A design of forceps-type coincidence radiation detector for intraoperative LN diagnosis: clinical impact estimated from LNs data of 20 esophageal cancer patients.

Purpose: To reduce postoperative complications, intraoperative lymph node (LN) diagnosis with 18F-fluoro-2-deoxy-D-glucose (FDG) is expected to optimize the extent of LN dissection, leading to less invasive surgery. However, such a diagnostic device has not yet been realized. We proposed the concept...

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Publicado en:Annals of Nuclear Medicine Vol. 36; no. 3; pp. 285 - 293
Autores principales: Takahashi, Miwako, Yoshimura, Shuntaro, Takyu, Sodai, Aikou, Susumu, Okumura, Yasuhiro, Yagi, Koichi, Fukayama, Masashi, Momose, Toshimitsu, Seto, Yasuyuki, Yamaya, Taiga
Formato: Journal Article
Publicado: Springer Nature Mar2022
Acceso en línea:Ver este registro en EBSCOhost
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        09147187
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      jtl: Annals of Nuclear Medicine
      issn: 09147187
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    pubinfo:
      dt: Mar2022
      vid: 36
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      pub: Springer Nature
      place: New York, New York
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        155624926
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        NLM34843102
        10.1007/s12149-021-01701-9
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        155624926
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        atl: A design of forceps-type coincidence radiation detector for intraoperative LN diagnosis: clinical impact estimated from LNs data of 20 esophageal cancer patients.
      aug:
        au:
          Takahashi, Miwako
          Yoshimura, Shuntaro
          Takyu, Sodai
          Aikou, Susumu
          Okumura, Yasuhiro
          Yagi, Koichi
          Fukayama, Masashi
          Momose, Toshimitsu
          Seto, Yasuyuki
          Yamaya, Taiga
        affil: Department of Advanced Nuclear Medicine Sciences, Institute for Quantum Medical Science, National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Inage-ku, 263-8555, Chiba, Japan
      sug:
        subj:
          Fludeoxyglucose F 18
          Esophageal Neoplasms Surgery
          Esophageal Neoplasms
          Lymph Nodes Pathology
          Neoplasm Metastasis
          Neoplasm Staging
          Surgical Instruments
          Impact of Events Scale
          Scales
      ab: Purpose: To reduce postoperative complications, intraoperative lymph node (LN) diagnosis with 18F-fluoro-2-deoxy-D-glucose (FDG) is expected to optimize the extent of LN dissection, leading to less invasive surgery. However, such a diagnostic device has not yet been realized. We proposed the concept of coincidence detection wherein a pair of scintillation crystals formed the head of the forceps. To estimate the clinical impact of this detector, we determined the cut-off value using FDG as a marker for intraoperative LN diagnosis in patients with esophageal cancer, the specifications needed for the detector, and its feasibility using numerical simulation.Methods: We investigated the dataset including pathological diagnosis and radioactivity of 1073 LNs resected from 20 patients who underwent FDG-positron emission tomography followed by surgery for esophageal cancer on the same day. The specifications for the detector were determined assuming that it should measure 100 counts (less than 10% statistical error) or more within the intraoperative measurement time of 30 s. The detector sensitivity was estimated using GEANT4 simulation and the expected diagnostic ability was calculated.Results: The cut-off value was 620 Bq for intraoperative LN diagnosis. The simulation study showed that the detector had a radiation detection sensitivity of 0.96%, which was better than the estimated specification needed for the detector. Among the 1035 non-metastatic LNs, 815 were below the cut-off value.Conclusion: The forceps-type coincidence detector can provide sufficient sensitivity for intraoperative LN diagnosis. Approximately 80% of the prophylactic LN dissections in esophageal cancer can be avoided using this detector.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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