedure, and 2 minutes and 10 seconds for lumpectomy.
CONCLUSIONS: This study suggests that TReCam is easy-to-use and does not increase operative time. Its exact role in radio-guided surgery needs to be clearly defined in a larger study. However, its usefulness and benefits in radio-guided breast surgery seem to be promising.

KEY WORDS: Gamma camera - Breast neoplasms - Sentinel lymph node biopsy - Computer-assisted surgery - Lymphoscintigraphy