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REVIEW  IMAGE-GUIDED SURGERY: FROM CLASSICAL TECHNIQUES TO NOVEL ASPECTS AND APPROACHES Freefree

The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2021 September;65(3):244-60

DOI: 10.23736/S1824-4785.21.03361-6

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

PET- and SPECT-based navigation strategies to advance procedural accuracy in interventional radiology and image-guided surgery

Imke BOEKESTIJN 1, 2, Samaneh AZARGOSHASB 2, Clare SCHILLING 3, Nassir NAVAB 4, 5, Daphne RIETBERGEN 1, 2, Matthias N. van OOSTEROM 2, 6

1 Department of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, Leiden, the Netherlands; 2 Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands; 3 Head and Neck Academic Center, Department of Head and Neck Surgery, University College London Hospital, London, UK; 4 Computer Aided Medical Procedures, Technical University of Munich, Munich, Germany; 5 Computer Aided Medical Procedures, Department of Computer Science, Johns Hopkins University, Baltimore, MD, USA; 6 Department of Urology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands



INTRODUCTION: Nuclear medicine has a crucial role in interventional strategies where a combination between the increasing use of targeted radiotracers and intraprocedural detection modalities enable novel, but often complex, targeted procedures in both the fields of interventional radiology and surgery. 3D navigation approaches could assist the interventional radiologist or surgeon in such complex procedures.
EVIDENCE ACQUISITION: This review aimed to provide a comprehensive overview of the current application of computer-assisted navigation strategies based on nuclear imaging to assist in interventional radiology and image-guided surgery. This work starts with a brief overview of the typical navigation workflow from a technical perspective, which is followed by the different clinical applications organized based on their anatomical organ of interest.
EVIDENCE SYNTHESIS: Although many studies have proven the feasibility of PET- and SPECT-based navigation strategies for various clinical applications in both interventional radiology and surgery, the strategies are spread widely in both navigation workflows and clinical indications, evaluated in small patient groups. Hence, no golden standard has yet been established.
CONCLUSIONS: Despite that the clinical outcome is yet to be determined in large patient cohorts, navigation seems to be a promising technology to translate nuclear medicine findings, provided by PET- and SPECT-based molecular imaging, to the intervention and operating room. Interventional Nuclear Medicine (iNM) has an exciting future to come using both PET- and SPECT-based navigation.


KEY WORDS: Surgical navigation systems; Augmented reality; Image-guided biopsy; Radioguided surgery; Interventional radiology

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