title: Intraoperative imaging for sentinel node identification in prostate carcinoma: its use in combination with other techniques.
abstract: We evaluated a portable γ-camera for sentinel node identification during laparoscopic sentinel lymphadenectomy for prostate cancer.
  
  
  METHODS
  We analyzed the portable γ-camera for intraoperative sentinel node visualization in 55 patients after (99m)Tc injection, preoperative planar lymphoscintigraphy, and SPECT/CT.
  
  
  RESULTS
  Sixteen percent of 178 nodes seen on SPECT/CT could not be detected with the portable γ-camera. A seed pointer was useful for localizing sentinel nodes intraoperatively in 27% of patients. Seventeen additional sentinel nodes (2 tumor-positive nodes) were removed by monitoring after excision. The location of each sentinel node was significantly associated with the ability to detect it intraoperatively.
  
  
  CONCLUSIONS
  Intraoperative imaging leads to excision of more radioactive nodes and can determine the residual radioactivity after excision. The use of a radioactive source as a pointer enables efficient identification of nodes in difficult locations (paraaortic nodes) and in patients with a high body mass index.
authors.affiliation: Department of Nuclear Medicine, Antoni van Leeuwenhoek Hospital, Netherlands Cancer Institute, Amsterdam, The Netherlands.
authors.forename: Lenka
authors.initials: L
authors.lastname: Vermeeren
authors.forename: Renato A
authors.initials: RA
authors.lastname: Valdés Olmos
authors.forename: Willem
authors.initials: W
authors.lastname: Meinhardt
authors.forename: Simon
authors.initials: S
authors.lastname: Horenblas
mesh_terms: D000368:Aged; D015902:Gamma Cameras; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D011877:Radionuclide Imaging / Q000295:instrumentation / Q000379:methods*; D015203:Reproducibility of Results; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*