3D scintigraphic imaging and navigation in radioguided surgery: freehand SPECT technology and its clinical applications

ABSTRACT

Freehand SPECT (fhSPECT) is a technology platform for providing 3-dimensional (3D) navigation for radioguided surgical procedures, such as sentinel lymph node (SLN) biopsy (SLNB). In addition to the information provided by conventional handheld gamma detection probes, fhSPECT allows for direct visualization of the distribution of radioactivity in any given region of interest, allowing for improved navigation to radioactive target lesions and providing accurate lesion depth measurements.

Herein, we will review the currently available clinical data on the use of fhSPECT: (i) for SLNB of various malignancies, including difficult-to-detect SLNs, and (ii) for radioguided localization of solid tumors. Moreover, the combination of fhSPECT with other technologies (e.g., small field-of-view gamma cameras, and diagnostic ultrasound) is discussed. These technical advances have the potential to greatly expand the clinical application of radioguided surgery in the future.

KEYWORDS:

• 3D
• navigation
• augmented reality
• radioguided surgery
• sentinel lymph node
• freehand SPECT
• fhSPECT
• gamma detection probe
• gamma camera
• field-of-view

Acknowledgements

The authors would like to thank Joerg Traub (CEO Surgiceye GmbH) for helping with the literature search for applications of the fhSPECT system.

Financial & competing interests disclosure

K Herrmann is a co-founder of Surgiceye GmbH (Munich, Germany), the company that owns and manufactures the fhSPECT system discussed in this manuscript (declipse®SPECT; SurgicEye, Munich, Germany). The work of P Matthies was partially funded by TUM Institute for Advanced Study (funded by the German Excellence Initiative), and the Bayerische Forschungsstiftung (project RoBildOR).The other authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest or financial conflict with the subject matter or material discussed in this manuscript, apart from those disclosed above.