scholarly journals Introducing the GammaPen: All-in-One Gamma Probe for Sentinel Lymph Node Biopsy

2021 ◽  
Author(s):  
Aram Radnia ◽  
Hamed Abdollahzadeh ◽  
Behnoosh Teimourian ◽  
Mohammad Hossein Farahani ◽  
Mohammad Reza Ay
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Gamma Probe ◽  
Lymph Node Biopsy ◽  
Cesium Iodide ◽  
Shielding Effectiveness ◽  
Node Localization ◽  
Fully Integrated ◽  
Regional Metastasis ◽  
Surgeon Experience

Purpose: Using an itra-operative gamma probe after injection of radiotracer during surgery helps the surgeon to identify the sentinel lymph node of regional metastasis through the detection of radiation. This work reports the design and specification of an integrated gamma probe (GammaPen), developed by our company. Materials and Methods: GammaPen is a compact and fully integrated gamma probe. The detector module consists of a thallium-activated Cesium Iodide (CsI (Tl)) scintillator, and a Silicon Photo Multiplier (SiPM), shielded using Tungsten housing. Probe sensitivity, spatial resolution and angular resolution in air and water, and side and back shielding effectiveness were measured to evaluate the performance of the probe based on NEMA NU3 standard. Results: The sensitivity of the probe in the air/water at distances of 10, 30, and 50 mm is 18784/176800, 3500/3050, and 1575/1104 cps/MBq. The spatial and angular resolutions in the air/scattering medium are 40/47 mm and 77/87 degrees at a 30 mm distance from the probe. The detector shielding effectiveness and leakage sensitivity are 99.91% and 0.09%, respectively. Conclusion: The results and surgeon experience in the operating room showed that GammaPen can be effectively used for sentinel lymph node localization.

scholarly journals Development and characterization of an all-in-one gamma probe with auto-peak detection for sentinel lymph node biopsy based on NEMA NU3-2004 standard

2021 ◽  
Author(s):  
Aram Radnia ◽  
Hamed Abdollahzadeh ◽  
Behnoosh Teimourian ◽  
Mohammad Hossein Farahani ◽  
Mohammad Esmaeil Akbari ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Gamma Probe ◽  
Peak Detection ◽  
Cesium Iodide ◽  
Shielding Effectiveness ◽  
Scattering Medium ◽  
Silicon Photomultiplier ◽  
Regional Lymph Nodes ◽  
Handheld Device

Abstract Background A gamma probe is a handheld device used for intraoperative interventions following interstitial injection of a radiotracer to locate regional lymph nodes through the external detection of radiation. This work reports on the design and performance evaluation of a novel fully integrated gamma probe (GammaPen), recently developed by our group. Materials and methods GammaPen is an all-in-one pocket gamma probe with low weight and adequate dimensions, consisting of a detector, a control unit and output all together. The detector module consists of a cylindrical Thallium-activated Cesium Iodide [CsI (Tl)] crystal optically coupled to a Silicon photomultiplier (SiPM), shielded using Tungsten housing on side and back faces. The electronics of the probe consists of two small boards to handle signal processing and analog peak detection tasks. A number of parameters, including probe sensitivity in air/water, spatial resolution in air/water, angular resolution in air/water, and side and back shielding effectiveness, were measured to evaluate the performance of the probe based on NEMA NU3-2004 standards. Results The sensitivity of the probe in air at distances of 10, 30, and 50 mm is 18784, 3500, and 1575 cps/MBq. The sensitivity in scattering medium was also measured at distances of 10, 30, and 50 mm as 17,680, 3050, and 1104 cps/MBq. The spatial and angular resolutions in scattering medium were 47 mm and 87 degree at 30 mm distance from the probe, while they were 40 mm and 77 degree in air. The detector shielding effectiveness and leakage sensitivity are 99.91% and 0.09%, respectively. Conclusion The performance characterization showed that GammaPen can be used effectively for sentinel lymph node localization. The probe was successfully used in several surgical interventions by an experienced surgeon confirming its suitability in a clinical setting.

Evaluation of mobile gamma camera imaging in sentinel lymph node biopsy for melanoma independent of pre-operative lymphscintigraphy.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e19062-e19062
Author(s):  
Joshua Marshall Judge ◽  
Craig L. Slingluff ◽  
Lynn Thacher Dengel ◽  
Mark Williams ◽  
Kosta Popovic
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Sentinel Node ◽  
Gamma Camera ◽  
Gamma Probe ◽  
Lymph Node Biopsy ◽  
Node Localization ◽  
Node Biopsy ◽  
Imaging Results

e19062 Background: Sentinel lymph node biopsy (SLNB) is the standard method for staging cutaneous melanoma and involves identifying the first node(s) draining a tumor, by detecting an intradermally-injected radioactive colloid tracer. Intra-operatively the sentinel node(s) are identified with a hand-held gamma probe. Pre-operative lymphoscintigraphy is obtained to identify draining lymph node basins, but requires coordinating schedules between nuclear medicine and the operating room. A pilot study utilizing Mobile Gamma Camera (MGC) devices in conjunction with conventional lymphoscintigraphy for intraoperative sentinel node localization provided clinical benefit in 20% of patients. However, utilizing MGC devices to localize lymph node basins at the time of surgery independent of conventional lymphoscintigraphy with a fixed gamma camera (FGC) has not been adequately studied. Here, we present the results of a clinical trial utilizing MGC devices to localize lymph node basins in a manner blinded to the FGC images in order to compare the modalities directly. Methods: In 2011-12 18 patients underwent Tc99 sulfur colloid lymphoscintigraphy, and MGC survey immediately pre-operative by the study surgeon. The study surgeon established an operative plan using the MGC survey, while blinded to lymphoscintigraphy results. SLNB was then performed with use of a gamma probe and intra-operative MGC imaging. Results: 22 lymph node basins were detected in 18 imaged patients by lymphoscintigraphy. All of these basins were identified by the study surgeon using the MGC device in the pre-operative setting prior to un-blinding. In every case the operative plan established based on pre-operative MGC imaging was confirmed by the FGC images. In two cases, additional information from the MGC images aided surgical decision-making. 5 of 22 lymph node basins were positive for metastasis. All of these basins were identified by pre-operative MGC imaging, and all individual positive nodes were identified by intra-operative MGC imaging. Conclusions: Pre-operative MGC imaging in sentinel lymph node biopsy can provide comparable information for operative planning, compared to standard FGC imaging.

Dye- and gamma probe-guided sentinel lymph node biopsy in breast cancer patients: using patent blue dye and technetium-99m-labeled human serum albumin

Breast Cancer ◽  
2000 ◽  
Vol 7 (1) ◽  
pp. 87-94 ◽  
Author(s):  
Koichiro Tsugawa ◽  
Masakuni Noguchi ◽  
Koichi Miwa ◽  
Etsuro Bando ◽  
Kunihiko Yokoyama ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Gamma Probe ◽  
Lymph Node Biopsy ◽  
Blue Dye ◽  
Breast Cancer Patients ◽  
Patent Blue ◽  
Node Biopsy ◽  
Patent Blue Dye

Use of the gamma probe in sentinel lymph node biopsy in patients with prostate cancer

2005 ◽  
Vol 26 (12) ◽  
pp. 1081-1086 ◽  
Author(s):  
Neivo Silva ◽  
Carlos E. Anselmi ◽  
Osvaldo E. Anselmi ◽  
Rafael R. Madke ◽  
Angela Hunsche ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Gamma Probe ◽  
Lymph Node Biopsy ◽  
Node Biopsy

Sentinella: Portable gamma camera versus conventional scintigram for intraoperative sentinel lymph node detection in breast cancer.

2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 22-22
Author(s):  
Debashis B. Ghosh ◽  
Nikolaus Michalopoulos ◽  
Caspar Wickham ◽  
Timothy Davidson ◽  
Mohammed R. Keshtgar
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Gamma Camera ◽  
Gamma Probe ◽  
Lymph Node Biopsy ◽  
Breast Cancer Patients ◽  
Medicine Department ◽  
Portable Gamma Camera ◽  
The Uk

22 Background: Sentinel lymph node biopsy (SLNB) is a standard practice for staging the axilla in breast cancer. Access to nuclear medicine department and sentinel node imaging remain an issue in number of hospitals in the UK and rest of the world. Preoperative scintigrams are performed to confirm uptake of radioactivity and localisation of nodes in centres where facilities are available. Sentinella is a portable imaging camera used intraoperatively to produce real time visual localisation of SLNs. Sentinella was tested in a controlled laboratory environment at our centre followed by the first use of this device in breast cancer patients from UK. Methods: Sensitivity and spatial resolution of Sentinella was compared with conventional gamma camera (CGC).Intraoperative Sentinella Scans were performed in 130 patients and their yield compared with Lymphoscintigrams from CGC. Further Sentinella scans were performed after the axilla was deemed clear by silent activity of hand held gamma probe. Results: Sentinella resolution is comparable with the CGC for objects close to the camera. Sentinella detects high radioactivity (500 kBq) faster than CGC (1 vs 2.5min). In cases of low radioactivity (10kBq) Sentinella was equally accurate and faster than CGC, when placed nearer to skin.Intra-operative Sentinella scans detected an average of 2 sentinel nodes compared to 1.4 nodes by CGC scans. Sentinella demonstrated a serial decay in activity with removal of every hot node and its LED guidance helped in detecting residual nodes. Sentinella picked up extra nodes in 5/130 cases after the axilla was found silent using hand held gamma probe. In 2/130 cases extra nodes found using Sentinella had presence of cancer that led to a complete axillary clearance. Conclusions: This data confirms the excellent sensitivity and specificity of the machine in localisation of radioactive nodes. This new imaging technique increases our pick up of SLNs intraoperatively that are missed due to inadequate visualisation and provide a superior detection compared to static scintigram imaging. This portable gamma camera can replace the use of conventional lymphoscintigrams saving camera time and cost.

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