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https://t.me/med1917
Pref ace
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Radioguided surgery, a concept dating back to the late 1940s, is simply a surgical procedure which incorporates the use of some sort of radiation detection
device, in a real-time fashion, for the identifi cation of a radioisotope that has
been administered to a patient prior to the time of attempted detection and for the
sole purpose of guiding the successful performance of the surgical procedure. Its
successful undertaking requires a collaborative interplay of the disciplines of
surgery and nuclear medicine, and its clinical application has dramatically
impacted upon our current surgical management of cancer patients.
The purpose of this book is to provide the readership (including surgeons,
surgical technologists, nuclear medicine physicians, nuclear medicine technologists, and various trainees) with a comprehensive overview of the stateof- the-art practice of radioguided surgery. This includes chapters devoted to
discussing the basic physics principles for detection and imaging, radiation
detection device technology, principles of surgical navigation, radionuclides
and radiopharmaceuticals, and radiation safety. Likewise, this includes chapters devoted to discussing a wide range of clinical applications of radioguided
surgery for a variety of malignancies, including breast cancer, melanoma and
other cutaneous malignancies, gynecologic malignancies, head and neck
malignancies, thyroid cancer, urologic malignancies, colon cancer, gastroesophageal cancer, lung cancer, bone tumors, parathyroid adenomas, and
neuroendocrine tumors. The editors have enlisted the talents of over 65
authors, each considered an expert in his or her own fi eld. For each clinical
application, the recommended methodological approaches are discussed, and
the available cumulative clinical experiences of investigators from across the
globe are reviewed. A conscious effort is made to bring forth and highlight
recent developments and innovative approaches within each clinical area.
Interesting cases and novel approaches are further highlighted by the presentation of a series of selected case reports at the end of the book.
It is our hopes that the information provided in this book will allow surgeons and nuclear medicine physicians alike to gain a broad-based understanding of the basic yet essential procedural skills and clinical acumens that
are necessary for incorporating radioguided surgery technologies into the
care of their cancer patients.
Würzburg , Germany Ken Herrmann
North Sydney , NSW , Australia Omgo E. Nieweg
Columbus , OH , USA Stephen P. Povoski
xi
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Acknowledgments
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We wish to acknowledge the collective dedicated efforts of over 65 contributing authors for the successful writing of all of the chapters included within
this book, as well as the expert and sometimes frank advice provided by many
of them along the way. In particular, we are deeply indebted and forever
grateful to Dr. Christina Blümel for her commitment and dedication of untold
hours to the development and successful execution of this book, from
researching potential relevant authors to reviewing and revising numerous
chapters, and with keeping the book writing process on track whenever the
editorial focus seemed to be misplaced. Likewise, we would very much like
to offer a special thanks to Prof. Sergi Vidal-Sicart, without whom several
essential chapters within the book would have never been realized without his
personal and expert intervention in the writing process. Additionally, we
would also like to thank Petra Thomas and Christina Racke-Nestler for providing administrative assistance, as well Rick Mills for providing copyediting
assistance on several chapters.
Lastly, we would like to recognize and acknowledge all of the past and
present pioneers and iconic fi gures in the fi eld of radioguided surgery, and for
whom without their innovative thinking, this integrated surgical and nuclear
medicine discipline would have never been developed. In similar regard, we
are hopeful that all those who have contributed to the fi eld of radioguided
surgery over the past seven decades have been appropriately recognized and
acknowledged within the pages of this book.
Ken Herrmann
Omgo E. Nieweg
Stephen P. Povoski
xiii
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C o n t e n t s
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Part I Introduction
1 The History of Radioguided Surgery: Early Historical
Milestones and the Development of Later Innovative
Clinical Applications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Stephen P. Povoski
Part II Detailed Methodology Part
2 Physics of Radioguided Surgery:
Basic Principles and Methods of Radiation Detection . . . . . . . 15
Thomas Wendler , Uta Eberlein , and Michael Lassmann
3 The Use of Intraoperative Small and Large Field
of View Gamma Cameras for Radioguided Surgery . . . . . . . . 35
Daan Hellingman and Sergi Vidal-Sicart
4 Surgical Navigation: An Overview
of the State-of-the-Art Clinical Applications. . . . . . . . . . . . . . . 57
Paulo Waelkens , Matthias N. van Oosterom ,
Nynke S. van den Berg , Nassir Navab ,
and Fijs W. B. van Leeuwen
5 Tracers Applied in Radioguided Surgery . . . . . . . . . . . . . . . . . 75
Anton Bunschoten , Nynke S. van den Berg ,
Renato A. Valdés Olmos , Jacobus A. K. Blokland ,
and Fijs W. B. van Leeuwen
6 Radiation Safety and Dosimetry. . . . . . . . . . . . . . . . . . . . . . . . . 103
Michael Lassmann and Uta Eberlein
Part III Clinical Application: Breast
7 Radioguided Sentinel Lymph Node Mapping
and Biopsy in Breast Cancer. . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
Andrea V. Barrio and Hiram S. Cody III
8 Radioguided Surgery for Non- palpable Breast
Lesions: I-125 Radioactive Seed Localization. . . . . . . . . . . . . . 125
Richard J. Gray , Charles E. Cox , and Emilia L. Dauway
xv
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9 Radioguided Surgery of Non- palpable Breast Lesions:
Radio Occult Lesion Localization (ROLL) . . . . . . . . . . . . . . . . 139
Bas Pouw , Marie-Jeanne T. F. D. Vrancken Peeters ,
and Renato A. Valdés Olmos
Part IV Clinical Application: Skin
10 Radioguided Sentinel Lymph Node Mapping
and Biopsy in Cutaneous Melanoma . . . . . . . . . . . . . . . . . . . . . 151
Omgo E. Nieweg , Roger F. Uren , and John F. Thompson
Part V Clinical Application: Head and Neck
11 Radioguided Sentinel Lymph Node Mapping and Biopsy
in Oral Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167
Remco de Bree and Christina Bluemel
Part VI Clinical Application: Thyroid and Parathyroid
12 Radioguided Sentinel Lymph Node Mapping
and Biopsy in Thyroid Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . 183
Isabella Merante Boschin , Domenico Rubello ,
Christina Bluemel , Ken Herrmann ,
and Maria Rosa Pelizzo
Contents
13 Radioguided Parathyroid Surgery . . . . . . . . . . . . . . . . . . . . . . . 197
Irene Lou , Rebecca S. Sippel , and Herbert Chen
14 Radioguided Surgery of Thyroid Carcinoma
Recurrences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209
Christina Bluemel , Ken Herrmann , Gerhard Wolf ,
Giorgo Castagnola , and Carlo Bellotti
Part VII Clinical Application: Urogenital Tract
15 Radioguided Sentinel Lymph Node Biopsy
and Lymphatic Mapping in Urogenital Malignancies . . . . . . . 227
Henk G. van der Poel , Joost A. P. Leijte , and Simon Horenblas
16 Radioguided Sentinel Lymph Node Mapping
and Biopsy in Gynaecological Malignancies . . . . . . . . . . . . . . . 249
Pilar Paredes and Sergi Vidal-Sicart
Part VIII Clinical Application: Gastrointestinal Tract
17 Radioguided Sentinel Lymph Node Mapping
and Biopsy in Esophagogastric Cancer . . . . . . . . . . . . . . . . . . . 267
Hiroya Takeuchi and Yuko Kitagawa
Contents
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xvii
18 Radioguided Sentinel Lymph Node Mapping
and Biopsy in Colorectal Cancer . . . . . . . . . . . . . . . . . . . . . . . . 279
Dawid Murawa , Piotr Nowaczyk , and Armin Wiegering
19 Radioguided Surgery for Gastroenteropancreatic
Neuroendocrine Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 299
Nathan C. Hall , Christina Bluemel , Sergi Vidal-Sicart ,
and Stephen P. Povoski
Part IX Clinical Application: Thoracic
20 Radioguided Sentinel Lymph Node Mapping
and Biopsy in Non-small Cell Lung Cancer (NSCLC). . . . . . . 315
Leili Zarifmahmoudi , David N. Krag , Ramin Sadeghi ,
Reza Bagheri , and Susan Shafi ee
21 Radioguided Surgery of Small Pulmonary Nodules. . . . . . . . . 335
Amelia W. Maiga and Eric L. Grogan
Part X Miscellaneous
22 Radioguided Localization of Bone Lesions . . . . . . . . . . . . . . . . 353
Erik M. Von Meyenfeldt and Karel W. E. Hulsewé
23 Radioguided Monitoring of Systemic Leakage
During Isolated Limb Perfusion for Melanoma . . . . . . . . . . . . 359
Sergi Vidal-Sicart , Ramon Rull , Clemente Barriuso ,
and Omgo E. Nieweg
24 Radioimmunoguided Surgery: Intraoperative
Radioimmunodetection for the Radioguided
Localization and Resection of Tumors . . . . . . . . . . . . . . . . . . . . 371
Stephen P. Povoski , Cathy M. Mojzisik ,
and Brandon J. Sullivan
18
F-FDG-Directed Surgery and 18F-FDG-Directed
2 5
Interventional Procedures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 419
Stephen P. Povoski , Douglas A. Murrey Jr. ,
and Nathan C. Hall
Part XI Outlook: New Techniques, Image Fusion,
Optical Imaging
26 Fluorescent Tracers, Hybrid Tracers . . . . . . . . . . . . . . . . . . . . . 449
Dawid Murawa and Karol Połom
27 Magnetic Advances in Cancer Surgery . . . . . . . . . . . . . . . . . . . 463
B. Anninga , M. Ahmed , and Michael Douek
28 Ultrasound Fusion (SPECT/US). . . . . . . . . . . . . . . . . . . . . . . . . 471
Martin Freesmeyer and Thomas Winkens
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Part XII Examples (Conventional Techniques
and Innovations)
29 Case Reports. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 483
Christina Bluemel, Francisco Campos, Angela Collarino,
Andreas Cramer, Stephan Dik, Alessandro Giordano,
Hanns-Jörg Grimminger, Niel Groen, Ken Herrmann,
Martin Horn, Georg W. Kajdi, Dikra Lajaab, Stefan Paepke,
Jaume Pahisa, Pilar Paredes, Germano Perotti,
Sergi Vidal-Sicart, Erik M. Von Meyenfeldt,
and Thomas Wendler
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 495
Contents
P a r t I
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Introduction
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