PURPOSE: To explore the clinical feasibility and accuracy of intraoperative navigation based on preoperatively acquired 3D functional imaging data.
MATERIALS AND METHODS: 10 patients with penile carcinoma who were scheduled for sentinel node (SN) biopsy were prospectively included. After tracer injection, preoperative SPECT/CT was performed with a reference target (ReT) fixed on the patient. Repositioning of a sterile ReT shortly before surgery allowed 3D SPECT/CT mixed-reality-based navigation of the gamma probe (also containing an ReT) to the SN. The accuracy of the navigation approach (declipseSPECT system; SurgicEye, Munich, Germany) was determined in relation to the incision site pointed out by the conventional gamma probe (coronal plane) and the depth estimation measured on the axial CT slices (sagittal/axial plane).
RESULTS: The 3D SPECT/CT-based mixed-reality-approach enabled navigation of the gamma probe towards the SN in all 10 patients. The average navigation error in the coronal plane was 5.0±3.9mm. The average navigation error in the saggital/axial plane was 5.3±3.9mm.
CONCLUSIONS: This is the first study demonstrating the feasibility of intraoperative navigation based on preoperatively acquired 3D SPECT/CT images. Although confirmation of successful target localization (e.g. using gamma tracing or fluorescence imaging) remains indispensable, this opens the way to translate 3D functional imaging data to the operating room.
Written by:
Brouwer OR, van den Berg NS, Mathéron HM, Wendler T, van der Poel HG, Horenblas S, Valdés Olmos RA, van Leeuwen FW. Are you the author?
Department of Nuclear Medicine, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam (NKI-AVL), The Netherlands; Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands; Department of Urology; SurgicEye GmBH, Munich, Germany; Department of Head and Neck Surgery and Oncology, NKI-AVL, Amsterdam, The Netherlands.
Reference: J Urol. 2014 Jul 24. pii: S0022-5347(14)04046-4.
doi: 10.1016/j.juro.2014.03.127
PubMed Abstract
PMID: 25066868
UroToday.com Penile and Urethral Cancers Section
