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Role of a portable gamma-camera with optical view for margins assessment of pulmonary nodules resected by radioguided surgery

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

Radioguided occult lesion localization (ROLL) of pulmonary nodules is an alternative to hook-wire. Both required of a histological margin assessment. The activity emerging from the radiotracer allows to obtain an intraoperative scintigraphic image of the surgical specimen by a portable gamma-camera (PGC) fitted with an optical view, which provides information about the localization of the nodule in relation to the margins. The aim of this study was to evaluate the intraoperative use of a PGC for margin assessment of pulmonary nodules.

Methods

ROLL technique was used in 38 nodules (36 pulmonary, 1 chest wall, and 1 pleural nodules). A PGC intraoperative image of the surgical specimen was obtained in 32. Scintigraphic results were compared to the histological assessment. Other factors, such as nodule size, distance from the pleural surface, or distance covered by the needle, were considered as possible factors for non-centered lesions.

Results

PGC images showed that the lesion was in contact with the margins in 8/32 cases and centered in 24. In all cases in which the lesion was considered as centered by the PGC, the margins were free of involvement (NPV 100%), although the PPV is low.

Conclusions

The use of a PGC for margin assessment after pulmonary nodule resection is feasible and provides a high NPV in our series. In addition, the short intraoperative time required for its use makes the PGC a useful tool for providing supplementary information to histopathologic results. Further studies from different surgical teams are required for an external validation.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Code availability

Not applicable

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Author information

Author notes

  1. Ivan Vollmer and Nuria Sánchez-Izquierdo contributed equally to this work.

Authors and Affiliations

  1. Radiology Department, Hospital Clínic Barcelona, Barcelona, Spain

    Ivan Vollmer

  2. Faculty of Medicine, University of Barcelona (UB), Barcelona, Spain

    Ivan Vollmer, Daniel Martínez, David Sánchez-Lorente & Pilar Paredes

  3. Nuclear Medicine Department, Hospital Clínic Barcelona, Barcelona, Spain

    Nuria Sánchez-Izquierdo, Sebastián Casanueva-Eliceiry, Inmaculada Romero-Zayas, Sergi Vidal-Sicart & Pilar Paredes

  4. Pathology Department, Hospital Clínic Barcelona, Barcelona, Spain

    Daniel Martínez

  5. Thoracic Surgery Department, Hospital Clínic Barcelona, Barcelona, Spain

    David Sánchez-Lorente, Marc Boada & Ángela Guirao

  6. Institut D’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Villarroel 170, 08036, Barcelona, Spain

    Sergi Vidal-Sicart & Pilar Paredes

Authors
  1. Ivan Vollmer
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Contributions

Conceptualization: I. Vollmer, N. Sánchez-Izquierdo, S. Vidal-Sicart, P. Paredes. Data curation: I. Vollmer, N. Sánchez-Izquierdo, D. Martínez, D. Sánchez-Lorente, S. Casanueva-Eliceiry, I. Romero, M. Boada, A. Guirao. Formal analysis: I. Vollmer, N. Sánchez-Izquierdo. Investigation: I. Vollmer, D. Sánchez-Lorente, P. Paredes. Methodology: I. Vollmer, D. Sánchez-Lorente, P. Paredes. Project administration: P. Paredes. Resources: I. Vollmer, N. Sánchez-Izquierdo, D. Martínez, D. Sánchez-Lorente, P. Paredes. Supervision: P. Paredes. Visualization: I. Vollmer, S. Vidal-Sicart, P. Paredes. Writing original draft: I. Vollmer, N. Sánchez-Izquierdo. Writing — review and editing: I. Vollmer, N. Sánchez-Izquierdo, S. Vidal-Sicart, P. Paredes. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Pilar Paredes.

Ethics declarations

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Hospital Clinic de Barcelona (approval registration number HCB/2016/0417).

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

The authors have no conflicts of interest to declare that are relevant to the content of this article. S. Vidal-Sicart had served on advisory boards for Oncovision®, Spain.

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This article is part of the Topical Collection on Oncology - Chest

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Vollmer, I., Sánchez-Izquierdo, N., Martínez, D. et al. Role of a portable gamma-camera with optical view for margins assessment of pulmonary nodules resected by radioguided surgery. Eur J Nucl Med Mol Imaging 49, 361–370 (2021). https://doi.org/10.1007/s00259-021-05466-1

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  • DOI: https://doi.org/10.1007/s00259-021-05466-1

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