Photo-Guided Sentinel Node Mapping in Breast Cancer Using Marker-Free Photo-Gamma Fusion Lymphoscintigraphy
Identifieur interne : 004033 ( Main/Merge ); précédent : 004032; suivant : 004034Photo-Guided Sentinel Node Mapping in Breast Cancer Using Marker-Free Photo-Gamma Fusion Lymphoscintigraphy
Auteurs : Eun Seong Lee ; In Kook Chun ; Seunggyun Ha ; Hai-Jeon Yoon ; So-Youn Jung [Corée du Sud] ; Seeyoun Lee [Corée du Sud] ; Seok Won Kim [Corée du Sud] ; Eun Sook Lee [Corée du Sud] ; Taeyoon Kim [Corée du Sud] ; Kwang Gi Kim [Corée du Sud] ; Byung Il Lee [Corée du Sud] ; Tae Sung Kim ; Seok-Ki Kim [Corée du Sud]Source :
- Nuclear Medicine and Molecular Imaging [ 1869-3474 ] ; 2012.
Abstract
Photo-gamma fusion lymphoscintigraphy (PGFLS) was developed by overlying a conventional planar gamma image on a photograph for the guidance of sentinel node biopsy. The feasibility and accuracy of PGFLS was assessed in breast cancer patients.
A digital camera and a gamma camera were coordinated to obtain photograph and gamma images from the same angle. Using the distance to the object and calibration acquisition with a flat phantom and radioactive markers, PGFLS was performed both in phantom and in patients without fiducial markers. Marker-free PGFLS was verified using flat phantom, anthropomorphic phantom with markers simulating sentinel nodes and breast cancer patients. In addition, the depth of the radioactive marker or sentinel node was calculated using two gamma images taken at right angles. The feasibility and accuracy of PGFLS were assessed in terms of mismatch errors of co-registration and depth with reference to the data from SPECT/CT.
The mismatch error was less than 6 mm in the flat phantom image at a distance from 50 to 62 cm without misalignment. In the anthropomorphic phantom study, co-registration error was 0.42 ± 0.29 cm; depth error was 0.51 ± 0.37 cm, which was well correlated with the reference value on SPECT/CT (x scale: R2 = 0.99,
The novel and convenient PGFLS technique is clinically feasible, showing acceptable accuracy and providing additional visual and quantitative information for sentinel lymph node mapping. This approach will facilitate photo-guided sentinel lymph node dissection in breast cancer.
Url:
DOI: 10.1007/s13139-012-0170-8
PubMed: 24895503
PubMed Central: 4035202
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Photo-Guided Sentinel Node Mapping in Breast Cancer Using Marker-Free Photo-Gamma Fusion Lymphoscintigraphy</title>
<author><name sortKey="Lee, Eun Seong" sort="Lee, Eun Seong" uniqKey="Lee E" first="Eun Seong" last="Lee">Eun Seong Lee</name>
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<wicri:noCountry code="subfield">Gyeonggi-do Korea 410-769</wicri:noCountry>
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<author><name sortKey="Ha, Seunggyun" sort="Ha, Seunggyun" uniqKey="Ha S" first="Seunggyun" last="Ha">Seunggyun Ha</name>
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<wicri:noCountry code="subfield">Gyeonggi-do Korea 410-769</wicri:noCountry>
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<author><name sortKey="Kim, Taeyoon" sort="Kim, Taeyoon" uniqKey="Kim T" first="Taeyoon" last="Kim">Taeyoon Kim</name>
<affiliation wicri:level="1"><nlm:aff id="Aff3">Department of Medical Engineering, National Cancer Center, Goyang, Republic of Korea</nlm:aff>
<country xml:lang="fr">Corée du Sud</country>
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<author><name sortKey="Kim, Kwang Gi" sort="Kim, Kwang Gi" uniqKey="Kim K" first="Kwang Gi" last="Kim">Kwang Gi Kim</name>
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<author><name sortKey="Lee, Byung Il" sort="Lee, Byung Il" uniqKey="Lee B" first="Byung Il" last="Lee">Byung Il Lee</name>
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<author><name sortKey="Kim, Tae Sung" sort="Kim, Tae Sung" uniqKey="Kim T" first="Tae Sung" last="Kim">Tae Sung Kim</name>
<affiliation><nlm:aff id="Aff1">Department of Nuclear Medicine, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do Korea 410-769</nlm:aff>
<wicri:noCountry code="subfield">Gyeonggi-do Korea 410-769</wicri:noCountry>
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<author><name sortKey="Kim, Seok Ki" sort="Kim, Seok Ki" uniqKey="Kim S" first="Seok-Ki" last="Kim">Seok-Ki Kim</name>
<affiliation><nlm:aff id="Aff1">Department of Nuclear Medicine, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do Korea 410-769</nlm:aff>
<wicri:noCountry code="subfield">Gyeonggi-do Korea 410-769</wicri:noCountry>
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<front><div type="abstract" xml:lang="en"><sec><title>Purpose</title>
<p>Photo-gamma fusion lymphoscintigraphy (PGFLS) was developed by overlying a conventional planar gamma image on a photograph for the guidance of sentinel node biopsy. The feasibility and accuracy of PGFLS was assessed in breast cancer patients.</p>
</sec>
<sec><title>Methods</title>
<p>A digital camera and a gamma camera were coordinated to obtain photograph and gamma images from the same angle. Using the distance to the object and calibration acquisition with a flat phantom and radioactive markers, PGFLS was performed both in phantom and in patients without fiducial markers. Marker-free PGFLS was verified using flat phantom, anthropomorphic phantom with markers simulating sentinel nodes and breast cancer patients. In addition, the depth of the radioactive marker or sentinel node was calculated using two gamma images taken at right angles. The feasibility and accuracy of PGFLS were assessed in terms of mismatch errors of co-registration and depth with reference to the data from SPECT/CT.</p>
</sec>
<sec><title>Results</title>
<p>The mismatch error was less than 6 mm in the flat phantom image at a distance from 50 to 62 cm without misalignment. In the anthropomorphic phantom study, co-registration error was 0.42 ± 0.29 cm; depth error was 0.51 ± 0.37 cm, which was well correlated with the reference value on SPECT/CT (x scale: R<sup>2</sup>
= 0.99, <italic>p</italic>
< 0.01; y scale: R<sup>2</sup>
= 0.99, <italic>p</italic>
< 0.01; depth: R<sup>2</sup>
= 0.99, <italic>p</italic>
< 0.01). In ten patients with breast cancer referred for lympho-SPECT/CT, PGFSL enabled photo-guided sentinel lymph node mapping with acceptable accuracy (co-registration error, 0.47 ± 0.24 cm; depth error, 1.20 ±0.41 cm). The results from PGFSL showed close correlation with those from SPECT/CT (x scale: R<sup>2</sup>
= 0.99, <italic>p</italic>
< 0.01; y scale: R<sup>2</sup>
= 0.98, <italic>p</italic>
< 0.01; depth: R<sup>2</sup>
= 0.77, <italic>p</italic>
< 0.01).</p>
</sec>
<sec><title>Conclusions</title>
<p>The novel and convenient PGFLS technique is clinically feasible, showing acceptable accuracy and providing additional visual and quantitative information for sentinel lymph node mapping. This approach will facilitate photo-guided sentinel lymph node dissection in breast cancer.</p>
</sec>
</div>
</front>
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