Precise Localization of Sentinel Lymph Nodes

In 15 patients (28%), the location of the SLNs designated for biopsy by lymphoscintigraphy were first marked on the overlying skin with the handheld gamma-camera and a ⁵⁷Co-penpoint marker using its dual-isotope function (Fig. 4). Then, with the patient in a similar position, the location of the identified SLNs were marked using the conventional gamma-camera (Siemens Symbia T16 system) and the ⁵⁷Co-penpoint marker, according to standard protocol. Subsequently, the location of both cutaneous markings were compared, with cutaneous markings based on the conventional gamma-camera as reference standard. The marked location of SLNs using the handheld gamma-camera was considered accurate if they deviated ≤ 10 mm in any direction from the location as marked with the conventional gamma-camera.Fig. 4

a Cutaneous marking of the location of SLNs using Crystal Cam handheld gamma-camera and a ⁵⁷Co-penpoint marker. To simulate the definite surgical position, the patient is placed in supine position with head slightly extended and rotated to the opposite side. b Separate ⁵⁷Co-hotspot (⁵⁷Co) and ^99mTc-hotspot (^99mTc) within the handheld gamma-camera’s field-of-view. (c) Overlapping ⁵⁷Co-hotspot and ^99mTc-hotspot, indicating that the ⁵⁷Co-penpoint marker is positioned on the SLN’s location

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Mahieu R., Tijink B.M., van Es R.J., van Nierop B.J., Beijst C., de Keizer B, & de Bree R. (2023). The potential of the Crystal Cam handheld gamma-camera for preoperative and intraoperative sentinel lymph node localization in early-stage oral cancer. European Archives of Oto-Rhino-Laryngology, 280(12), 5519-5529.

Publication 2023

Biopsy Gamma camera Head Isotope Lymphoscintigraphy Patient Slns Surgical

Corresponding Organization :

Other organizations : University Medical Center Utrecht, Heidelberg University, University Hospital Heidelberg

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Variable analysis

independent variables

Location of the SLNs designated for biopsy by lymphoscintigraphy

dependent variables

Deviation of the marked location of SLNs using the handheld gamma-camera from the location as marked with the conventional gamma-camera

control variables

Patient position (supine position with head slightly extended and rotated to the opposite side) during marking of SLN locations using both the handheld and conventional gamma-cameras
Use of 57Co-penpoint marker for marking the location of SLNs with both the handheld and conventional gamma-cameras

positive controls

Marking of SLN locations using the conventional gamma-camera and 57Co-penpoint marker, which is considered the reference standard

negative controls

Not mentioned

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