Handheld 3D Imaging Device for the OR May Transform Radio-Guided Surgeries

For quite a while, nonimaging gamma probes have been employed to guide surgeons to critical lymph nodes in cancer patients. More recently, a procedure has been developed to guide tumor surgery using the same probe; however, the nonimaging probes used in these procedures cannot provide accurate depth information.

According to the recent findings, an intraoperative, handheld three-dimensional (3D) image-viewing device cleared by the US Food and Drug Administration (FDA) may improve the accuracy of these procedures by providing 3D images of the tumor and lymph nodes.

The findings were presented by two leading medical institutions at the Society of Surgical Oncology 2012 annual Cancer Symposium, held March 21, 2012, in Orlando (FL, USA). Leading surgeons from The Netherlands Cancer Institute (Amsterdam) presented data on the use of the declipseSPECT in the radioguided resection of nonpalpable breast cancer. Their results showed that the SurgicEye (Munich, Germany) declipseSPECT (single photon emission tomography) could support radioguided surgery by determining the precise 3D localization of the marked tumor and lymph nodes in the operating room. Moreover, the system allowed them to determine the depth of each structure and to image the lumpectomy specimen to verify margins; all margins were confirmed to be negative by pathology.

The lead author, Dr. Omgo E. Nieweg, a surgeon at The Netherlands Cancer Institute, commented that, “The innovative 3D declipseSPECT technology may make the sentinel node biopsy easier and more reliable. New technologies like 3D declipseSPECT will also open up lymphatic mapping to additional cancer types, cancer types in locations with a more intricate anatomy and cancer types with more complex lymph drainage.”

The team of surgeons from the general surgery department of the University Hospital of the Technische Universitat Munchen (Munich, Germany) presented their findings on the use of the declipseSPECT in locating sentinel nodes of melanoma patients. The system enabled the physicians to intraoperatively image all of the nodes seen in preoperative imaging. In addition, by using the device for postexcision imaging in the operating room (OR), the clinicians was able to confirm and validate complete resection of the nodes.

The declipseSPECT device is provided in the US exclusively by Dilon Diagnostics ((Newport News, VA, USA), a developer of molecular breast imaging technology, a new diagnostic test that can find cancers missed by other modalities. According to company CEO, Mr. Robert Moussa, “Dilon is the market leader in gamma imaging technologies for breast cancer detection. The declipseSPECT system is a natural fit for our product portfolio since it extends gamma-imaging capabilities into the operating room. We are excited and encouraged by these results and our company continues to lead the molecular imaging market through innovation and partnerships like the one we share with SurgicEye.”

Dilon Diagnostics, a brand of Dilon Technologies Inc.’s cornerstone product, the Dilon 6800, is a high-resolution, small field-of view gamma camera, optimized to perform breast-specific gamma imaging/molecular breast imaging (BSGI/MBI), a molecular breast imaging procedure that images the metabolic activity of breast lesions through radiotracer uptake.

SurgicEye provides systems for intraoperative 3D imaging and instrument navigation. The declipseSPECT implements the so-called freehand SPECT technology for detection, localization, and guided biopsy of sentinel lymph nodes in breast cancer, melanoma, and head and neck malignancies. Clinical investigations in other tumor surgery fields show potential a wide application field and huge potential for quality assurance during surgery.

Related Links:
The Netherlands Cancer Institute
SurgicEye
Dilon Diagnostics