title: Is there a role for a handheld gamma camera (TReCam) in the SNOLL breast cancer procedure?
abstract: BACKGROUND
  Sentinel node and occult lesion localization (SNOLL) calls for a combination of two specific procedures: intraoperative detection of sentinel lymph node (SLN) and radio-guided occult lesion localization (ROLL). The safety and benefits of radio-guided localization in the surgical treatment of non-palpable breast cancer have been confirmed. The aim of this study was to evaluate the potential role for an intra-operative handheld tumor resection gamma camera (TReCam) in SNOLL procedures.
  
  
  METHODS
  Fifteen patients were enrolled. The SNOLL procedure was performed in all patients with conventional lymphoscintigraphy (LS). TReCam was used to obtain nuclear imaging in the operating theater. Concordance between LS and TReCam images, duration of use and assessment of difficulties in data acquisition with TReCam were reported.
  
  
  RESULTS
  Concordance for tumor localization between single-detector gamma probe and TReCam was excellent (15/15). The number of radioactive SLNs visualized between LS and TReCam was equivalent in 53.3% of cases (8/15). TReCam was considered to be very easy-to-use (12/15) or easy-to-use (3/15). Average duration of acquisition with TReCam was 4 minutes and 45 seconds for the SLN procedure, and 2 minutes and 10 seconds for lumpectomy.
  
  
  CONCLUSIONS
  This study suggests that TReCam is easy-to-use and does not increase operative time. Its exact role in radio-guided surgery needs to be clearly defined in a larger study. However, its usefulness and benefits in radio-guided breast surgery seem to be promising.
authors.affiliation: Department of Gynecology, AP-HP, Jean-Verdier Hospital, Bobigny University, Bondy, France - alex.bricou@gmail.com.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Bricou
authors.affiliation: Laboratory of Imaging and Modeling in Neurobiology and Oncology (IMNC), IN2P3 National Institute of Nuclear and Particle Physics, National Center for Scientific Research (CNRS), Orsay, France.|University of Evry Val d'Essonne, Evry, France.
authors.forename: Marie-Alix
authors.initials: MA
authors.lastname: Duval
authors.affiliation: Department of Gynecology, AP-HP, Jean-Verdier Hospital, Bobigny University, Bondy, France.
authors.forename: Léna
authors.initials: L
authors.lastname: Bardet
authors.affiliation: Department of Gynecology, AP-HP, Jean-Verdier Hospital, Bobigny University, Bondy, France.
authors.forename: Amélie
authors.initials: A
authors.lastname: Benbara
authors.affiliation: Department of Gynecology, AP-HP, Jean-Verdier Hospital, Bobigny University, Bondy, France.
authors.forename: Grégoire
authors.initials: G
authors.lastname: Moreaux
authors.affiliation: Laboratory of Imaging and Modeling in Neurobiology and Oncology (IMNC), IN2P3 National Institute of Nuclear and Particle Physics, National Center for Scientific Research (CNRS), Orsay, France.
authors.forename: Françoise
authors.initials: F
authors.lastname: Lefebvre
authors.affiliation: Laboratory of Imaging and Modeling in Neurobiology and Oncology (IMNC), IN2P3 National Institute of Nuclear and Particle Physics, National Center for Scientific Research (CNRS), Orsay, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Ménard
authors.affiliation: Laboratory of Imaging and Modeling in Neurobiology and Oncology (IMNC), IN2P3 National Institute of Nuclear and Particle Physics, National Center for Scientific Research (CNRS), Orsay, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Pinot
authors.affiliation: Laboratory of Imaging and Modeling in Neurobiology and Oncology (IMNC), IN2P3 National Institute of Nuclear and Particle Physics, National Center for Scientific Research (CNRS), Orsay, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Charon
authors.affiliation: Department of Pathology, AP-HP, Jean-Verdier Hospital, Bobigny University, Bondy, France.
authors.forename: Iulia
authors.initials: I
authors.lastname: Tengher Barna
authors.affiliation: Department of Nuclear Medicine, AP-HP, Avicenne Hospital, Bobigny University, Bobigny, France.
authors.forename: Michaël
authors.initials: M
authors.lastname: Soussan
authors.affiliation: Department of Radiology, AP-HP, Jean-Verdier Hospital, Bobigny University, Bondy, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Sellier
authors.affiliation: Breast and Gynecological Surgical Oncology Unit, Centre Antoine Lacassagne, University of Nice-Sophia-Antipolis, Nice, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Barranger
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D015902:Gamma Cameras; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D021701:Sentinel Lymph Node Biopsy / Q000295:instrumentation*