Symbia intevo 16 bold spect scanner

Patients were prescribed oral thyroid protecting medication (thyroxine, thiamazole, and potassium iodide, according to our national protocol) for three days, starting one day before [¹²³I]mIBG injection [8 (link)]. Medication known to interfere with [¹²³I]mIBG uptake was avoided [7 ]. Scintigraphy and SPECT-CT were obtained 24 h after intravenous injection of [¹²³I]mIBG (4 MBq/kg bodyweight) on a Symbia Intevo 16 Bold SPECT scanner (Siemens Healthineers, Erlangen, Germany). Planar (anterior and posterior) total body scintigraphy was acquired with a 256 × 1024 matrix size (2.4 × 2.4 mm²), low-medium-energy (LME) collimators, and 5 cm/min scan speed. SPECT of an area of interest (axial field-of-view of 38.7 cm) was acquired with a 256 × 256 matrix size (2.4 × 2.4 mm²); LME collimators; a 15% wide photo peak window centred at 159 keV and similarly sized upper and lower scatter windows; 30 s acquisition time per view; 60 views per head (120 projections in total) with a 3˚ angular step (continuous acquisition); and a non-circular orbit. A low-dose CT scan was acquired using 110 kV and 10–40 mAs depending on height and weight of the patient. Images were reconstructed using xSPECT Broad Quant, 20 iterations with no subsets, attenuation correction, triple energy window scatter correction, and 7.5-mm Gaussian filtering.

Preparation and labeling of ICG–TC was performed in the UMC Utrecht according to the good manufacturing practice (GMP) guidelines. Patients received a preoperative injection of either 100 MBq ^99mtechnetium nanocolloid on the day of surgery (4–6 h before surgery, 1-day protocol), or 240 MBq the day before surgery (20–24 h before surgery, 2-day protocol) premixed with 0.25 mg ICG (ICG Pulsion, Pulsion Medical Systems, Munich, Germany) The injection was given in four intradermal deposits around the scar tissue of the primary tumor in patients with melanoma and peritumoral in patients with sarcoma and squamous cell carcinoma. Afterward, dynamic and early plus late static lymphoscintigraphy, and in most cases SPECT–CT images, were acquired to identify the locations of SLNs on a Symbia Intevo 16 Bold SPECT scanner (Siemens Healthineers, Erlangen, Germany). SLN was defined as the first lymph nodes on a direct lymphatic drainage pathway from the injection site. It is important to note that this is not always just one SLN. The tumor could drain on several SLNs at the same time. The location of the SLN was verified using a handheld probe and marked on the skin using a non-fluorescent marker.