| Novel handheld PET probes provide intraoperative localization of PET-avid lymph nodes. | |
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MedLine Citation:
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PMID: 21512878 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: The accurate intraoperative localization of malignant nodes can pose a challenge to the surgical oncologist. Positron emission tomography (PET) scanning has significantly increased our ability to detect suspicious lesions. We investigated the ability of a novel, handheld tool to evaluate suspicious nodes intraoperatively and to correlate its findings with those seen on preoperative PET scan. METHODS: Ten nude rats were inoculated with a lymphogenic mesothelioma tumor line and followed weekly with PET scan studies. When suspicious lymph nodes were found, animals were dissected and the intraoperative amount of tissue radiation was analyzed as "tumor-to-background ratio" (TBR) using the PET probes. RESULTS: The intraoperative probe was used to guide dissections and select high-risk nodes based on their specific radiotracer uptake. A total of 52 nodes were harvested; eight of these were suspicious on preoperative PET scan studies. Using a TBR of 2.5, the intraoperative probes were able to localize all suspicious nodes previously seen on PET scan. Both gamma (sensitivity: 100%; specificity: 86%; positive predictive value (PPV): 57%; negative predictive value (NPV): 100%) and beta (sensitivity: 88%; specificity: 91%; PPV: 64%; NPV: 98%) probes showed an excellent area under the curve (AUC) in the receiver operating characteristic analysis (ROC). Both probes had an AUC of 0.95 for localizing suspicious nodes on PET scan. Furthermore, the AUC for detecting malignancy for the gamma probe was 0.90 (95% confidence interval (CI), 0.83-0.99), and for the beta probe it was 0.97 (95% CI, 0.94-1.0), suggesting a better performance of the beta probe for detecting malignancy. CONCLUSIONS: This novel tool may be used synergistically with the PET scan examination to maximize intraoperative nodal selection and sampling. |
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Authors:
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Segundo J González; Joyce Wong; Lorena González; Peter Brader; Maureen Zakowski; Mithat Gönen; Yuman Fong; Vivian E Strong |
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Publication Detail:
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Type: Journal Article Date: 2011-04-22 |
Journal Detail:
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Title: Surgical endoscopy Volume: 25 ISSN: 1432-2218 ISO Abbreviation: Surg Endosc Publication Date: 2011 Oct |
Date Detail:
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Created Date: 2011-09-19 Completed Date: 2012-01-26 Revised Date: 2012-02-01 |
Medline Journal Info:
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Nlm Unique ID: 8806653 Medline TA: Surg Endosc Country: Germany |
Other Details:
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Languages: eng Pagination: 3214-21 Citation Subset: IM |
Affiliation:
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Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Animals Fluorodeoxyglucose F18 / diagnostic use Lymph Nodes / pathology, radionuclide imaging* Lymphatic Metastasis / pathology, radionuclide imaging* Mesothelioma / pathology, radiography* Positron-Emission Tomography / instrumentation* Predictive Value of Tests ROC Curve Radiopharmaceuticals / diagnostic use Rats Rats, Nude Sensitivity and Specificity Transplantation, Heterologous |
| Chemical | |
Reg. No./Substance:
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0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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