1
|
Meißner T, Cerbone LA, Russo P, Nahm W, Hesser J. 3D-localization of single point-like gamma sources with a coded aperture camera. Phys Med Biol 2024; 69:165004. [PMID: 39008979 DOI: 10.1088/1361-6560/ad6370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 07/15/2024] [Indexed: 07/17/2024]
Abstract
Objective.3D-localization of gamma sources has the potential to improve the outcome of radio-guided surgery. The goal of this paper is to analyze the localization accuracy for point-like sources with a single coded aperture camera.Approach.We both simulated and measured a point-like241Am source at 17 positions distributed within the field of view of an experimental gamma camera. The setup includes a0.11mmthick Tungsten sheet with a MURA mask of rank 31 and pinholes of0.08mmin diameter and a detector based on the photon counting readout circuit Timepix3. Two methods, namely an iterative search including either a symmetric Gaussian fitting or an exponentially modified Gaussian fitting (EMG) and a center of mass method were compared to estimate the 3D source position.Main results.Considering the decreasing axial resolution with source-to-mask distance, the EMG improved the results by a factor of 4 compared to the Gaussian fitting based on the simulated data. Overall, we obtained a mean localization error of0.77mmon the simulated and2.64mmon the experimental data in the imaging range of20-100mm.Significance.This paper shows that despite the low axial resolution, point-like sources in the nearfield can be localized as well as with more sophisticated imaging devices such as stereo cameras. The influence of the source size and the photon count on the imaging and localization accuracy remains an important issue for further research.
Collapse
Affiliation(s)
- Tobias Meißner
- Institute of Biomedical Engineering (IBT), Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
- Mannheim Institute for Intelligent Systems in Medicine (MIISM), Heidelberg University, Mannheim, Germany
| | - Laura Antonia Cerbone
- Scuola Superiore Meridionale, Napoli, Italy
- INFN Sezione di Napoli, Istituto Nazionale di Fisica Nucleare (INFN), Napoli, Italy
- Dipartimento di Fisica 'Ettore Pancini', Università di Napoli Federico II, Napoli, Italy
| | - Paolo Russo
- INFN Sezione di Napoli, Istituto Nazionale di Fisica Nucleare (INFN), Napoli, Italy
- Dipartimento di Fisica 'Ettore Pancini', Università di Napoli Federico II, Napoli, Italy
| | - Werner Nahm
- Institute of Biomedical Engineering (IBT), Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| | - Jürgen Hesser
- Mannheim Institute for Intelligent Systems in Medicine (MIISM), Heidelberg University, Mannheim, Germany
- Interdisciplinary Center for Scientific Computing (IWR), Heidelberg University, Heidelberg, Germany
- Central Institute for Computer Engineering (ZITI), Heidelberg University, Heidelberg, Germany
- CZS Heidelberg Center for Model-Based AI, Heidelberg University, Heidelberg, Germany
| |
Collapse
|
2
|
Cerbone LA, Cimmino L, Sarno A, Biesuz NV, Bolzonella R, Mettivier G, Fiorini M, Russo P. Monte Carlo and experimental evaluation of a Timepix4 compact gamma camera for coded aperture nuclear medicine imaging with depth resolution. Phys Med 2023; 113:102663. [PMID: 37672844 DOI: 10.1016/j.ejmp.2023.102663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 05/17/2023] [Accepted: 08/05/2023] [Indexed: 09/08/2023] Open
Abstract
PURPOSE We designed a prototype compact gamma camera (MediPROBE4) for nuclear medicine tasks, including radio-guided surgery and sentinel lymph node imaging with a 99mTc radiotracer. We performed Monte Carlo (MC) simulations for image performance assessment, and first spectroscopic imaging tests with a 300 μm thick silicon detector. METHODS The hand-held camera (1 kg weight) is based on a Timepix4 readout circuit for photon-counting, energy-sensitive, hybrid pixel detectors (24.6 × 28.2 mm2 sensitive area, 55 μm pixel pitch), developed by the Medipix4 Collaboration. The camera design adopts a CdTe detector (1 or 2 mm thick) bump-bonded to a Timepix4 readout chip and a coded aperture collimator with 0.25 mm diameter round holes made of 3D printed 1-mm thick tungsten. Image reconstruction is performed via autocorrelation deconvolution. RESULTS Geant4 MC simulations showed that, for a 99mTc source in air, at 50 mm source-collimator distance, the estimated collimator sensitivity (4 × 10-4) is 292 times larger than that of a single hole in the mask; the system sensitivity is 0.22 cps/kBq (2 mm CdTe); the lateral spatial resolution is 1.7 mm FWHM. The estimated axial longitudinal resolution is 8.2 mm FWHM at 40 mm distance. First experimental tests with a 300 μm thick Silicon pixel detector bump-bonded to a Timepix4 chip and a high-resolution coded aperture collimator showed time-over-threshold and time-of-arrival capabilities with 241Am and 133Ba gamma-ray sources. CONCLUSIONS MC simulations and validation lab tests showed the expected performance of the MediPROBE4 compact gamma camera for gamma-ray 3D imaging.
Collapse
Affiliation(s)
- Laura Antonia Cerbone
- Scuola Superiore Meridionale, Largo San Marcellino 10, 80138, Napoli, Italy; Istituto Nazionale di Fisica Nucleare (INFN), Sezione di Napoli, I-80126 Napoli, Italy; Università di Napoli Federico II, 80138, Napoli, Italy.
| | - Luigi Cimmino
- Dipartimento di Fisica "Ettore Pancini", Università di Napoli Federico II, I-80126 Napoli, Italy; Istituto Nazionale di Fisica Nucleare (INFN), Sezione di Napoli, I-80126 Napoli, Italy
| | - Antonio Sarno
- Dipartimento di Fisica "Ettore Pancini", Università di Napoli Federico II, I-80126 Napoli, Italy; Istituto Nazionale di Fisica Nucleare (INFN), Sezione di Napoli, I-80126 Napoli, Italy
| | - Nicolò Vladi Biesuz
- Dipartimento di Fisica e Scienze della Terra, Università di Ferrara, I-44122 Ferrara, Italy; Istituto Nazionale di Fisica Nucleare (INFN), Sezione di Ferrara, I-44122 Ferrara, Italy
| | - Riccardo Bolzonella
- Dipartimento di Fisica e Scienze della Terra, Università di Ferrara, I-44122 Ferrara, Italy; Istituto Nazionale di Fisica Nucleare (INFN), Sezione di Ferrara, I-44122 Ferrara, Italy
| | - Giovanni Mettivier
- Dipartimento di Fisica "Ettore Pancini", Università di Napoli Federico II, I-80126 Napoli, Italy; Istituto Nazionale di Fisica Nucleare (INFN), Sezione di Napoli, I-80126 Napoli, Italy
| | - Massimiliano Fiorini
- Dipartimento di Fisica e Scienze della Terra, Università di Ferrara, I-44122 Ferrara, Italy; Istituto Nazionale di Fisica Nucleare (INFN), Sezione di Ferrara, I-44122 Ferrara, Italy
| | - Paolo Russo
- Dipartimento di Fisica "Ettore Pancini", Università di Napoli Federico II, I-80126 Napoli, Italy; Istituto Nazionale di Fisica Nucleare (INFN), Sezione di Napoli, I-80126 Napoli, Italy
| |
Collapse
|
3
|
Farnworth AL, Bugby SL. Intraoperative Gamma Cameras: A Review of Development in the Last Decade and Future Outlook. J Imaging 2023; 9:jimaging9050102. [PMID: 37233321 DOI: 10.3390/jimaging9050102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/05/2023] [Accepted: 05/08/2023] [Indexed: 05/27/2023] Open
Abstract
Portable gamma cameras suitable for intraoperative imaging are in active development and testing. These cameras utilise a range of collimation, detection, and readout architectures, each of which can have significant and interacting impacts on the performance of the system as a whole. In this review, we provide an analysis of intraoperative gamma camera development over the past decade. The designs and performance of 17 imaging systems are compared in depth. We discuss where recent technological developments have had the greatest impact, identify emerging technological and scientific requirements, and predict future research directions. This is a comprehensive review of the current and emerging state-of-the-art as more devices enter clinical practice.
Collapse
Affiliation(s)
- Andrew L Farnworth
- Department of Physics, Loughborough University, Loughborough LE11 3TU, UK
| | - Sarah L Bugby
- Department of Physics, Loughborough University, Loughborough LE11 3TU, UK
| |
Collapse
|
4
|
Privitera L, Paraboschi I, Cross K, Giuliani S. Above and Beyond Robotic Surgery and 3D Modelling in Paediatric Cancer Surgery. Front Pediatr 2021; 9:777840. [PMID: 34988038 PMCID: PMC8721224 DOI: 10.3389/fped.2021.777840] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 11/17/2021] [Indexed: 12/15/2022] Open
Abstract
Although the survival rates for children's cancers have more than doubled in the last few decades, the surgical practise has not significantly changed. Among the most recent innovations introduced in the clinic, robotic surgery and augmented reality are two of the most promising, even if they are not widespread. The increased flexibility of the motion, the magnification of the surgical field and the tremor reduction provided by robotic surgery have been beneficial to perform complex oncological procedures in children. Besides, augmented reality has been proven helpful in planning for tumour removal, facilitating early discrimination between cancer and healthy organs. Nowadays, research in the field of surgical oncology is moving fast, and new technologies and innovations wich will help to shape a new way to perform cancer surgery. Paediatric surgeons need to be ready to adopt these novel devices and intraoperative techniques to allow more radical tumour resections with fewer complications. This review aims to present the mechanism of action and indications of several novel technologies such as optical imaging surgery, high definition cameras, and intraoperative loco-regional treatments. We hope this will enhance early adoption and more research on how to employ technology for the benefit of children.
Collapse
Affiliation(s)
- Laura Privitera
- Wellcome/Engineering and Physical Sciences Research Council Centre for Interventional & Surgical Sciences, University College London, London, United Kingdom
- Developmental Biology and Cancer Department, University College London Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Irene Paraboschi
- Wellcome/Engineering and Physical Sciences Research Council Centre for Interventional & Surgical Sciences, University College London, London, United Kingdom
- Developmental Biology and Cancer Department, University College London Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Kate Cross
- Department of Specialist Neonatal and Paediatric Surgery, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Stefano Giuliani
- Wellcome/Engineering and Physical Sciences Research Council Centre for Interventional & Surgical Sciences, University College London, London, United Kingdom
- Developmental Biology and Cancer Department, University College London Great Ormond Street Institute of Child Health, London, United Kingdom
- Department of Specialist Neonatal and Paediatric Surgery, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| |
Collapse
|
5
|
Bugby SL, Lees JE, McKnight WK, Dawood NS. Stereoscopic portable hybrid gamma imaging for source depth estimation. Phys Med Biol 2021; 66:045031. [PMID: 33412543 DOI: 10.1088/1361-6560/abd955] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Advances in gamma imaging technology mean that is now technologically feasible to conduct stereoscopic gamma imaging in a hand-held unit. This paper derives an analytical model for stereoscopic pinhole imaging which can be used to predict performance for a wide range of camera configurations. Investigation of this concept through Monte Carlo and benchtop studies, for an example configuration, shows camera-source distance measurements with a mean deviation between calculated and actual distances of <5 mm for imaging distances of 50-250 mm. By combining this technique with stereoscopic optical imaging, we are then able to calculate the depth of a radioisotope source beneath a surface without any external positional tracking. This new hybrid technique has the potential to improve surgical localisation in procedures such as sentinel lymph node biopsy.
Collapse
Affiliation(s)
- S L Bugby
- Centre for Sensing and Imaging Science, Department of Physics, Loughborough University, Loughborough, E11 3TU, United Kingdom
| | | | | | | |
Collapse
|
6
|
Feasibility study on the use of CMOS sensors as detectors in radioguided surgery with β -- emitters. Appl Radiat Isot 2020; 165:109347. [PMID: 32938536 DOI: 10.1016/j.apradiso.2020.109347] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 03/16/2020] [Accepted: 07/17/2020] [Indexed: 11/20/2022]
Abstract
Radioguided surgery (RGS) is a medical practice which thanks to a radiopharmaceutical tracer and a probe allows the surgeon to identify tumor residuals up to a millimetric resolution in real-time. The employment of β- emitters, instead of γ or β+, reduces background from healthy tissues, administered activity to the patient, and medical exposure. In a previous work the possibility of using a CMOS Imager (Aptina MT9V011), initially designed for visible light imaging, to detect β- from 90Y or 90Sr sources has been established. Because of its possible application as counting probe in RGS, the performances of MT9V011 in clinical-like conditions were studied.1 Through horizontal scans on a collimated 90Sr source of different sizes (1, 3, 5, 7 mm), we have determined relationships between scan fit parameters and the source dimension, namely A quadratic correlation and a linear dependency of, respectively, signal integrated over scan interval, and maximum signal against source diameter, are determined. Horizontal scan measurements on a source, interposing collimators of different size, aim to determine relationships or correlations between scan fit parameters and source dimension. A quadratic correlation and a linear dependency of, respectively, signal integrated over scan interval, and maximum signal against source diameter are determined. In order to get closer to clinical conditions, agar-agar phantoms containing 90Y with different dimensions and activities were prepared. A 90Y phantom is characterized by a central spot and a ring all around, for simulating both signal (tumor) and background (surrounding healthy tissue). The relationship found between scan maximum and 90Sr source diameter is then exploited to extract the concentration ratio between spot and external ring of the 90Y phantom. This observable, defined as the ratio between the tumor and the nearby healthy tissues uptake simulates the Tumor-to-Non-tumor Ratio (TNR). With the aim of evaluating the sensor's ability to discriminate signal from background relying on the significance parameter, a further 90Y phantom, featuring a well-known and clinical-like activity will mimic the signal only condition. This result is used to extrapolate to different source sizes, after having estimated the background for various TNR. The obtained significance values suggest that the MT9V011 sensor is capable of distinguishing a signal from an estimated background, depending on the interplay among TNR, acquisition time and tumor diameter.
Collapse
|
7
|
CdTe compact gamma camera for coded aperture imaging in radioguided surgery. Phys Med 2020; 69:223-232. [DOI: 10.1016/j.ejmp.2019.12.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 12/22/2019] [Accepted: 12/27/2019] [Indexed: 11/20/2022] Open
|
8
|
Procz S, Avila C, Fey J, Roque G, Schuetz M, Hamann E. X-ray and gamma imaging with Medipix and Timepix detectors in medical research. RADIAT MEAS 2019. [DOI: 10.1016/j.radmeas.2019.04.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
9
|
Acampa W, Capussela T, Cuocolo A, Di Lillo F, Punzo G, Quarto M, Roberti G, Russo P, Serra M. CHARACTERIZATION OF A SMALL FOV PORTABLE GC: MediPROBE. RADIATION PROTECTION DOSIMETRY 2019; 183:290-296. [PMID: 30535407 DOI: 10.1093/rpd/ncy229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 11/14/2018] [Indexed: 06/09/2023]
Abstract
In this work, we evaluated the performance of the prototype SFOV MediPROBE developed at the University of Naples Federico II through the protocol proposed by (Bhatia B.S., Bugby S.L., Lees J.E., Perkins A.C. A scheme for assessing the performance characteristics of a small field of-view gamma cameras. Physica. Medica., 31 (1), pp. 98-103. (2015) doi: 10.1016/j.ejmp.2014.08.004). We extensively investigated a new device configuration where the pinhole collimator was placed outside the housing of the probe, in order to increase the system spatial resolution, and the pixel size was doubled, in order to reduce the charge sharing effect. The experimental measurements show that the spatial resolution is enhanced by only about 10%, but the sensitivity decreases strongly. Therefore, the trade-off between these two features does not seem to be advantageous. In addition, our experiments suggest that the charge sharing effect is not completely canceled. Despite these results, the features of this device appear suitable for intraoperative surgical survey. We aim to use this device in the clinical practice for the intraoperative imaging of lymph nodes, breast, thyroid and parathyroid tumors.
Collapse
Affiliation(s)
- Wanda Acampa
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli Federico II, Via Pansini 5, Napoli
| | | | - Alberto Cuocolo
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli Federico II, Via Pansini 5, Napoli
| | - Francesca Di Lillo
- Dipartimento di Fisica 'E. Pancini', Università degli Studi di Napoli Federico II, Via Cinthia, Fuorigrotta, Napoli
| | - Giorgio Punzo
- CNR, Istituto di Biostrutture e Bioimmagini, Via Tommaso De Amicis 95, Napoli
| | - Maria Quarto
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli Federico II, Via Pansini 5, Napoli
| | - Giuseppe Roberti
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli Federico II, Via Pansini 5, Napoli
| | - Paolo Russo
- Dipartimento di Fisica 'E. Pancini', Università degli Studi di Napoli Federico II, Via Cinthia, Fuorigrotta, Napoli
| | - Marcello Serra
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli Federico II, Via Pansini 5, Napoli
| |
Collapse
|
10
|
Sajedi S, Sabet H, Choi HS. Intraoperative biophotonic imaging systems for image-guided interventions. NANOPHOTONICS 2019; 8:99-116. [PMID: 31187017 PMCID: PMC6559750 DOI: 10.1515/nanoph-2018-0134] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Biophotonic imaging has revolutionized the operation room by providing surgeons intraoperative image-guidance to diagnose tumors more efficiently and to resect tumors with real-time image navigation. Among many medical imaging modalities, near-infrared (NIR) light is ideal for image-guided surgery because it penetrates relatively deeply into living tissue, while nuclear imaging provides quantitative and unlimited depth information. It is therefore ideal to develop an integrated imaging system by combining NIR fluorescence and gamma-positron imaging to provide surgeons with highly sensitive and quantitative detection of diseases, such as cancer, in real-time without changing the look of the surgical field. The focus of this review is to provide recent progress in intraoperative biophotonic imaging systems, NIR fluorescence imaging and intraoperative nuclear imaging devices, and their future perspectives for image-guided interventions.
Collapse
Affiliation(s)
- Salar Sajedi
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Hamid Sabet
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Hak Soo Choi
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| |
Collapse
|
11
|
A Multimodality Hybrid Gamma-Optical Camera for Intraoperative Imaging. SENSORS 2017; 17:s17030554. [PMID: 28282957 PMCID: PMC5375840 DOI: 10.3390/s17030554] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 03/06/2017] [Accepted: 03/07/2017] [Indexed: 11/17/2022]
Abstract
The development of low profile gamma-ray detectors has encouraged the production of small field of view (SFOV) hand-held imaging devices for use at the patient bedside and in operating theatres. Early development of these SFOV cameras was focussed on a single modality—gamma ray imaging. Recently, a hybrid system—gamma plus optical imaging—has been developed. This combination of optical and gamma cameras enables high spatial resolution multi-modal imaging, giving a superimposed scintigraphic and optical image. Hybrid imaging offers new possibilities for assisting clinicians and surgeons in localising the site of uptake in procedures such as sentinel node detection. The hybrid camera concept can be extended to a multimodal detector design which can offer stereoscopic images, depth estimation of gamma-emitting sources, and simultaneous gamma and fluorescence imaging. Recent improvements to the hybrid camera have been used to produce dual-modality images in both laboratory simulations and in the clinic. Hybrid imaging of a patient who underwent thyroid scintigraphy is reported. In addition, we present data which shows that the hybrid camera concept can be extended to estimate the position and depth of radionuclide distribution within an object and also report the first combined gamma and Near-Infrared (NIR) fluorescence images.
Collapse
|
12
|
A scheme for assessing the performance characteristics of small field-of-view gamma cameras. Phys Med 2015; 31:98-103. [DOI: 10.1016/j.ejmp.2014.08.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 08/13/2014] [Accepted: 08/20/2014] [Indexed: 11/21/2022] Open
|
13
|
Riccardi L, Gabusi M, Bignotto M, Gregianin M, Vecchiato A, Paiusco M. Assessing good operating conditions for intraoperative imaging of melanoma sentinel nodes by a portable gamma camera. Phys Med 2014; 31:92-7. [PMID: 25454154 DOI: 10.1016/j.ejmp.2014.10.079] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 10/17/2014] [Accepted: 10/18/2014] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To provide guidance for reliable identification of low-activity sentinel nodes in the setting of melanoma surgery using a commercial hand-held gamma camera. METHODS The average uptake of (99m)Tc nanocolloid by sentinel nodes was evaluated in 95 excised nodes using a Sentinella 102(®) (Oncovision, Valencia, Spain) portable gamma camera. The device sensitivity was assessed for different source depths and collimator distances, imaging an 8-mm sphere filled with a known-activity solution of (99m)Tc. Five nuclear medicine physicians were asked to identify the source at different activity levels and positions within the field of view. For each image the number of signal counts inside a circular region of interest (ROI) was measured, while the variability of ROI counts among operators was assessed. The number of counts providing a minimal, near-constant inter-operator variability was determined as a criterion for a consistent identification of the source. Either the minimum activity or the acquisition time needed to collect the appropriate statistics were then calculated. RESULTS The median SN uptake (0.5%) turned out to be compatible with values reported in the literature. The sensitivity of the compact gamma camera ranged from ∼25 cpm/kBq to ∼1 cpm/kBq. A total of 50 counts in the ROI circumscribing the lymph node-simulating sphere appeared to be a robust criterion for identification of the source. CONCLUSIONS Ten megabecquerels of injected activity at the time of surgery and one minute of acquisition allows reliable identification of sentinel nodes for collimator-to-source distances up to 10 cm.
Collapse
Affiliation(s)
- Lucia Riccardi
- Medical Physics Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy.
| | - Michele Gabusi
- Medical Physics Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy.
| | - Michele Bignotto
- Medical Physics Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy.
| | - Michele Gregianin
- Radiotherapy and Nuclear Medicine Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy.
| | - Antonella Vecchiato
- Melanoma and Sarcoma Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy.
| | - Marta Paiusco
- Medical Physics Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy.
| |
Collapse
|
14
|
Characterisation of a high resolution small field of view portable gamma camera. Phys Med 2014; 30:331-9. [DOI: 10.1016/j.ejmp.2013.10.004] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 09/27/2013] [Accepted: 10/21/2013] [Indexed: 11/22/2022] Open
|
15
|
Olcott P, Pratx G, Johnson D, Mittra E, Niederkohr R, Levin CS. Clinical evaluation of a novel intraoperative handheld gamma camera for sentinel lymph node biopsy. Phys Med 2013; 30:340-5. [PMID: 24239343 DOI: 10.1016/j.ejmp.2013.10.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Revised: 09/18/2013] [Accepted: 10/24/2013] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE Preoperative lymphoscintigraphy (PLS) combined with intraoperative gamma probe (GP) localization is standard procedure for localizing the sentinel lymph nodes (SLN) in melanoma and breast cancer. In this study, we evaluated the ability of a novel intraoperative handheld gamma camera (IHGC) to image SLNs during surgery. METHODS The IHGC is a small-field-of-view camera optimized for real-time imaging of lymphatic drainage patterns. Unlike conventional cameras, the IHGC can acquire useful images in a few seconds in a free-running fashion and be moved manually around the patient to find a suitable view of the node. Thirty-nine melanoma and eleven breast cancer patients underwent a modified SLN biopsy protocol in which nodes localized with the GP were imaged with the IHGC. The IHGC was also used to localize additional nodes that could not be found with the GP. RESULTS The removal of 104 radioactive SLNs was confirmed ex vivo by GP counting. In vivo, the relative node detection sensitivity was 88.5 (82.3, 94.6)% for the IHGC (used in conjunction with the GP) and 94.2 (89.7, 98.7)% for the GP alone, a difference not found to be statistically significant (McNemar test, p = 0.24). CONCLUSION Small radioactive SLNs can be visualized intraoperatively using the IHGC with exposure time of 20 s or less, with no significant difference in node detection sensitivity compared to a GP. The IHGC is a useful complement to the GP, especially for SLNs that are difficult to locate with the GP alone.
Collapse
Affiliation(s)
- Peter Olcott
- Department of Bioengineering, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA 94305, USA.
| | - Guillem Pratx
- Department of Radiation Oncology, Stanford University School of Medicine, 875 Blake Wilbur Drive, Stanford, CA 94305, USA.
| | - Denise Johnson
- St Francis and Franciscan Alliance Hospitals, Indianapolis, IN 46237, USA
| | - Erik Mittra
- Department of Radiology-Nuclear Medicine, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA 94305, USA
| | - Ryan Niederkohr
- Department of Nuclear Medicine, Kaiser Permanente, 700 Lawrence Expressway, Santa Clara, CA 94051, USA
| | - Craig S Levin
- Department of Bioengineering, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA 94305, USA; Department of Radiology-Nuclear Medicine, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA 94305, USA; Molecular Imaging Program at Stanford (MIPS), Stanford University, 300 Pasteur Drive, Stanford, CA 94305, USA.
| |
Collapse
|
16
|
Intraoperative gamma cameras for radioguided surgery: Technical characteristics, performance parameters, and clinical applications. Phys Med 2013; 29:126-38. [DOI: 10.1016/j.ejmp.2012.05.002] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2011] [Revised: 04/26/2012] [Accepted: 05/03/2012] [Indexed: 12/12/2022] Open
|