Comparison of 3 γ-probes for Simultaneous Iodine-125-seed and Technetium-99m Breast Cancer Surgery: NEMA Standard Characterisation with Extended Processing

Overview

Journal EJNMMI Phys

Specialty Radiology

Date 2020 Jun 7

PMID 32504305

Authors

Christopher Hoog

Pierre-Malick Koulibaly

Catherine Dejean

Tom Desdoits

Olivier Humbert

Emmanuel Barranger

Jacques Darcourt

Affiliations

Soon will be listed here.

Abstract

Purpose: Iodine-125 (I) seeds can be used as landmarks to locate non-palpable breast lesions instead of implanting metal wires. This relatively new technique requires a nuclear probe usually used for technetium-99m (Tc) sentinel node detection. This study aimed to compare the performances of different probes and valid the feasibility of this technique, especially in the case of simultaneous I-seed and Tc breast cancer surgery.

Methods: Three probes with different features (SOE-3211, SOE-3214 and GammaSUP-II) were characterised according to the NEMA NU3-2004 standards for a Tc source and a I-seed. Several tests such as sensitivity, linearity or spatial resolution allowed an objective comparison of their performances. NEMA testing was extended to work on signals discrimination in case of simultaneous detection of two different sources (innovative figure of merit "Shift Index") and to assess the Tc scatter fraction, a useful parameter for the improvement of the probes in terms of detector materials and electronic system.

Results: Although the GammaSUP-II probe saturated at a lower activity (1.6 MBq at 10 mm depth), it allowed better sensitivity and spatial resolution at the different NEMA tests performed with the Tc source (7865 cps/MBq and 15 mm FWHM at 10 mm depth). With the I-seed, the GammaSUP-II was the most sensitive probe (3106 cps/MBq at 10 mm depth) and the SOE-3211 probe had the best spatial resolution (FWHM 20 mm at 10 mm depth). The SOE-3214 probe was more efficient on discriminating I from Tc in case of simultaneous detection. The SOE probes were more efficient concerning Tc scatter fraction assessments. The SOE-3211 probe, with overall polyvalent performances, seemed to be an interesting trade-off for detection of both I and Tc.

Conclusion: The three probes showed heterogeneous performances but were all suitable for simultaneous Tc sentinel node and I-seed detection. This study provides an objective and innovative methodology to compare probes performances and then choose the best trade-off regarding their expected use.

References

McGugin C, Spivey T, Coopey S, Smith B, Kelly B, Gadd M . Radiofrequency identification tag localization is comparable to wire localization for non-palpable breast lesions. Breast Cancer Res Treat. 2019; 177(3):735-739. DOI: 10.1007/s10549-019-05355-0. View

Pouw B, van der Ploeg I, Muller S, Valdes Olmos R, Janssen-Pinkse L, Oldenburg H . Simultaneous use of an (125)I-seed to guide tumour excision and (99m)Tc-nanocolloid for sentinel node biopsy in non-palpable breast-conserving surgery. Eur J Surg Oncol. 2014; 41(1):71-8. DOI: 10.1016/j.ejso.2014.10.046. View

Classe J, Fiche M, Rousseau C, Sagan C, Dravet F, Pioud R . Prospective comparison of 3 gamma-probes for sentinel lymph node detection in 200 breast cancer patients. J Nucl Med. 2005; 46(3):395-9. View

Itikawa E, Santos L, Trevisan A, Pitella F, Kato M, Moraes E . Characterization of resolution, sensitivity, and shielding of a gamma-probe for sentinel lymph node localization: an experimental study. Nucl Med Commun. 2017; 38(10):837-842. DOI: 10.1097/MNM.0000000000000725. View

van Oosterom M, Rietbergen D, Welling M, van der Poel H, Maurer T, van Leeuwen F . Recent advances in nuclear and hybrid detection modalities for image-guided surgery. Expert Rev Med Devices. 2019; 16(8):711-734. DOI: 10.1080/17434440.2019.1642104. View

Janssen N, Nijkamp J, Alderliesten T, Loo C, Rutgers E, Sonke J . Radioactive seed localization in breast cancer treatment. Br J Surg. 2015; 103(1):70-80. DOI: 10.1002/bjs.9962. View

Ahmed M, Anninga B, Goyal S, Young P, Pankhurst Q, Douek M . Magnetic sentinel node and occult lesion localization in breast cancer (MagSNOLL Trial). Br J Surg. 2015; 102(6):646-52. DOI: 10.1002/bjs.9800. View

Curtet C, Carlier T, Mirallie E, Bodet-Milin C, Rousseau C, Barbet J . Prospective comparison of two gamma probes for intraoperative detection of 18F-FDG: in vitro assessment and clinical evaluation in differentiated thyroid cancer patients with iodine-negative recurrence. Eur J Nucl Med Mol Imaging. 2007; 34(10):1556-62. DOI: 10.1007/s00259-007-0393-6. View

Gray R, Salud C, Nguyen K, Dauway E, Friedland J, BERMAN C . Randomized prospective evaluation of a novel technique for biopsy or lumpectomy of nonpalpable breast lesions: radioactive seed versus wire localization. Ann Surg Oncol. 2001; 8(9):711-5. DOI: 10.1007/s10434-001-0711-3. View

10.

Angarita F, Acuna S, Down N, Leung C, Pirmoradi F, Osman F . Comparison of Radioactive Seed Localized Excision and Wire Localized Excision of Breast Lesions: A Community Hospital's Experience. Clin Breast Cancer. 2019; 19(2):e364-e369. DOI: 10.1016/j.clbc.2019.01.001. View

11.

van Leeuwen F, Hardwick J, van Erkel A . Luminescence-based Imaging Approaches in the Field of Interventional Molecular Imaging. Radiology. 2015; 276(1):12-29. DOI: 10.1148/radiol.2015132698. View

12.

Sung J, King V, Thornton C, Brooks J, Fry C, El-Tamer M . Safety and efficacy of radioactive seed localization with I-125 prior to lumpectomy and/or excisional biopsy. Eur J Radiol. 2013; 82(9):1453-7. DOI: 10.1016/j.ejrad.2013.04.008. View

13.

Hung T, Burrage J, Bourke A, Taylor D . Intraoperative Localisation of Impalpable Breast Lesions Utilising the ROLLIS Technique Following Peritumoral Tc-colloid Sentinel Node Lymphoscintigraphy. Curr Radiopharm. 2017; 10(2):111-114. DOI: 10.2174/1874471010666170428113052. View

14.

Zamburlini M, Keymeulen K, Bemelmans M, Brans B, Kemerink G . Comparison of sentinel gamma probes for 99mTc breast cancer surgery based on NEMA NU3-2004 standard. Nucl Med Commun. 2010; 30(11):854-61. DOI: 10.1097/MNM.0b013e32832f34e7. View

15.

Ng A, Clay D, Blackshaw P, Bugby S, Morgan P, Lees J . Assessment of the performance of small field of view gamma cameras for sentinel node imaging. Nucl Med Commun. 2015; 36(11):1134-42. DOI: 10.1097/MNM.0000000000000377. View